System-based participatory research in health care: an approach for sustainable translational research and quality improvement

Abstract

Translational research seeks to improve health care by promoting action and change in real-world health care settings. Although translational research advocates a break from the traditional researcher-initiated approach to science, strategies to successfully engage clinicians and leaders of health care delivery organizations in research are still under development. We propose that applying the principles of community-based participatory research in a way that considers delivery systems-including their leaders, clinicians, and staff-as a focal community can enhance the ability of translational research to improve health care. Applying participatory research methods, such as engaging in collaborative partnerships, building on existing community strengths, investing in long-term relationships, and engaging in research as a cyclical, iterative process, can be a successful approach to sustainable quality improvement at the systems level.

Figure 1.

Engaging communities in system-based participatory research. Note: Systems-based participatory research engages in research partnerships at the level of the health delivery system, including the clinicians and patients nested within a delivery system, as well as delivery system leaders and other stakeholders in the organization. Practice-based research networks traditionally focus on research engagement with individual clinicians and practices, some of which may be part of an organized delivery system, but others are not. Similarly, community-based participatory research initially developed as a form of research engagement directly with patients, community members, and community-based organizations, which may or may not be part of an organized clinical delivery system.