Clinician engagement in research as a path toward the learning health system: A regional survey across the northwestern United States.
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ABSTRACT:
SUBMITTER: Ciemins EL
PROVIDER: S-EPMC10729705 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Publications
Clinician engagement in research as a path toward the learning health system: A regional survey across the northwestern United States.
Ciemins Elizabeth L EL Mollis Brenda L BL Brant Jeannine M JM Hassell Laurie A LA Albritton Sandra S Amoroso Paul P Lloyd Angela A Smith Jodi M JM Pflugeisen Bethann M BM Tuttle Katherine R KR Baldwin Laura-Mae LM
Health services management research 20190818 1
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Project description:ObjectivePatient-centered clinical trial design and execution is becoming increasingly important. No best practice guidelines exist despite a key stakeholder declaration to create more effective engagement models. This study aims to gain a better understanding of attitudes and practices for engaging patient groups so that actionable recommendations may be developed.MethodsIndividuals from industry, academic institutions, and patient groups were identified through Clinical Trials Transformation Initiative and Drug Information Association rosters and mailing lists. Objectives, practices, and perceived barriers related to engaging patient groups in the planning, conduct, and interpretation of clinical trials were reported in an online survey. Descriptive and inferential statistical analysis of survey data followed a literature review to inform survey questions.ResultsSurvey respondents (n = 179) valued the importance of involving patient groups in research; however, patient group respondents valued their contributions to research protocol development, funding acquisition, and interpretation of study results more highly than those contributions were valued by industry and academic respondents (all p < .001). Patient group respondents placed higher value in open communications, clear expectations, and detailed contract execution than did non-patient group respondents (all p < .05). Industry and academic respondents more often cited internal bureaucratic processes and reluctance to share information as engagement barriers than did patient group respondents (all p < .01). Patient groups reported that a lack of transparency and understanding of the benefits of collaboration on the part of industry and academia were greater barriers than did non-patient group respondents (all p< .01).ConclusionsDespite reported similarities among approaches to engagement by the three stakeholder groups, key differences exist in perceived barriers and benefits to partnering with patient groups among the sectors studied. This recognition could inform the development of best practices for patient-centered clinical trial design and execution. Additional research is needed to define and optimize key success factors.
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Project description:Background: Research on stakeholder perspectives of HIV cure research has involved people with HIV (PWH), who generally cite the importance of HIV clinician advice in making decisions about trial participation. However, there has been little exploration of non-researcher community HIV clinician perspectives, which are clearly critical to the success of HIV cure-related research.Objective: We aimed to learn how community HIV clinicians perceive HIV cure research and identify factors that would lead them to support or discourage HIV cure trial participation by their patients.Methods: We recruited a purposive sample of 12 community HIV clinicians in metro-Seattle, WA to participate in structured interviews. We completed 11 interviews via teleconference and received one written response. We used conventional content analysis to analyze the data.Results: Overall, community HIV clinicians were supportive of patient participation in HIV cure trials. Factors affecting support included knowledge of local trials, ease of referral, patient immune function and health stability, study risks and benefits, burden of study requirements, patient characteristics, patient life stability, potential impact on engagement in care, study communication plans, and beliefs that patients should have the autonomy to decide to participate. Participants had concerns about trials requiring treatment delays or interruptions and HIV transmission risk. While their knowledge of the field was limited, they were interested in learning more about open HIV cure trials.Conclusions: It would benefit the HIV cure research community if those leading HIV cure trials make stronger efforts to engage community clinicians who care for PWH, but are not active researchers, early in the trial design process. Such engagement prior to launching HIV cure trials will improve trial designs, leading to better enrollment and retention within these important studies.
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Project description:PurposeThe purpose of this study was to characterize clinician-scientists in ophthalmology and identify factors associated with successful research funding, income, and career satisfaction.DesignCross-sectional study.MethodsA survey was conducted of clinician-scientists in ophthalmology at US academic institutions between April 17, 2019, and May 19, 2019. Collected information including 1) demographic data; 2) amount, type, and source of startup funding; first extramural grant; and first R01-equivalent independent grant; 3) starting and current salaries; and 4) Likert-scale measurements of career satisfaction were analyzed using multivariate regression.ResultsNinety-eight clinician-scientists in ophthalmology were surveyed across different ages (mean: 48 ± 11 years), research categories, institutional types, geographic regions, and academic ranks. Median startup funding ranged from $50-99k, and median starting salaries ranged from $150-199k. A majority of investigators (67%) received their first extramural award from the National Eye Institute, mainly through K-award mechanisms (82%). The median time to receiving their first independent grant was 8 years, mainly through an R01 award (70%). Greater institutional startup support (P = .027) and earlier extramural grant success (P = .022) were associated with earlier independent funding. Male investigators (P = .001) and MD degreed participants (P = .008) were associated with higher current salaries but not starting salaries. Overall career satisfaction increased with career duration (P = .011) but not with earlier independent funding (P = .746) or higher income (P = .300).ConclusionsSuccess in research funding by clinician-scientists in ophthalmology may be linked to institutional support and earlier acquisition of extramural grants but does not impact academic salaries. Nevertheless, career satisfaction among clinician-scientists improves with time, which is not necessarily influenced by research or financial success.
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Project description:Background: Biobanks have become an increasingly important means of biomedical research and innovation. However, they entail a variety of ethical, social and legal challenges, which need to be publicly discussed and managed collectively. A certain level of public awareness of biobank research is an important prerequisite for the public to form an opinion on the issue at hand and to be willing to participate in public engagement activities. For many countries, including Germany, recent information on the public's awareness of and attitude toward biobanks is scarce. Methods: Therefore, by means of a postal survey in a German urban region, this study updates data from the 2010 Eurobarometer by analyzing (1) the public's awareness of biobanks, (2) their general attitude toward biobanks, and (3) their hypothetical willingness to donate their own biological samples and personal or medical data. Results: Overall, 204 (20.4%) of 998 delivered questionnaires were returned. The majority of survey respondents stated a positive attitude toward medical research (95.5%) and - to a somewhat lower degree - toward genetic research (61.3%). Attitudes toward biobanks were mixed but positive for the majority of respondents: in a question about their spontaneous assessment of biobanks as a means for medical research, 77% showed positive attitudes toward biobanks (36.6% "definitely" and 40.5% "somewhat positive"). This finding is also reflected in a high proportion of individuals willing to participate in biobank research: 70.4% of respondents would be willing to donate biomaterial to a biobank during a hypothetical stay in hospital. In spite of the high overall support respondents show for biobanks (e.g., positive general attitude and willingness to participate), only about one third (30.8%) had previously heard of biobanks. Discussion and Conclusion: The comparison of survey results with prior data from the 2010 Eurobarometer indicates that public awareness of biobanks remains low. A higher level of biobank awareness can be assumed to be one prerequisite for public engagement in future decisions on biobank governance. We therefore argue that to increase public awareness of biobanks and to enable public involvement in biobank governance, publicly available and understandable information must be provided and disseminated.
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Project description:A wildlife hospital and rehabilitation center in northwestern United States received several big brown bats with necrosuppurative osteomyelitis in multiple joints. Wing and joint tissues were positive by PCR for poxvirus. Thin-section electron microscopy showed poxvirus particles within A-type inclusions. Phylogenetic comparison supports establishment of a new genus of Poxviridae.
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Project description:BackgroundHealth services research can benefit from frontline clinician input across all stages of research, yet their key perspectives are often not meaningfully engaged.ObjectiveHow can we improve clinician engagement in research?DesignConvenience sampling and semi-structured interviews followed by descriptive content analysis with an inductive approach, followed by group participatory listening sessions with interviewees to further contextualize findings.ParticipantsTwenty-one multidisciplinary clinicians from one healthcare system.Key resultsWe identified two major themes: perceptions of research (how research fits within job role) and characterizing effective engagement (what works and what does not work in frontline clinician engagement). "Perceptions of Research" encompassed three subthemes: prior research experience; desired degree of engagement; and benefits to clinicians engaging in research. "Characterizing Effective Engagement" had these subthemes: engagement barriers; engagement facilitators; and impact of clinician's racial identity.ConclusionsInvesting in frontline clinicians as research collaborators is beneficial to clinicians themselves, the health systems that employ them, and those for which they care. Yet, there are multiple barriers to meaningful engagement.
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Project description:BackgroundThe principle of equity is fundamental to many current debates about social issues and plays an important role in community and individual health. Traditional research has focused on singular dimensions of equity (e.g., wealth), and often lacks a comprehensive perspective. The goal of this study was to assess relationships among three domains of equity, health, wealth, and civic engagement, in a nationally representative sample of U.S. residents.MethodsWe developed a conceptual framework to guide our inquiry of equity across health, wealth, and civic engagement constructs to generate a broad but nuanced understanding of equity. Through Ipsos' KnowledgePanel service, we conducted a cross-sectional, online survey between May 29-June 20, 2020 designed to be representative of the adult U.S.PopulationBased on our conceptual framework, we assessed the population-weighted prevalence of health outcomes and behaviors, as well as measures of wealth and civic engagement. We linked individual-level data with population-level environmental and social context variables. Using structural equation modeling, we developed latent constructs for wealth and civic engagement, to assess associations with a measured health variable.ResultsWe found that the distribution of sociodemographic, health, and wealth measures in our sample (n = 1267) were comparable to those from other national surveys. Our quantitative illustration of the relationships among the domains of health, wealth, and civic engagement provided support for the interrelationships of constructs within our conceptual model. Latent constructs for wealth and civic engagement were significantly correlated (p = 0.013), and both constructs were used to predict self-reported health. Beta coefficients for all indicators of health, wealth, and civic engagement had the expected direction (positive or negative associations).ConclusionThrough development and assessment of our comprehensive equity framework, we found significant associations among key equity domains. Our conceptual framework and results can serve as a guide for future equity research, encouraging a more thorough assessment of equity.
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Project description:The heterogeneous nucleation of ice processes involving loess particles that influences the formation of mixed-phase clouds are poorly understood. Here, the ice nucleating ability of wind-blown dust or loess accumulated from the past glaciated area was investigated at three temperatures: -26, -30, and -34 °C and at below and above saturation with respect to liquid water conditions. Total six loess samples from different regions across Columbia Basin province, WA, USA were collected, dry dispersed, size-selected at mobility diameter 200 nm, and investigated for their ice nucleation efficiency. To understand the effect of atmospheric processing during long-range transport on their ice nucleating ability, similar experiments were also performed on acid-treated loess samples. Additionally, the ice nucleating properties of Arizona Test Dust (ATD) were investigated as a surrogate for natural mineral dust particles to test the experimental approach. Results show that treated particles have lower ice nucleation efficiency compared to untreated particles at all temperature and saturation with respect to liquid water conditions. Comparison based on ice-active site density (Ns) metric indicate that loess particles at saturation with respect to liquid water conditions are marginally more efficient than the mineral and soil dust values reported in the literature, but they have lower efficiencies than the predicted Ns efficiency of K-feldspar particles at supercooled temperatures greater than -38 °C.
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Project description:Mobile health and mobile rehabilitation (mHealth and mRehab) services and technologies have attracted considerable interest from healthcare providers, technology vendors, rehabilitation engineers, investors and policy makers in recent years. Successful adoption and use of mHealth/mRehab requires clinician support and engagement, including the ability to identify appropriate use cases and possible barriers to use for themselves and their patients, and acquire adequate knowledge and confidence using mHealth/mRehab interventions. This article reports results from a survey of rehabilitation clinicians in the United States on their attitudes, experience, expectations and concerns regarding mHealth/mRehab interventions and technologies. Over 500 clinicians in physical, occupational, speech, recreation and psychological therapy professions, among others, participated in the survey. Respondents reported that an overwhelming majority of their patients need additional therapy after discharge from inpatient environments, and over half of outpatients need additional therapy between visits. A large majority reported prescribing specific exercises and interventions for patients to work on outside of the clinic. However, only 51% reported being comfortable integrating mRehab technology into their practice; and only 23% feel knowledgeable about rehabilitation technology currently available. Technologies to support mRehab are maturing rapidly. Clinicians recognize the need for mRehab, but their knowledge and confidence prescribing mRehab represents a significant barrier to adoption.
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