title: Building a primary care/research partnership: lessons learned from a telehealth intervention for diabetes and depression.
abstract: BACKGROUND
  Evidence-based interventions are often poorly translated into primary care settings due to inadequate integration into organizational cultures and clinical workflows. Study designs that blend evaluation of effectiveness and implementation may enhance uptake of interventions into primary care settings. Community-Based Participatory Research (CBPR) models are useful for developing partnerships between research teams and primary care clinical partners to test blended study designs.
  
  
  METHODS
  We conducted a formative evaluation of partnership building between a health services research team and a primary care community in US Veterans Affairs Health System to conduct a randomized effectiveness trial of an intervention embedded in routine primary care. The formative evaluation used qualitative data drawn from research/clinical partnership meetings. Data were coded and analysed using qualitative framework analysis.
  
  
  RESULTS
  The CBPR model guided development of a research/clinical partnership based on a facilitation team consisting of 'external facilitators' (research team), 'internal facilitators' (primary care leadership) and a 'clinical advisory committee' drawn from the primary care community. Qualitative themes focused on: how the intervention components ('evidence') aligned with local clinical cultures, barriers and facilitators to acceptance and adoption of the intervention processes within the context of clinical workflows and identified 'facilitators' of intervention uptake and sustainability.
  
  
  CONCLUSIONS
  A CBPR model can guide the development of research/clinical partnerships. Partnerships can identify barriers and craft modifications to intervention procedures that promote integration and into primary care workflows. Formative research/clinical partnerships are critical for designing and testing interventions focused on implementation and sustainability of new evidence within routine primary care.
authors.affiliation: VA HSR&D Houston Center of Innovation, Michael E. DeBakey VA Medical Center, Department of Medicine, Baylor College of Medicine, Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, anaik@bcm.edu.
authors.forename: Aanand D
authors.initials: AD
authors.lastname: Naik
authors.affiliation: VA HSR&D Houston Center of Innovation, Michael E. DeBakey VA Medical Center, Department of Medicine, Baylor College of Medicine, Susan G. Komen Cancer Disparities Trainee, The University of Texas School of Public Health.
authors.forename: Briana
authors.initials: B
authors.lastname: Lawrence
authors.affiliation: VA HSR&D Houston Center of Innovation, Michael E. DeBakey VA Medical Center, Department of Medicine, Baylor College of Medicine.
authors.forename: Lea
authors.initials: L
authors.lastname: Kiefer
authors.affiliation: VA HSR&D Houston Center of Innovation, Michael E. DeBakey VA Medical Center, Department of Medicine, Baylor College of Medicine, Department of Counseling Psychology, University of Houston.
authors.forename: Katherine
authors.initials: K
authors.lastname: Ramos
authors.affiliation: Department of Medicine, Baylor College of Medicine, Primary Care Line, Michael E. DeBakey VA Medical Center.
authors.forename: Anne
authors.initials: A
authors.lastname: Utech
authors.affiliation: Primary Care Line, Michael E. DeBakey VA Medical Center.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Masozera
authors.affiliation: Primary Care Line, Michael E. DeBakey VA Medical Center.
authors.forename: Radha
authors.initials: R
authors.lastname: Rao
authors.affiliation: VA HSR&D Houston Center of Innovation, Michael E. DeBakey VA Medical Center, Department of Medicine, Baylor College of Medicine.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Petersen
authors.affiliation: VA HSR&D Houston Center of Innovation, Michael E. DeBakey VA Medical Center, Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine and VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Kunik
authors.affiliation: VA HSR&D Houston Center of Innovation, Michael E. DeBakey VA Medical Center, Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine and VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cully
mesh_terms: D026683:Advisory Committees; D055812:Community-Based Participatory Research; D003863:Depression / Q000517:prevention & control / Q000523:psychology; D003920:Diabetes Mellitus / Q000517:prevention & control / Q000523:psychology; D019317:Evidence-Based Medicine; D006302:Health Services Research; D006801:Humans; D007857:Leadership; D017146:Models, Organizational; D015279:Organizational Culture; D011320:Primary Health Care; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D017216:Telemedicine; D057170:Translational Research, Biomedical
keywords: Community-based partnership; formative evaluation; implementation; medical home; primary care.