School of Medicine, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia.
BMC Fam Pract. 2012 Mar 12;13:16. doi: 10.1186/1471-2296-13-16.
There is a continuing need for research capacity building initiatives for primary health care professionals. Historically strategies have focused on interventions aimed at individuals but more recently theoretical frameworks have proposed team-based approaches. Few studies have evaluated these new approaches. This study aims to evaluate a team-based approach to research capacity building (RCB) in primary health using a validated quantitative measure of research capacity in individual, team and organisation domains.
A non-randomised matched-pairs trial design was used to evaluate the impact of a multi-strategy research capacity building intervention. Four intervention teams recruited from one health service district were compared with four control teams from outside the district, matched on service role and approximate size. All were multi-disciplinary allied health teams with a primary health care role. Random-effects mixed models, adjusting for the potential clustering effect of teams, were used to determine the significance of changes in mean scores from pre- to post-intervention. Comparisons of intervention versus control groups were made for each of the three domains: individual, team and organisation. The Individual Domain measures the research skills of the individual, whereas Team and Organisation Domains measure the team/organisation's capacity to support and foster research, including research culture.
In all three domains (individual, team and organisation) there were no occasions where improvements were significantly greater for the control group (comprising the four control teams, n = 32) compared to the intervention group (comprising the four intervention teams, n = 37) either in total domain score or domain item scores. However, the intervention group had a significantly greater improvement in adjusted scores for the Individual Domain total score and for six of the fifteen Individual Domain items, and to a lesser extent with Team and Organisation Domains (two items in the Team and one in the Organisation domains).
A team-based approach to RCB resulted in considerable improvements in research skills held by individuals for the intervention group compared to controls; and some improvements in the team and organisation's capacity to support research. More strategies targeted at team and organisation research-related policies and procedures may have resulted in increased improvements in these domains.
初级卫生保健专业人员需要持续进行研究能力建设计划。从历史上看,策略主要集中在针对个人的干预措施上,但最近的理论框架已经提出了基于团队的方法。很少有研究评估这些新方法。本研究旨在使用个体、团队和组织领域的研究能力的经过验证的定量测量方法,评估初级保健中基于团队的研究能力建设 (RCB) 方法。
采用非随机配对试验设计评估多策略研究能力建设干预措施的影响。从一个卫生服务区招募的四个干预团队与区外的四个对照组进行比较,在服务角色和大致规模上相匹配。所有团队都是具有初级保健作用的多学科联合保健团队。使用随机效应混合模型,调整团队的潜在聚类效应,以确定干预前后平均得分变化的显著性。对三个领域(个体、团队和组织)中的每个领域进行干预组与对照组的比较。个体领域衡量个体的研究技能,而团队和组织领域则衡量团队/组织支持和促进研究的能力,包括研究文化。
在所有三个领域(个体、团队和组织)中,在总领域得分或领域项目得分方面,对照组(由四个对照组组成,n = 32)的改善都没有明显大于干预组(由四个干预组组成,n = 37)。然而,干预组在个体领域总分和十五个个体领域项目中的六个项目的调整得分上有显著改善,在团队和组织领域的改善程度较小(团队领域的两个项目和组织领域的一个项目)。
基于团队的 RCB 方法导致干预组个体的研究技能有了相当大的提高,而对照组则有所提高;团队和组织支持研究的能力也有所提高。针对团队和组织与研究相关的政策和程序的更多策略可能会导致这些领域的进一步改善。