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The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
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Are we being equitable enough? Lessons learned from sites lost in an implementation trial.

Elizabeth J Austin1, Jessica Chen1, Lori Ferro2

  • 1Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA.

Implementation Research and Practice
|August 16, 2024
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Summary

Community sites face significant barriers in implementation research, citing staff burden, skill gaps, and lack of clear return on investment. Future trials must adapt to include diverse practice settings equitably.

Keywords:
clinical trialcommunity engagementresearch implementation

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Area of Science:

  • Implementation Science
  • Health Services Research
  • Community-Based Participatory Research

Background:

  • Practice-based implementation research often favors academic settings over community sites.
  • A national trial evaluating Collaborative Care for opioid use and mental health disorders lost three community-based implementation sites.

Purpose of the Study:

  • To identify barriers and needed supports for community site participation in implementation trials.
  • To understand the challenges faced by community sites in research settings.

Main Methods:

  • Conducted exit interviews with key staff (n=5) at the three departed community sites.
  • Analyzed interview transcripts using Rapid Assessment Process and double-coding.
  • Iteratively reviewed qualitative themes with the study team.

Main Results:

  • Key challenges identified: research strains limited staff resources.
  • Staff reported a lack of research-related comfort and skills.
  • Current research participation models offer no clear return on investment for community sites.

Conclusions:

  • Community sites perceive themselves as ill-equipped for traditional clinical trial participation.
  • Implementation trials need to disrupt conventional approaches to ensure equitable inclusion of diverse practice settings.
  • Future research should focus on developing strategies to better support community site engagement.