From the Department of Family Medicine, Oregon Health & Science University, Portland, OR (JED, SLA, HEA, NH, DJC, SAF, MM); OCHIN, Inc., Portland, OR (JED, RG); Kaiser Permanente Northwest Center for Health Research, Portland, OR (RG).
J Am Board Fam Med. 2020 Sep-Oct;33(5):774-778. doi: 10.3122/jabfm.2020.05.200053.
Primary care practice-based research networks (PBRNs) are critical laboratories for generating evidence from real-world settings, including studying natural experiments. Primary care's response to the novel coronavirus-19 (COVID-19) pandemic is arguably the most impactful natural experiment in our lifetime. EVALUATING THE IMPACT OF COVID-19: We briefly describe the OCHIN PBRN of community health centers (CHCs), its partnership with implementation scientists, and how we are leveraging this infrastructure and expertise to create a rapid research response evaluating how CHCs across the country responded to the COVID-19 pandemic. COVID-19 RESEARCH ROADMAP: Our research agenda focuses on asking: How has care delivery in CHCs changed due to COVID-19? What impact has COVID-19 had on the delivery of preventive services in CHCs? Which PBRN services (e.g., data surveillance, training, evidence synthesis) are most impactful to real-world practices? What decision-making strategies were used in the PBRN and its practices to make real-time changes in response to the pandemic? What critical factors in successfully and sustainably transforming primary care are illuminated by pandemic-driven changes?
PBRNs enable real-world evaluation of practice change and natural experiments, and thus are ideal laboratories for implementation science research. We present a real-time example of how a PBRN Implementation Laboratory activated a response to study a historic natural experiment, to help other PBRNs charting a course through this pandemic.
初级保健实践为基础的研究网络(PBRNs)是从现实环境中产生证据的关键实验室,包括研究自然实验。初级保健对新型冠状病毒-19(COVID-19)大流行的反应可以说是我们一生中最具影响力的自然实验。评估 COVID-19 的影响:我们简要描述了 OCHIN 社区卫生中心(CHC)的 PBRN,及其与实施科学家的合作关系,以及我们如何利用这一基础设施和专业知识,创建一个快速研究反应,评估全国各地的 CHC 如何应对 COVID-19 大流行。COVID-19 研究路线图:我们的研究议程侧重于以下问题:由于 COVID-19,CHC 的护理提供方式发生了哪些变化?COVID-19 对 CHC 提供预防服务的影响如何?PBRN 服务(例如,数据监测、培训、证据综合)对现实实践最有影响?PBRN 及其实践中使用了哪些决策策略来实时应对大流行做出改变?大流行驱动的变化揭示了成功和可持续地改变初级保健的哪些关键因素?讨论和结论:PBRNs 能够对实践变革和自然实验进行真实世界的评估,因此是实施科学研究的理想实验室。我们提出了一个实时的例子,说明一个 PBRN 实施实验室如何激活对研究历史性自然实验的反应,以帮助其他 PBRNs 在这场大流行中规划路线。