title: A qualitative study examining healthcare managers and providers' perspectives on participating in primary care implementation research.
abstract: Primary care reforms should be supported by high-quality evidence across the entire life cycle of research. Front-line healthcare providers play an increasing role in implementation research. We recently evaluated two interventions for people with type 2 diabetes (T2D) in partnership with four Primary Care Networks (PCNs) in Alberta, Canada. Here, we report healthcare professionals perspectives on participating in primary care implementation research.
  
  
  
  Guided by the RE-AIM framework, we collected qualitative data before, during, and after both interventions. We conducted 34 in-person or telephone interviews with 17 individual PCN professionals. We used content analysis to identify emerging codes and concepts.
  
  
  
  Two major themes emerged from the data. First, healthcare managers were eager to conduct implementation research in a primary care setting. Second, regardless of willingness to conduct research, there were challenges to implementing experimental study designs for both interventions. PCN professionals presumed the interventions were better than usual care, expressed role conflict, and reported administrative burdens related to research participation. Perceptions of patient vulnerability and an obligation to intervene exacerbated these issues.
  
  
  
  Healthcare professionals with limited practical research experience might not foresee the challenges in implementing experimental study designs in primary care settings to generate high-quality evidence. These issues are intensified when healthcare professionals perceive target patient populations as vulnerable and in need of intervention based on the presenting illness. Possible solutions include further research training, involving healthcare professionals in study design development, and using non-clinical staff to conduct research activities, particularly among acutely unwell patient populations.
authors.affiliation: 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, T6G 2G3, Canada.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Wozniak
authors.affiliation: 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, T6G 2G3, Canada.
authors.forename: Allison
authors.initials: A
authors.lastname: Soprovich
authors.affiliation: 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, T6G 2G3, Canada.
authors.forename: Sandra
authors.initials: S
authors.lastname: Rees
authors.affiliation: 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, T6G 2G3, Canada.|Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada.
authors.forename: Steven T
authors.initials: ST
authors.lastname: Johnson
authors.affiliation: 5-112 Clinical Sciences, Department of Medicine, University of Alberta, Edmonton, T6G 2G3, Canada.
authors.forename: Sumit R
authors.initials: SR
authors.lastname: Majumdar
authors.affiliation: 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, T6G 2G3, Canada. jeff.johnson@ualberta.ca.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
mesh_terms: D000416:Alberta; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012108:Research Personnel / Q000523:psychology
keywords: Experimental study design; Healthcare provider perspectives; Implementation research; Primary care; Qualitative study