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Recruiting Primary Care Practices for Research: Reflections and Reminders.

Douglas H Fernald1, Bonnie T Jortberg2, Danielle M Hessler2

  • 1From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (DHF, BTJ, RW, LMD, WPD); Department of Family and Community Medicine, University of California-San Francisco, San Francisco, CA (DMH, LF). doug.fernald@ucdenver.edu.

Journal of the American Board of Family Medicine : JABFM
|November 11, 2018
PubMed
Summary

Recruiting primary care practices for research, especially practice transformation trials, requires engaging multiple stakeholders and adapting strategies. Successful recruitment involves sustained communication and flexibility to address turnover and workflow needs.

Keywords:
Ambulatory Care FacilitiesHealth Services ResearchLeadershipPrimary Health CareSelf-ManagementType 2 Diabetes MellitusWorkflow

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Area of Science:

  • Health Services Research
  • Primary Care Medicine
  • Clinical Trial Management

Background:

  • Recruiting primary care practices for research necessitates strong relationships, clear messaging, and opportune timing.
  • Practice transformation research trials demand unique and intensified recruitment efforts.
  • This study reflects on recruiting 36 practices across two states for a diabetes self-management support system trial.

Purpose of the Study:

  • To analyze the challenges and strategies involved in recruiting primary care practices for a practice transformation research trial.
  • To identify key lessons learned from the recruitment process for a diabetes self-management support system trial.

Main Methods:

  • Iterative qualitative analysis of field notes, semistructured interviews with clinicians and staff, and meeting minutes.
  • Data collected from a 2-state, cluster-randomized trial focused on improving diabetes self-management support.
  • Analysis informed by experiences across 36 participating primary care practices.

Main Results:

  • All 36 enrolled practices completed the study, but initial recruitment demanded significant effort.
  • Key lessons include the need for practice-based research networks (PBRNs) to engage diverse stakeholders at multiple levels (clinic, system, roles).
  • Recruitment is a dynamic process requiring adaptability, including communication support, message alignment, workflow integration, sustained leadership engagement, and contingency planning for staff turnover.

Conclusions:

  • PBRN leaders must develop comprehensive strategies for pragmatic clinical trials requiring significant practice change.
  • Engaging a broad range of practice stakeholders, understanding their research priorities, and maintaining consistent communication are crucial.
  • A structured communication strategy is vital for sustained engagement throughout all project phases.