Closing the Gap Between Research and Real-World Clinical Practices: Tips and Resources

Julie C. Gass, PhD; Keri Dotson Bayley, MS; Jennifer S. Funderburk, PhD, Integrated Primary Care Special Interest Group (IPC SIG) Co-Chair

Similar to other areas within behavioral medicine, there remains a gap between “research” and “clinical care” within integrated primary care. Current research is limited on essential elements that are relevant for real-world application, and/or criticized for being idealistic. The activation and engagement of clinicians in the research process can help to fill this gap. One way to integrate clinicians into the process is to examine real-world processes and clinical innovations, such as those developed and deemed efficacious. However, schemas of randomized clinical trials and insurmountable time may become activated when the word “research” is mentioned to non-researchers. Using integrated primary care as one example, this article offers practical considerations and resources to overcome barriers, and provides suggestions for clinicians considering ways to contribute to a significant gap in the literature and researchers interested in increasing the applicability of their work:

• Develop cross-professional relationships.
  • Primary care clinics are often located near or affiliated with academic centers, offering opportunities for clinicians and researchers to interface. ‘Cross the street’ to develop collegial relationships.
  • Professional organizations offer email listservs, mentorship, websites, twitter feeds, and other ways to professionally connect with either clinicians or researchers with similar interests (e.g., our IPC SIG, American Psychological Association Division 38, Collaborative Family Healthcare Research and Evaluation Committee, North American Primary Care Research Group, American Psychiatric Association IPS).
  • Look within your own healthcare or academic system for professionals to build connections.
  • Consider registering your site with the Practice-based Research Group which provides resources and assistance to clinical and health researchers.
• Researchers
  • Ensure findings are disseminated to clinicians.
  • In addition to publishing in peer-reviewed journals, disseminate results via email, blogs, webinars, or other avenues that can reach larger groups of clinicians.
  • Identify and disseminate how clinicians can help support you and extend your work.
  • Engage clinicians in your setting in the early development of your research ideas to ensure that the innovation is clinically relevant.
• Clinicians
  • Search the literature to guide new clinical innovations, as well as gaps in the literature. When identifying a need in your clinical practice, see if research can help guide it.
  • Use a structured approach to help refine local practices such as the Plan-Do-Study-Act model as a first step in improving your rigor.
  • To make local evaluations more generalizable, increase the rigor:
  • Conduct strategic planning to further refine your question and outcomes and do this with others outside your area of expertise.
  • Consider program evaluation frameworks to help identify outcomes (e.g. Reach, Effectiveness, Adoption, Implementation, and Maintenance) or examine quality indicators of integrated healthcare such as those identified by the Agency for Healthcare Research and Quality or Sunderji et al. (2016).
  • Consider existing data that is already available (e.g., electronic medical record, performance metrics, healthcare utilization).
  • Find additional resources in the June 2017 Special Issue of Families, Systems, & Health, or workshops available at the Collaborative Family Healthcare Association annual conference.

We hope that these tips and resources can help clinicians and researchers (and anyone in between) to consider ways to better bridge the gap between complex research and day-to-day clinical practice.