title: Bridging the gap between basic science and clinical practice: a role for community clinicians.
abstract: BACKGROUND
  Translating the extraordinary scientific and technological advances occurring in medical research laboratories into care for patients in communities throughout the country has been a major challenge. One contributing factor has been the relative absence of community practitioners from the US biomedical research enterprise. Identifying and addressing the barriers that prevent their participation in research should help bridge the gap between basic research and practice to improve quality of care for all Americans.
  
  
  METHODS
  We interviewed over 200 clinicians and other healthcare stakeholders from 2004 through 2005 to develop a conceptual framework and set of strategies for engaging a stable cadre of community clinicians in a clinical research program.
  
  
  RESULTS
  Lack of engagement of community practitioners, lack of necessary infrastructure, and the current misalignment of financial incentives and research participation emerged as the three primary barriers to community clinician research participation. Although every effort was made to learn key motivators for engagement in clinical research from interviewees, we did not observe their behavior and self-report by clinicians does not always track with their behavior.
  
  
  CONCLUSIONS
  A paradigm shift involving acknowledgement of the value of clinicians in the context of community research, establishment of a stable infrastructure to support a cohort of clinicians across time and research studies, and realignment of incentives to encourage participation in clinical research is required.
authors.affiliation: RAND Health, Santa Monica, California, USA. kahn@rand.org
authors.forename: Katherine
authors.initials: K
authors.lastname: Kahn
authors.forename: Gery
authors.initials: G
authors.lastname: Ryan
authors.forename: Megan
authors.initials: M
authors.lastname: Beckett
authors.forename: Stephanie
authors.initials: S
authors.lastname: Taylor
authors.forename: Claude
authors.initials: C
authors.lastname: Berrebi
authors.forename: Michelle
authors.initials: M
authors.lastname: Cho
authors.forename: Elaine
authors.initials: E
authors.lastname: Quiter
authors.forename: Allen
authors.initials: A
authors.lastname: Fremont
authors.forename: Harold
authors.initials: H
authors.lastname: Pincus
mesh_terms: D035843:Biomedical Research / Q000458:organization & administration; D020408:Health Insurance Portability and Accountability Act; D006801:Humans; D033181:Information Dissemination; D007407:Interviews as Topic; D010819:Physician's Role; D012051:Reimbursement Mechanisms; D012111:Residence Characteristics; D057170:Translational Research, Biomedical / Q000191:economics / Q000379:methods*; D035502:Trust; D014481:United States; D000078329:Workforce