Manojlovich Milisa, Bedard Louise, Griggs Jennifer J, McBratnie Michaella, Mendelsohn-Victor Kari, Friese Christopher R
School of Nursing, University of Michigan, Ann Arbor, MI, United States.
Michigan Oncology Quality Consortium, Ann Arbor, MI, United States.
JMIR Cancer. 2020 Apr 20;6(1):e14476. doi: 10.2196/14476.
Practice-based research is essential to generate the data necessary to understand outcomes in ambulatory oncology care. Although there is an increased interest in studying ambulatory oncology care, given the rising patient volumes and complexity in those settings, little guidance is available on how best to recruit ambulatory oncology practices for research.
This paper aimed to describe the facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study.
Using a mixed methods design, we sought to recruit 52 ambulatory oncology practices that have participated in a state-wide quality improvement collaborative for the quantitative phase. We used 4 domains of the Consolidated Framework for Implementation Research (CFIR) to describe facilitators and barriers to recruitment.
We successfully recruited 28 of the 52 collaborative-affiliated practices, collecting survey data from 2223 patients and 297 clinicians. Intervention attributes included multimodal outreach and training activities to assure high fidelity to the data collection protocol. The implementation process was enhanced through interactive training and practice-assigned champions responsible for data collection. External context attributes that facilitated practice recruitment included partnership with a quality improvement collaborative and the inclusion of a staff member from the collaborative in our team. Key opinion leaders within each practice who could identify challenges to participation and propose flexible solutions represented internal context attributes. We also reported lessons learned during the recruitment process, which included navigating diverse approaches to human subjects protection policies and understanding that recruitment could be a negotiated process that took longer than anticipated, among others.
Our experience provides other researchers with challenges to anticipate and possible solutions for common issues. Using the CFIR as a guide, we identified numerous recruitment barriers and facilitators and devised strategies to enhance recruitment efforts. In conclusion, researchers and clinicians can partner effectively to design and implement research protocols that ultimately benefit patients who are increasingly seeking care in ambulatory practices.
基于实践的研究对于生成理解门诊肿瘤护理结果所需的数据至关重要。尽管对研究门诊肿瘤护理的兴趣日益增加，但鉴于这些环境中患者数量的上升和复杂性，关于如何最好地招募门诊肿瘤护理机构参与研究的指导却很少。
本文旨在描述在一项大型多中心研究中招募门诊肿瘤护理机构的促进因素和障碍。
采用混合方法设计，我们试图招募52家参与全州质量改进协作项目的门诊肿瘤护理机构参与定量阶段研究。我们使用实施研究综合框架（CFIR）的4个领域来描述招募的促进因素和障碍。
我们成功招募了52家协作附属机构中的28家，收集了来自2223名患者和297名临床医生的调查数据。干预属性包括多模式外展和培训活动，以确保高度符合数据收集协议。通过互动培训和指定负责数据收集的实践倡导者，实施过程得到了加强。促进实践招募的外部环境属性包括与质量改进协作项目的合作以及在我们团队中纳入协作项目的一名工作人员。每个实践机构中能够识别参与挑战并提出灵活解决方案的关键意见领袖代表了内部环境属性。我们还报告了在招募过程中吸取的经验教训，其中包括应对人类受试者保护政策的不同方法，以及认识到招募可能是一个比预期更长的协商过程等。
我们的经验为其他研究人员提供了需要预见的挑战和常见问题的可能解决方案。以CFIR为指导，我们识别了众多招募障碍和促进因素，并设计了加强招募工作的策略。总之，研究人员和临床医生可以有效合作，设计和实施最终使越来越多地在门诊实践中寻求护理的患者受益的研究方案。
