Considering the Environmental Impact of Practice-Based Research

Abstract

Introduction: Practice-based research networks (PBRNs) improve primary care by addressing issues that matter to clinicians. Building trust between researchers and care teams is essential to this process, which often requires visiting practices to cultivate relationships and perform research activities. However, in a recent study using practice facilitation to improve the delivery of a preventive service, the COVID-19 pandemic prompted us to convert all planned facilitation from an in-person to virtual format. This eliminated the need to commute by automobile to and from practices across the state, greatly reducing the carbon footprint of the study.

Methods: From practice facilitator field notes that detailed practice locations and number of sessions, we calculated the total number of driving miles averted by virtual facilitation. We then determined metric tons of carbon dioxide we avoided producing using the Environmental Protection Agency Greenhouse Gases Equivalencies Calculator. During post-intervention interviews, we assessed practices' perspectives and experiences with the virtual format.

Results: Three practice facilitators provided an average of 3.4 sessions for 64 practices. Virtual facilitation averted 32,574.8 drive miles and prevented the release of 12.7 metric tons of carbon dioxide, an offset equivalent to growing 210 trees for 10 years. Practices reported that virtual facilitation fostered greater engagement and allowed more clinicians and staff to attend sessions.

Discussion: Climate change poses a significant threat to the health of people and communities. Given their commitment to improving population health, it may be time for PBRNs to routinely assess their environmental impact and minimize preventable environmental costs.

Keywords: Climate Change; Population Health; Practice-based Research; Practice-based Research Networks.

Figure 1.. Greenhouse gas equivalencies for carbon dioxide production prevented by virtual practice facilitation.

Notes: Pivoting from in-person to virtual practice facilitation due to the COVID-19 pandemic, practice facilitators held 190 virtual sessions from September 2020 to May 2023, which avoided driving 32,574.8 miles and emitting 12.7 metric tons of carbon dioxide. The graphic shows selected equivalencies sourced from the Environmental Protection Agency (EPA) Greenhouse gases equivalencies calculator.