Program Summary

A practice-based research network (PBRN) is a group of ambulatory practices devoted principally to the primary care of patients and affiliated in their mission to investigate questions related to community-based practice and to improve the quality of primary care. PBRNs draw on the experience and insight of practicing clinicians to identify and frame research questions whose answers can improve the practice of primary care. By linking these questions with rigorous methods, PBRNs produce research and quality improvement findings that are relevant to clinicians and readily translated into everyday practice.

The Certificate Program in Practice-Based Research Methods seeks to develop a new generation of independent investigators within the PBRN community.  The program will provide training in concepts, skills, and methods for conducting practice-based research and building PBRNs.

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PBRM Webinar Sessions

Session 1: Introduction and Theory of Practice-Based Research Networks (PBRNs)
Session 2: Program orientation for Fellows & Primary Mentors
Session 3: PBRN development and maintenance: Use of practice facilitators
Session 4: Recruitment and engagement of clinicians, practices, patients, & healthcare systems
Session 5: Participatory Research in PBRNs Patient Centered Outcomes Research
Session 6: Research Using Electronic Health Records & Big Data
Session 7: Quality improvement Research; Alliances and methods for practice improvement

 

Session 8: Research Designs, Sampling Methods and Nested Analyses
Session 9: Obtaining Funding for PBRN Research
Session 10: Comparing and contrasting U.S. and Canadian healthcare systems and research infrastructures
Session 11: Translational research in PBRNs – Linking research to policy
Session 12: Qualitative methods and multimethod research methods in PBRN research
Session 13: Writing PBRN research for publication – Methods of research dissemination
Session 14: Methods for implementation of complex interventions in PBRNs

Session 1: Introduction and Theory of Practice-Based Research Networks (PBRNs)

Presenter: Kurt Stange, MD, PhD, Professor of Family Medicine & Community Health, Epidemiology & Biostatistics, Oncology and Sociology, Case Western Reserve University, Collaborative Ohio Inquiry Network (COIN)
• Required readings (PDFs)
  1. Green LA, Fryer Jr GE, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med. 2001 Oct 18;2001(345):1211-2. PMID: 11430334
  2. Green LA. The weekly return as a practical instrument for data collection in office based research. Family medicine. 1988;20(3):182-4. PMID: 3417065
  3. Nutting PA, Beasley JW, Werner JJ. Practice-based research networks answer primary care questions. JAMA. 1999 Feb 24;281(8):686-8. PMID: 10052423
  4. Thomas P. The research needs of primary care: trials must be relevant to patients. BMJ: British Medical Journal. 2000 Jul 1;321(7252):2. PMC1127682
  5. Werner JJ, Stange KC. Praxis-based research networks: an emerging paradigm for research that is rigorous, relevant, and inclusive. The Journal of the American Board of Family Medicine. 2014 Nov 1;27(6):730-5. PMID: 25381067 

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Session 2: Program Orientation for Fellows & Primary Mentors

Presenter:
Jim Werner, PhD, Associate Professor, Department of Family Medicine & Community Health, Case Western Reserve University, Collaborative Ohio Inquiry Network (COIN);
LJ Fagnan, MD, Professor, Department of Family Medicine, Oregon Health & Science University, Meta-network Learning and Research Center (Meta-LARC)

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Session 3: PBRN Development and Maintenance: Use of Practice Facilitators

Presenters:
Zsolt Nagykaldi, PhD, Associate Professor, Department of Family & Preventive Medicine, University of Oklahoma, Coordinated Consortium of Networks (CoCoNet2)

Required readings (PDF)

  1. Nagykaldi Z, Mold JW, Aspy CB. Practice facilitators: a review of the literature. FAMILY MEDICINE-KANSAS CITY-. 2005 Sep 1;37(8):581. PMID: 16145629
  2. Green LA, Hickner J. A short history of primary care practice-based research networks: from concept to essential research laboratories. The Journal of the American Board of Family Medicine. 2006 Jan 1;19(1):1-0. PMID: 16491999
  3. Hickner J, Green LA. Practice-based research networks (PBRNs) in the United States: growing and still going after all these years. The Journal of the American Board of Family Medicine. 2015 Sep 1;28(5):541-5. PMID: 26355124 
  4. Baskerville NB, Liddy C, Hogg W. Systematic review and meta-analysis of practice facilitation within primary care settings. The Annals of Family Medicine. 2012 Jan 1;10(1):63-74. PMID: 22230833
  5. Nagykaldi Z. Practice-based research networks at the crossroads of research translation. PMID: 25381066 

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Session 4: Recruitment and Engagement of Clinicians, Practices, Patients, & Healthcare Systems 

Presenters:
LJ Fagnan, MD, Professor, Department of Family Medicine, Oregon Health & Science University, Meta-network Learning and Research Center (Meta-LARC)
Melinda Davis, PhD, Research Assistant Professor, Department of Family Medicine, Oregon Health & Science University, Meta-network Learning and Research Center (Meta-LARC)

• Required readings (PDFs)

  1. Carey TS, Halladay JR, Donahue KE, Cykert S. Practice-based research networks (PBRNs) in the era of integrated delivery systems. The Journal of the American Board of Family Medicine. 2015 Sep 1;28(5):658-62. PMID: 26355138 
  2. Westfall JM, Mold J, Fagnan L. Practice-based research—“Blue Highways” on the NIH roadmap. Jama. 2007 Jan 24;297(4):403-6. PMID: 17244837 

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Session 5: Participatory Research in PBRNs Patient Centered Outcomes Research  

Presenters:
Lyndee Knox, PhD, Assistant Professor, Department of Family Medicine, University of Southern California, Coordinated Consortium of Networks (CoCoNet2), PRIME Net Center in Practice-based Research and Learning
Don Nease, MD, Associate Clinical Professor, Department of Family Medicine, University of Colorado, PRIME Net Center in Practice-based Research and Learning, Meta-network Learning and Research Center (Meta-LARC)
• Required readings (PDFs)
  1. Macaulay AC, Commanda LE, Freeman WL, Gibson N, McCabe ML, Robbins CM, Twohig PL. Participatory research maximises community and lay involvement. BMJ: British Medical Journal. 1999 Sep 18;319(7212):774. PMID: 10488012 
  2. Westfall J, Stevenson J. A guided tour of community-based participatory research: an annotated bibliography. The Annals of Family Medicine. 2007 Mar 1;5(2):185-6. PMID: 17389549 
  3. Macaulay AC, Nutting PA. Moving the frontiers forward: incorporating community-based participatory research into practice-based research networks. The Annals of Family Medicine. 2006 Jan 1;4(1):4-7. PMID: 16449390 
  4. Westfall JM, Fagnan LJ, Handley M, Salsberg J, McGinnis P, Zittleman LK, Macaulay AC. Practice-based research is community engagement. The Journal of the American Board of Family Medicine. 2009 Jul 1;22(4):423-7. PMID: 19587257
  5. Allison C, Zittleman L, Ringel M, Felzien M, Bennett C, Cowart S, Flores M, Flores R, Hernandez M, Norman N, Rodriquez M. Translating the medical home into patient-centred language. London journal of primary care. 2014 Jan 1;6(6):124-30. Click Here!

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Session 6: Research Using Electronic Health Records & Big Data  

Presenters:
Laura-Mae Baldwin, MD, Professor, Department of Family Medicine, University of Washington, MOSAIC: Meaningful Outcomes and Science to Advance Innovations Center of Excellence
Alex Fiks, MD, MSCE, Associate Professor, Department of Pediatrics, Associate Director, Pediatric Research in Office Settings (PROS), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
Alex Krist, MD, MPH, Associate Professor, Department of Family Medicine and Community Health, Virginia Commonwealth University, Co-director, Ambulatory Care Outcomes Research Network

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Session 7: Quality improvement Research; Alliances and Methods for Practice Improvement

Presenters:
Chet Fox, MD, Professor, Department of Family Medicine, University at Buffalo, The State University of New York, MOSAIC: Meaningful Outcomes and Science to Advance Innovations Center of Excellence
Mary Dolansky, PhD, RN, Associate Professor School of Nursing, Case Western Reserve University, Cleveland, OH

• Required readings (PDFs)

  1. Ogrinc G, Nelson WA, Adams SM, O’Hara AE. An instrument to differentiate between clinical research and quality improvement. IRB. 2013 Sep 1;35(5):1-8. PMID: 24350502
  2. Self WH, Mickanin J, Grijalva CG, Grant FH, Henderson MC, Corley G, Blaschke II, Glen D, McNaughton CD, Barrett TW, Talbot TR. Reducing blood culture contamination in community hospital emergency departments: a multicenter evaluation of a quality improvement intervention. Academic Emergency Medicine. 2014 Mar 1;21(3):274-82. PMID: 24628752 
  3. Balasubramanian BA, Cohen DJ, Davis MM, Gunn R, Dickinson LM, Miller WL, Crabtree BF, Stange KC. Learning evaluation: blending quality improvement and implementation research methods to study healthcare innovations. Implementation Science. 2015 Mar 10;10(1):31. PMID: 25889831

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Session 8: Research Designs, Sampling Methods and Nested Analyses

Presenters:
Miriam Dickinson, PhD, Professor, Department of Family Medicine, University of Colorado, PRIME Net Center in Practice-based Research and Learning
Don Nease, MD, Associate Clinical Professor, Department of Family Medicine, University of Colorado, PRIME Net Center in Practice-based Research and Learning, Meta-network Learning and Research Center (Meta-LARC)

• Required readings (PDFs)

  1. Hussey MA, Hughes JP. Design and analysis of stepped wedge cluster randomized trials. Contemporary clinical trials. 2007 Feb 28;28(2):182-91. PMID: 16829207
  2. Dickinson LM, Dickinson WP, Nutting PA, Fisher L, Harbrecht M, Crabtree BF, Glasgow RE, West DR. Practice context affects efforts to improve diabetes care for primary care patients: a pragmatic cluster randomized trial. Journal of general internal medicine. 2015 Apr 1;30(4):476-82. PMID: 25472509
  3. Dickinson WP, Dickinson LM, Nutting PA, Emsermann CB, Tutt B, Crabtree BF, Fisher L, Harbrecht M, Gottsman A, West DR. Practice facilitation to improve diabetes care in primary care: a report from the EPIC randomized clinical trial. The Annals of Family Medicine. 2014 Jan 1;12(1):8-16. PMID: 24445098 
  4. Brown CA, Lilford RJ. The stepped wedge trial design: a systematic review. BMC medical research methodology. 2006 Nov 8;6(1):54. o PMID: 17092344
  5. Dickinson LM, Beaty B, Fox C, Pace W, Dickinson WP, Emsermann C, Kempe A. Pragmatic cluster randomized trials using covariate constrained randomization: A method for practice-based research networks (PBRNs). The Journal of the American Board of Family Medicine. 2015 Sep 1;28(5):663-72. PMID: 26355139 
  6. Singer JD. Using SAS PROC MIXED to fit multilevel models, hierarchical models, and individual growth models. Journal of educational and behavioral statistics. 1998 Dec;23(4):323-55. Click Here!
  7. Dickinson LM, Basu A. Multilevel modeling and practice-based research. The Annals of Family Medicine. 2005 May 1;3(suppl 1):S52-60. PMID: 15928220

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Session 9: Obtaining Funding for PBRN Research

Presenters:
Rowena Dolor, MD, Associate Professor, Department of Medicine, Duke University, Meta-network Learning and Research Center (Meta-LARC)
Rebecca Roper, MS, MPH, Director, Practice-Based Research Network Initiative, Project Officer, Health IT-enabled Quality Measures, Agency for Healthcare Research and Quality, Rockville, MD
Sabrina Wong, RN, PhD Professor, UBC School of Nursing and Centre for Health Services and Policy Research, Co-Director of the BC Primary Care Sentinel Surveillance Network

• Required reading

  1. Westfall JM, Mold J, Fagnan L. Practice-based research–“Blue Highways” on the NIH roadmap. JAMA. 2007 Jan 24;297(4):403-6. PMID: 17244837

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Session 10: Comparing and Contrasting U.S. and Canadian Healthcare Systems and Research Infrastructures

Presenter:
LJ Fagnan, MD, Professor, Department of Family Medicine, Oregon Health & Science University, Meta-network Learning and Research Center (Meta-LARC),
France Légaré, MD, PhD, Director, QPBRN, Full, Professor, Family Medicine, Tier1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Québec City, QC

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Session 11: Translational Research in PBRNs – Linking Research to Policy

Presenters:
Jonathan N. Tobin, PhD, President/CEO, Clinical Directors Network (CDN) & N2 Network of Safety Net PBRNs; Co-Director, Community Engaged Research Core, The Rockefeller University Center for Clinical and Translational Science; Professor, Department of Epidemiology & Population Health, Albert Einstein College of Medicine/Montefiore Medical Center

Steven Woolf, MD, MPH, Professor, Department of Family Medicine and Population Health, Director, VCU Center on Society and Health, Virginia Commonwealth University, Richmond, VA

Required Readings:
1. Translational: 
  1. Hoffman,T. C., Glasziou. P.P., Boutron, I., Milne, R., Perera, R., Moher, D., Altman, D.G., Barbour, V., Macdonald, H., Johnston, M., Lamb, S.E., Dixon-Woods, M., McCulloch, P., Wyatt, J.C., Chan, A.W., Michie, S., “Better reporting on interventions: template for intervention description and replication (TIDieR) checklist and guide” BMJ 348:g1687, 2014. PMID: 24609605
  2. Westfall, J.M., Mold, J., Fagnan, L., “Practice-based research—“Blue Highways” on the NIH roadmap” JAMA 297(4): 403-6, 2007. PMID: 17244837
  3. Proctor, E.K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., Mittman, B., “Implementation Research in Mental Health Services: An Emerging Science with Conceptual, Methodological, and Training Challenges” Administration and Policy in Mental Health 36(1):24-34, 2009. PMID: 19104929
2.  Case Study (Cancer Screening):
  1. Dietrich, A.J., Tobin, J.N., Hill-Sox, C., Cassells, A., Negron, F., Younge, R.Y., Demby, N.A., Tosteson, T.D., “Cancer-Early Detection Services in Community Health Centers for the Underserved: A Randomized Trial.” Archives of Family Medicine, 7: 320-327, 1998. PMID: 9682685
  2. Ogedegbe, G., Cassells, A., Robinson, C.M., DuHamel, K., Tobin, J.N., Sox, C.H., Dietrich, A.J., “Perceptions of Barriers and Facilitators of Cancer Early Detection among Low-Income Minority Women in Community Health Centers.” Journal of the National Medical Association, 97(2): 162-170, 2005. PMID: 15712779
  3. Dietrich, A.J., Tobin, J.N., Cassells, A., Robinson, C.M., Greene, M.A., Sox, C.H., Beach, M.L., DuHamel, K., Younge, R.,“Telephone care management to improve cancer screening among low- income women: a randomized controlled trial” Annals of Internal Medicine, 144:563-571, 2006. PMID: 16618953
  4. Dietrich, A.J., Tobin, J.N., Cassells, A., Robinson, C.M., Reh, M., Romero, K.A., Flood, A.B., Beach, M.L., “Translation of an Efficacious Cancer Screening Intervention to a Medicaid Managed Care Organization” Annals of Family Medicine, 5(4): 320-327, 2007. PMID: 17664498
  5. Tobin, J.N., Cassells, A., Robinson, C.M., Dietrich, A., “Translating a Cancer Screening Intervention to Women in a Medicaid Managed Care Organization” Presented at the National
  6. Cassells, A., Tobin, J.N., Lin, T.J., Dietrich, A.J., Robinson, C.M. Greene, M.A., “Barriers and Facilitators to Colorectal Cancer Screening Among Publicly Insured Low-Income Women” Presented at A Dialogue for Action on Colorectal Cancer Screening, Baltimore, MD March 24-26, PMC4083754

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Session 12: Qualitative Methods and Multimethod Research Methods in PBRN Research

Presenter:

Nancy Elder, MD, MPH, Professor, Department of Family and Community Medicine, University of Cincinnati College of Medicine, Collaborative Ohio Inquiry Network (COIN)

• Required reading (PDF)

  1. Miller WL. A multimethod typology and qualitative roadmap. Doing Qualitative Research. Edited by: Crabtree B, Miller WL. 1999. Click Here!

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Session 13: Writing PBRN Research for Publication – Methods of Research Dissemination

Presenters:
Victoria Neale, PhD, MPH, Professor, Department of Family Medicine and Public Health Sciences, Wayne State University, PRIME Net Center in Practice-based Research and Learning
Juliann Binienda, PhD, Associate Professor, Wayne State University, Department of Family Medicine and Public Health Sciences

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Session 14: Methods for Implementation of Complex Interventions in PBRNs

Presenter:

Rodger Kessler, PhD, ABPP, Research Associate Professor, Department of Family Medicine University of Vermont, Burlington, VT

Connie Van Eeghen, DrPH, MHSA, MBA, Assistant Professor, Department of General Medicine, University of Vermont College of Medicine

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Supplemental Readings

Session 1:

  1. Task Force to Enhance Family Practice Research. Practice-Based Research Networks in the 21st Century: The Pearls of Research. Leawood, Kansas: American Academy of Family Physicians; 1999. Click Here!
  2. Nutting PA, Stange KC. Practice-based research: the opportunity to create a learning discipline. The textbook of family practice. New York: WB Saunders. 2000.
  3. Nutting PA, Green LA. Practice-based research networks: reuniting practice and research around the problems most of the people have most of the time. Journal of family practice. 1994 Apr 1;38(4):335-7. PMID: 8163956
  4. Nutting PA. Practice-based research networks: building the infrastructure of primary care research. Journal of Family Practice. 1996 Feb 1;42(2):199-204. PMID: 8606312
  5. While PT. Increasing research capacity and changing the culture of primary care towards reflective inquiring practice: the experience of the West London Research Network (WeLReN). Journal of Interprofessional Care. 2001 Jan 1;15(2):133-9.  PMID: 11705009
  6. Green LA, Dovey SM. Practice based primary care research networks: they work and are ready for full development and support. BMJ: British Medical Journal. 2001 Mar 10;322(7286):567. PMID: 11238139
  7. Stange KC, Miller WL, McWhinney I. Developing the knowledge base of family practice. Family medicine. 2001 Apr;33(4):286-97. PMID: 11322522
  8. Wolf LE, Croughan M, Lo B. The challenges of IRB review and human subjects protections in practice-based research. Medical care. 2002 Jun 1;40(6):521-9. PMID: 12021678
  9. Hickner JO. Practice-based network research. Conducting research in the practice setting. Newbury Park (CA): Sage Publications. 1993:126-39.
  10. Macaulay AC, Commanda LE, Freeman WL, Gibson N, McCabe ML, Robbins CM, Twohig PL. Participatory research maximises community and lay involvement. BMJ: British Medical Journal. 1999 Sep 18;319(7212):774. PMID: 10488012

Session 3: 

  1. Nutting PA, Baier M, Werner JJ, Cutter G, Reed FM, Orzano AJ. Practice patterns of family physicians in practice-based research networks: a report from ASPN. The Journal of the American Board of Family Practice. 1999 Jul 1;12(4):278-84. PMID: 10477192
  2. Green LA, Miller RS, Reed FM, Iverson DC, Barley GE. How representative of typical practice are practice-based research networks? A report from the Ambulatory Sentinel Practice Network Inc (ASPN). Archives of Family Medicine. 1993 Sep 1;2(9):939. PMID: 8111525
  3. Green LA, Niebauer LJ, Miller RS, Lutz LJ. An analysis of reasons for discontinuing participation in a practice-based research network. Family medicine. 1991 Aug;23(6):447-9. PMID: 1936720
  4. Stange KC. Practice-based research networks: their current level of validity, generalizability, and potential for wider application. Archives of family medicine. 1993 Sep 1;2(9):921. PMID: 8111523
  5. Niebauer L, Nutting PA. Practice-based research networks: the view from the office. Journal of family practice. 1994 Apr 1;38(4):409-15. PMID: 8163967
  6. Gilchrist V, Miller RS, Gillanders WR, Scheid DC, Logue EE, Iverson DC, Oprandi AM, Weldy DL, Krell MA. Does family practice at residency teaching sites reflect community practice?. Journal of family practice. 1993 Dec 1;37(6):555-64. PMID: 8245806
  7. Christoffel KK, Binns HJ, Stockman JA, McGuire P, Poncher J, Unti S, Typlin B, Lasin G, Seigel W. Practice-based research: opportunities and obstacles. Pediatrics. 1988 Sep 1;82(3):399-406. PMID: 3405674
  8. Wotman S, Lalumandier J, Nelson S, Stange K. Implications for dental education of a dental school-initiated practice research network. Journal of dental education. 2001 Aug 1;65(8):751-9. PMID: 11518246
  9. Nagykaldi Z, Mold JW, Robinson A, Niebauer L, Ford A. Practice facilitators and practice-based research networks. The Journal of the American Board of Family Medicine. 2006 Sep 1;19(5):506-10. PMID: 16951300
  10. Liddy C, Laferriere D, Baskerville B, Dahrouge S, Knox L, Hogg W. An overview of practice facilitation programs in Canada: current perspectives and future directions. Healthcare Policy. 2013 Feb;8(3):58. PMID: 23968627
  11. Liddy CE, Blazhko V, Dingwall M, Singh J, Hogg WE. Primary care quality improvement from a practice facilitator’s perspective. BMC family practice. 2014 Feb 3;15(1):23. PMID: 24490746

Session 4: 

  1. Fagnan LJ, Handley MA, Rollins N, Mold J. Voices from left of the dial: reflections of practice-based researchers. The Journal of the American Board of Family Medicine. 2010 Jul 1;23(4):442-51. PMID: 20616286 
  2. Davis MM, Keller S, DeVoe JE, Cohen DJ. Characteristics and lessons learned from practice-based research networks (PBRNs) in the United States. Journal of healthcare leadership. 2012 Sep;4:107. PMID: 26213481

Session 7: 

  1. Berwick DM. The science of improvement. Jama. 2008 Mar 12;299(10):1182-4. PMID: 18334694
  2. Lynn J, Baily MA, Bottrell M, Jennings B, Levine RJ, Davidoff F, Casarett D, Corrigan J, Fox E, Wynia MK, Agich GJ. The Ethics of Using Quality Improvement Methods in Health CareThe Ethics of Using Quality Improvement Methods in Health Care. Annals of internal medicine. 2007 May 1;146(9):666-73. PMID: 17438310