Orlando Elaina, Binnie Alexandra, Tsang Jennifer
Niagara Health Knowledge Institute, Niagara Health, 1200 Fourth Avenue, St. Catharines, ON, L2S 0A9, Canada.
Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada.
Health Res Policy Syst. 2025 Apr 7;23(1):44. doi: 10.1186/s12961-025-01318-8.
Canada's clinical research landscape is limited by minimal community hospital engagement. However, research participation in community hospitals may increase the speed of trial enrolment, enhance the generalizability of results and accelerate knowledge translation to community hospitals, where most Canadians receive care. Two identified barriers to community hospital participation are limited financial support and a lack of research mentorship.
This study is an intrinsic descriptive case study describing the impact of 1 year of research funding from the Canadian Critical Care Trials Group (CCCTG) and creation of a community of practice on research participation in 19 community hospitals. Thematic analysis was used to systematically identify themes from semistructured interviews and documents.
A total of nine individuals (physician research lead, n = 7; research staff, n = 2) participated in semistructured interviews between April and September 2023. Community of practice meeting minutes (n = 7), emails (n = 22), status reports (n = 21) and field notes (n = 7) were analysed alongside interview transcripts. Funding enabled community hospitals to hire research staff, sustain research programs, increase the number of clinical trials they were running and develop research policies. The community of practice facilitated reciprocal learning and networking that positively impacted research programs and produced a tangible output: a toolkit to help community hospitals build clinical research programs. Contextual influences on community hospital research activities were identified as: (1) system characteristics, (2) clinical trial design, (3) local context and (4) individual characteristics.
The perception of participants was that the CCCTG funding and community of practice positively influenced research activities in community hospitals. Lessons learned include the need to: (1) leverage the power of connections among community hospitals to expand linkages, enabling further knowledge transfer, (2) work with trialists on clinical trial design to facilitate implementation and (3) create resources to support community hospitals with building and sustaining research programs, including resources to foster engagement in hospitals without historic research participation. Our findings highlight the importance of context, including local populations, organizational research culture, provincial health systems and research funding structures, which need to be considered during research program implementation.
加拿大的临床研究格局因社区医院参与度极低而受到限制。然而，社区医院参与研究可能会提高试验入组速度，增强结果的普遍性，并加速知识转化到大多数加拿大人接受治疗的社区医院。已确定的社区医院参与的两个障碍是资金支持有限和缺乏研究指导。
本研究是一项内在描述性案例研究，描述了加拿大重症监护试验组（CCCTG）提供的1年研究资金以及创建一个实践社区对19家社区医院研究参与情况的影响。采用主题分析法从半结构化访谈和文件中系统地识别主题。
2023年4月至9月期间，共有9人（医生研究负责人，n = 7；研究人员，n = 2）参与了半结构化访谈。对实践社区会议记录（n = 7）、电子邮件（n = 22）、状态报告（n = 21）和实地记录（n = 7）以及访谈记录进行了分析。资金使社区医院能够雇佣研究人员、维持研究项目、增加正在进行的临床试验数量并制定研究政策。实践社区促进了相互学习和建立联系，对研究项目产生了积极影响，并产生了一个切实的成果：一个帮助社区医院建立临床研究项目的工具包。对社区医院研究活动的背景影响被确定为：（1）系统特征，（2）临床试验设计，（3）当地背景和（4）个人特征。
参与者认为CCCTG的资金和实践社区对社区医院的研究活动产生了积极影响。吸取的经验教训包括需要：（1）利用社区医院之间的联系力量来扩大联系，促进进一步的知识转移，（2）与试验人员合作进行临床试验设计以促进实施，以及（3）创建资源来支持社区医院建立和维持研究项目，包括为促进历史上未参与研究的医院的参与而提供的资源。我们的研究结果强调了背景的重要性，包括当地人群、组织研究文化、省级卫生系统和研究资金结构，在研究项目实施过程中需要考虑这些因素。
