10967319
A thematic analysis of the role of the organisation in building allied health research capacity: a senior managers’ perspective
BackgroundEvidence-based practice aims to achieve better health outcomes in the community. It relies on high quality research to inform policy and practice; however research in primary health care continues to lag behind that of other medical professions. The literature suggests that research capacity building (RCB) functions across four levels; individual, team, organisation and external environment. Many RCB interventions are aimed at an individual or team level, yet evidence indicates that many barriers to RCB occur at an organisational or external environment level. This study asks senior managers from a large healthcare organisation to identify the barriers and enablers to RCB. The paper then describes strategies for building allied health (AH) research capacity at an organisational level from a senior managers’ perspective.MethodsThis qualitative study is part of a larger collaborative RCB project. Semi-structured in-depth interviews were conducted with nine allied health senior managers. Recorded interviews were transcribed and NVivo was used to analyse findings and emergent themes were defined.ResultsThe dominant themes indicate that the organisation plays an integral role in building AH research capacity and is the critical link in creating synergy across the four levels of RCB. The organisation can achieve this by incorporating research into its core business with a whole of organisation approach including its mission, vision and strategic planning. Critical success factors include: developing a co-ordinated and multidisciplinary approach to attain critical mass of research-active AH and enhance learning and development; support from senior managers demonstrated through structures, processes and systems designed to facilitate research; forming partnerships to increase collaboration and sharing of resources and knowledge; and establishing in internal framework to promote recognition for research and career path opportunities.ConclusionsThis study identifies four key themes: whole of organisation approach; structures, processes and systems; partnerships and collaboration; and dedicated research centres, units and positions. These themes form the foundation of a model which can be applied to assist in achieving synergy across the four levels of RCB, overcome barriers and create an environment that supports and facilitates research development in AH.
44816518
Building applied health research capacity in less-developed countries: problems encountered by the ADDR Project.
As governments and other donors renew their support for research scientists in less developed countries, it becomes important to consider new questions about the process of funding scientific research and scientific researchers. This paper argues that research capacity building is a development goal subject to structural constraints and cultural impediments among both donors and recipients. Using data from one specific research capacity building program, the Applied Diarrheal Disease Research Project (ADDR), we describe a set of constraints among donors, recipient institutions, and individual recipients of research grants. We then describe how ADDR supports its investigators, how it has responded to the identified constraints, and what obstacles it still faces. Research capacity building programs in health would be well-served by focusing more attention on research problem identification, and dissemination and application of research findings.
22332515
Closing the gap and widening the scope. New directions for research capacity building in primary health care.
BACKGROUND
Research capacity building initiatives abound within primary health care to increase the research base of the many component health professionals and organisations. Most initiatives aim to close the gaps between research, policy and practice. Many of these approaches have been unable to build the necessary skills among primary health care researchers to fully integrate research evidence into clinical practice, and ultimately to inform policy in this complex arena.


OBJECTIVE
To propose a paradigm shift in the content of capacity building as a step toward closing the gaps between research, policy and practice.


DISCUSSION
The complexity of the primary health care environment and the concept of development as a means to understanding and operating within primary health care research, policy and practice environments is discussed. A small pilot study was used to identify the underlying skills required in research, evaluation and development. In order to facilitate the paradigm shift an organisational development model was utilised that demonstrated congruency with this skill set. Further research is required to validate and apply this model in a primary health care research capacity building context.
12369620
Four approaches to capacity building in health: consequences for measurement and accountability
SUMMARY The term capacity building has been used in respect of a wide range of strategies and processes which have the ultimate aim of improved health practices which are sustainable. After defining capacity building, this paper explores the processes and strategies associated with four distinct approaches to capacity building, considers the role of funding bodies and begins to question how these factors impact on the evaluation of capacity building.
45518656
Rehabilitation medicine summit: Building research capacity
The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: (1) researchers; (2) research culture, environment, and infrastructure; (3) funding; (4) partnerships; and (5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called to pursue the agendas outlined in this report.
39350357
A conceptual model for capacity building in Australian primary health care research.
BACKGROUND
Many general practitioners and primary health care practitioners lack research and evaluation skills. In response, the Australian Government has funded important capacity building initiatives.


AIM
To propose a conceptual model to assist these initiatives.


MODEL
Four groups of research involvement are suggested: nonparticipants; participating (as part of a research team); managing/training (either leading research, or in formal training to do so); and academic (with, or leading toward, a doctorate). We outline six guiding principles for research capacity building: 1) a whole system approach, 2) accommodating diversity, 3) reducing barriers to participation, 4) enabling collaboration, 5) mentoring, and 6) networking.


CONCLUSION
This model forms a framework to help plan and evaluate research capacity building initiatives.
24804549
Validation of the research capacity and culture (RCC) tool: measuring RCC at individual, team and organisation levels.
Research capacity building (RCB) in Australia has recently focussed on strategies that take a whole of system approach to developing research culture at individual, team and organisation levels. Although a theoretical framework exists, no tool has been published that quantitatively measures the effectiveness of RCB interventions aimed at these three levels. A sample of 134 allied health workers was used to validate the research capacity and culture (RCC) tool. Item level analysis was undertaken using Cronbach's α and exploratory factor analysis, and test-retest reliability was examined using intra-class correlations (ICC). The tool had one factor emerge for each domain, with excellent internal consistency for organisation, team and individual domains (α=0.95, 0.96 and 0.96 respectively; and factor loadings ranges of 0.58-0.89, 0.65-0.89 and 0.59-0.93 respectively). The overall mean score (total) for each domain was: 5.4 (inter-quartile range 3.9-7.7), 4.4 (IQR 2.6-6.1) and 3.9 (IQR 2.9-6) for the organisation, team and individual domains respectively. Test-retest reliability was strong for each domain: organisation ICC=0.77, team ICC=0.83 and individual ICC=0.82. The RCC tool has three domains measuring research capacity and culture at organisation, team and individual levels. It demonstrates excellent internal consistency and strong test-retest reliability.
73096368
Building research capacity in the allied health professions
This article discusses research capacity building and its relevance for health practitioners using allied health professionals (AHPs) as a case example. Allied health professionals is a term used to represent a diverse group of health workers, each with a discrete clinical focus, whose needs for research capacity building are likely to be similar to one another and to other medical and nursing professionals. The work of AHPs challenges many current research paradigms being complex and multidisciplinary in nature, often delivered in community settings and focusing on holistic outcomes. This article examines some of the current drivers in the healthcare context and highlights tensions for AHPs in developing their research base in basic science and applied health research. The authors argue for a strategic approach to research capacity building and examine the implications of current policy initiatives for AHP roles and activity in research. The importance of a sustained approach to capacity building is underscored.
58187905
Research Capacity: A challenge for the therapy professions
Summary Background and purpose To undertake a quantitative analysis of research activity in occupational therapy, physiotherapy and speech and language therapy using the 1997 and 1999 versions of the Register of Therapy Researchers. This provides an insight into one element of research capacity and allows career trajectories to be monitored so as to inform strategic planning. Method A Register of Therapy Researchers was first established in 1997 and updated in 1999. The database was funded by the Department of Health. All 55,000 members of the professional bodies, namely the Chartered Society of Physiotherapy, the Royal College of Speech and Language Therapists and the College of Occupational Therapists, were invited to submit entries via self-completion questionnaires. The data from the two versions were compared to map developments in the research workforce profile of these professions across the United Kingdom. Results There were 339 entries on version 1 (1997) of the register, which increased to 624 in version 2 (1999). The register shows an upward drift in qualifications with nearly twice as many therapists with research degrees in 1999. The majority were based in England, with most in London (n = 104, 21.5%) and fewest in the Eastern Region (n = 20, 4.1%). A total of 97 therapists had been lead grant holders for national or international research programmes/projects. Based on a self-definition, 96 therapists (15.4%) identified themselves as R&D leaders. Seventy-six had experience as members of research ethics committees and 51 had experience of national R&D committees. Conclusions Developing, supporting and sustaining research capacity among all practitioners, whether as research consumers or leaders, is an essential element of evidence-based healthcare. A national, co-ordinated strategic approach, with targets for researchers and research centres, is required to capitalise upon the current investment in research training if the benefits, particularly from post-doctoral researchers, are to be realised. Therapists are in a position to make a valuable and active contribution to the national R&D agenda.
10941107
Evaluating a team-based approach to research capacity building using a matched-pairs study design
BackgroundThere is a continuing need for research capacity building initiatives for primary health care professionals. Historically strategies have focused on interventions aimed at individuals but more recently theoretical frameworks have proposed team-based approaches. Few studies have evaluated these new approaches. This study aims to evaluate a team-based approach to research capacity building (RCB) in primary health using a validated quantitative measure of research capacity in individual, team and organisation domains.MethodsA non-randomised matched-pairs trial design was used to evaluate the impact of a multi-strategy research capacity building intervention. Four intervention teams recruited from one health service district were compared with four control teams from outside the district, matched on service role and approximate size. All were multi-disciplinary allied health teams with a primary health care role. Random-effects mixed models, adjusting for the potential clustering effect of teams, were used to determine the significance of changes in mean scores from pre- to post-intervention. Comparisons of intervention versus control groups were made for each of the three domains: individual, team and organisation. The Individual Domain measures the research skills of the individual, whereas Team and Organisation Domains measure the team/organisation's capacity to support and foster research, including research culture.ResultsIn all three domains (individual, team and organisation) there were no occasions where improvements were significantly greater for the control group (comprising the four control teams, n = 32) compared to the intervention group (comprising the four intervention teams, n = 37) either in total domain score or domain item scores. However, the intervention group had a significantly greater improvement in adjusted scores for the Individual Domain total score and for six of the fifteen Individual Domain items, and to a lesser extent with Team and Organisation Domains (two items in the Team and one in the Organisation domains).ConclusionsA team-based approach to RCB resulted in considerable improvements in research skills held by individuals for the intervention group compared to controls; and some improvements in the team and organisation's capacity to support research. More strategies targeted at team and organisation research-related policies and procedures may have resulted in increased improvements in these domains.
762877
Motivators, enablers, and barriers to building allied health research capacity
Purpose A sound, scientific base of high quality research is needed to inform service planning and decision making and enable improved policy and practice. However, some areas of health practice, particularly many of the allied health areas, are generally considered to have a low evidence base. In order to successfully build research capacity in allied health, a clearer understanding is required of what assists and encourages research as well as the barriers and challenges. Participants and methods This study used written surveys to collect data relating to motivators, enablers, and barriers to research capacity building. Respondents were asked to answer questions relating to them as individuals and other questions relating to their team. Allied health professionals were recruited from multidisciplinary primary health care teams in Queensland Health. Eighty-five participants from ten healthcare teams completed a written version of the research capacity and culture survey. Results The results of this study indicate that individual allied health professionals are more likely to report being motivated to do research by intrinsic factors such as a strong interest in research. Barriers they identified to research are more likely to be extrinsic factors such as workload and lack of time. Allied health professionals identified some additional factors that impact on their research capacity than those reported in the literature, such as a desire to keep at the “cutting edge” and a lack of exposure to research. Some of the factors influencing individuals to do research were different to those influencing teams. These results are discussed with reference to organizational behavior and theories of motivation. Conclusion Supporting already motivated allied health professional individuals and teams to conduct research by increased skills training, infrastructure, and quarantined time is likely to produce better outcomes for research capacity building investment.
25764003
Stakeholders' perceptions of a research capacity development project for nurses, midwives and allied health professionals.
AIMS
To evaluate stakeholders perceptions of the extent to which a research facilitator post was addressing aims of: * providing academic support to enable research involvement of nurses, midwives and allied health professionals; * supporting dissemination of research into practice; * contributing to research strategy development.


BACKGROUND
Barriers to research capacity development have been recognized for nurses, midwives and allied health professionals. A project established in a London NHS trust aimed to address these.


METHODS
A mixed methods approach was used.


RESULTS
Responses were generally very positive. The post effected improvements in the research culture and perceived increase in research-related activities.


CONCLUSION
The post made substantial progress towards its aims. This approach may be useful in other healthcare locations to build research capacity.


IMPLICATIONS FOR NURSING MANAGEMENT
Challenged by increasing priority accorded to research capacity and service research implementation yet recognition of barriers to achievement, this study offers insights from one means to address this.
17535717
What can management theories offer evidence-based practice? A comparative analysis of measurement tools for organisational context
BackgroundGiven the current emphasis on networks as vehicles for innovation and change in health service delivery, the ability to conceptualise and measure organisational enablers for the social construction of knowledge merits attention. This study aimed to develop a composite tool to measure the organisational context for evidence-based practice (EBP) in healthcare.MethodsA structured search of the major healthcare and management databases for measurement tools from four domains: research utilisation (RU), research activity (RA), knowledge management (KM), and organisational learning (OL). Included studies were reports of the development or use of measurement tools that included organisational factors. Tools were appraised for face and content validity, plus development and testing methods. Measurement tool items were extracted, merged across the four domains, and categorised within a constructed framework describing the absorptive and receptive capacities of organisations.ResultsThirty measurement tools were identified and appraised. Eighteen tools from the four domains were selected for item extraction and analysis. The constructed framework consists of seven categories relating to three core organisational attributes of vision, leadership, and a learning culture, and four stages of knowledge need, acquisition of new knowledge, knowledge sharing, and knowledge use. Measurement tools from RA or RU domains had more items relating to the categories of leadership, and acquisition of new knowledge; while tools from KM or learning organisation domains had more items relating to vision, learning culture, knowledge need, and knowledge sharing. There was equal emphasis on knowledge use in the different domains.ConclusionIf the translation of evidence into knowledge is viewed as socially mediated, tools to measure the organisational context of EBP in healthcare could be enhanced by consideration of related concepts from the organisational and management sciences. Comparison of measurement tools across domains suggests that there is scope within EBP for supplementing the current emphasis on human and technical resources to support information uptake and use by individuals. Consideration of measurement tools from the fields of KM and OL shows more content related to social mechanisms to facilitate knowledge recognition, translation, and transfer between individuals and groups.
141390
A quality improvement tool to assess self-management support in primary care.
BACKGROUND
Self management is an essential, central component of effective care for diabetes and other chronic illnesses, yet very few instruments exist to assess delivery or consistency of self-management support. The Assessment of Primary Care Resources and Supports for Chronic Disease Self-Management (PCRS) tool assesses both organizational infrastructure and delivery of self-management support services.


METHODS
The PCRS was developed by the Robert Wood Johnson Foundation Diabetes Initiative and underwent several stages of development, including three pilot tests, review by experts, and implementation by a national quality improvement (QI) program.


RESULTS
The development and testing of the instrument resulted in the current 16-item measure. Use of the PCRS in a QI collaborative with 20 diverse health care teams across the United States demonstrated that the instrument is helpful in assessing areas for improvement.


DISCUSSION
Initial experience suggests that the PCRS is a user-friendly self-assessment tool that primary care teams can use to assess their current capacity to support and implement consistent patient-centered self management. The initial evaluation indicates that the PCRS has acceptable psychometric properties and is applicable across different types of primary care teams and chronic illness conditions.
42897871
Evidence-based practice in everyday clinical practice: strategies for change in a tertiary occupational therapy department.
Evidence-based practice is an approach that has gained recognition for facilitating the transfer of evidence into quality clinical practice. While occupational therapy clinicians have a professional responsibility to ensure that their practice is effective, managers also have a responsibility to implement structures and systems that will support therapists in doing so. A review of the literature demonstrated limited evidence of specific organisational models of practice to facilitate the transfer of knowledge into occupational therapy practice. This paper outlines the steps undertaken by occupational therapists in a large tertiary teaching hospital to develop and implement a model of research utilisation. The resulting Research and Evidence in Practice model and the enabling strategies for its implementation are presented. A challenge for the future is to conduct a formal evaluation of the model.
45518656
Rehabilitation medicine summit: Building research capacity
The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: (1) researchers; (2) research culture, environment, and infrastructure; (3) funding; (4) partnerships; and (5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called to pursue the agendas outlined in this report.
22959912
Developing research management and governance capacity in primary care organizations: transferable learning from a qualitative evaluation of UK pilot sites.
BACKGROUND
The capacity and capabilities for undertaking primary care research have increased both within and outside of the UK in recent years. The UK Department of Health aims to facilitate this further by establishing a national network of primary care organizations (PCOs) ready to act as hosts for shared research governance systems. However, it is unclear which models offer the most effective option. In addition, there is confusion over new processes and concern that researchers may be deterred from addressing important questions.


OBJECTIVES
The research ascertains how PCOs selected as pilot sites have organized research management and governance (RM&G).


METHODS
We adopted a case study approach involving interviews with key informants in a purposive sample of eight pilot PCO (RM&G) sites.


RESULTS
Motivating factors for PCOs to host RM&G included the possibility of additional resources and more effective use of research to improve service delivery. A range of organizational models were adopted, often reflecting existing strategic alliances. It is envisaged that it will not be effective or cost-effective for many PCOs to make individual arrangements for RM&G, and so models are already developing among groups of PCOs and partner organizations. The extent of partnerships between PCOs varied with concern over critical mass and dilution of expertise in larger groupings. The development and implementation of systems in pilot sites was facilitated by the support of the wider PCO in recognizing research as a valued and integral part of the organization; the effective management of relationships and the establishment of equal partnership arrangements for RM&G, and the effective use of existing R&D infrastructure and expertise.


CONCLUSIONS
RM&G partnerships vary according to local circumstances. It is likely that groupings will develop in the future with increasing co-terminosity and across wider health organization boundaries, such as Strategic Heath Authorities (in the UK) or primary care research networks. Critical mass of RM&G arrangements is likely to be linked to levels of research activity. There are real concerns over the levels of bureaucracy associated with the implementation of research governance; however, those PCOs that develop as RM&G sites have the opportunity to enrich their organizations and expand clinically relevant R&D. Partnership working within PCOs and with primary care research networks, academic departments or acute trusts, may be the key to success. Those undertaking research within primary care settings outside of the UK can learn important lessons from the UK experience and ensure development of high quality research that informs improvements in patient care.