The sustainability of PBRNs and their contribution to community-based and population research

Anna Dania, Zsolt Nagykaldi, Jean Muris, Philip Evans, Ari Haaranen, Pekka Mäntyselkä, Chris Van Weel

Keywords: PBRN, community-based research, population research, learning communities

Background:

The EGPRN research Strategy 2021 set the mission to support research capacity building, foster translations of evidence into practice, and establish networks and collaborations where healthcare stakeholders and policymakers have more vital involvement. Practice-based Research Networks (PBRNs) are the research laboratories of primary care. The global literature shows that they not only focused on improving individual practices through practice-based evidence but also on multi-dimensional implementations of patient-centeredness and community/population health. In the context of a Ph.D. dissertation, an international team of PBRN leaders supported a scoping review on the facilitator and barriers to building PBRNs. The same group now investigates the sustainability of PBRNs, analyzing 56 interviews with PBRN leaders worldwide. The material produced through this research is used as a foundation to develop an initiative with WONCA WPR to support the PBRNs and their international collaboration.

Research questions:

What factors sustain the development, maturity, and continuity of PBRNs?

Method:

We used an interview guide for the 56 semi-structured interviews. We used memos to summarize the content of each interview, and we used inductive thematic analysis to code the quotations into key elements, sub-themes, and themes. The categories that emerged from our previous scoping review subthemes were used for the initial grouping, while new connections that crossed one or more codes were processed using matrix analysis.

Results:

Communication linked to training and learning activities and continuous reform to respond to transformations or challenges in the broader healthcare environment characterize the continuity of PBRNs. The current developments in PBRNs globally are intertwined with patient-centeredness and a broader engagement of community stakeholders, while the most critical sustainability factor is securing infrastructural funding.

Conclusions:

Business models, integration of community and population approaches, impacting policymakers, and alignment with the healthcare environment are at the core of successful PBRNs.

Points for discussion:

- The PBRNs are the research farms of primary care, and their activity must be supported through international advocacy and in-kind contributions from primary care and family medicine organizations. One crucial element is to have a PBRN registry to know “who is who” and where they stand and a virtual community of communication, collaboration, and co-learning. This research study supports the main goals of the WONCA WPR initiative to develop a platform that will sustain the development and activity of PBRNs and includes a registry, a knowledge repository, and a communication platform for PBRNs. What do you think about this idea?

- Europe has been the cradle of PBRNs. This research is attuned to the research strategy of EGPRN. How could EGPRN support the WONCA WPR initiative? What other benefits or contributions the EGPRN would see from this study?

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