ArticlePDF Available

The development of the Canadian Rural Health Research Society: creating capacity through connection

March 2007
Rural and Remote Health 7(1):622

DOI:10.22605/RRH622

Source
PubMed

Authors:

Martha L P Macleod

University of Northern British Columbia

Judith C Kulig

University of Lethbridge

Jennifer Mary Medves

Queen's University

The organization of rural health research in Canada has been a recent development. Over the past 8 years, rural and remote researchers from more than 15 universities and agencies across Canada have engaged in a process of research capacity building through the development of a network, the Canadian Rural Health Research Society (CRHRS) among the scientifically and geographically diverse researchers and their community partners. The purpose of this article is to discuss the development of the CRHRS as well as the challenges and lessons learned about creating networks and building capacity among rural and remote health researchers. Key elements of network development have included identifying and developing multidisciplinary research groupings, maintaining ongoing connections among researchers, and promoting the sharing of expertise and resources for research training. The focus has been on supporting research excellence among networks of researchers in smaller centres. Activities include a national annual scientific meeting, the informal formation of several regional and national research networks in specific areas, and the development of training opportunities. Challenges have included the issues of sustaining communication, addressing a range of networking and capacity-enhancement needs, cooperating in an environment that rewards competition, obtaining resources to support a secretariat and research activities, and balancing the demands to foster research excellence with the needs to create infrastructure and advocate for adequate research funding. The CRHRS has learned how to begin to support researchers with diverse interests and needs across sectors and wide geographical areas, specifically by: (1) focusing on research development through creating and supporting trusting connections among researchers; (2) building the science first, followed by infrastructure development; (3) making individual researchers the nodes in the network; (4) being inclusive by accommodating a wide variety of researchers and researcher strengths; (5) emphasizing social exchange, knowledge exchange, and mentoring in annual scientific meetings; (6) taking opportunities to develop separate projects while finding ways to link them; (7) finding a balance between advancing the science and advocating for adequate funding and appropriate peer review; (8) developing a network organizational structure that is both stable and flexible; and (9) maintaining sustained visionary leadership.

Milestones in Canadian Rural Health Research Society networking.

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R U R A L H E A L T H H I S T O R Y

The development of the Canadian Rural Health

Research Society: creating capacity through

connection

MLP MacLeod

, JA Dosman

, JC Kulig

, JM Medves

University of Northern British Columbia, Prince George, BC Canada

Institute of Agricultural Rural and Environmental Health/Canadian Centre for Health

and Safety in Agriculture Saskatoon, University of Saskatchewan, Canada

School of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada

School of Nursing, Queens University, Kingston, ON, Canada

Submitted: 13 July 2006; Resubmitted: 4 January 2007; Published: 27 March 2007

MacLeod MLP, Dosman JA, Kulig JC, Medves JM

The development of the Canadian Rural Health Research Society: creating capacity through connection

Rural and Remote Health 7: 622. (Online), 2007

Available from: http://www.rrh.org.au

A B S T R A C T

Context: The organization of rural health research in Canada has been a recent development. Over the past 8 years, rural and

remote researchers from more than 15 universities and agencies across Canada have engaged in a process of research capacity

building through the development of a network, the Canadian Rural Health Research Society (CRHRS) among the scientifically

and geographically diverse researchers and their community partners. The purpose of this article is to discuss the development of

the CRHRS as well as the challenges and lessons learned about creating networks and building capacity among rural and remote

health researchers.

Issue: Key elements of network development have included identifying and developing multidisciplinary research groupings,

maintaining ongoing connections among researchers, and promoting the sharing of expertise and resources for research training.

The focus has been on supporting research excellence among networks of researchers in smaller centres. Activities include a

national annual scientific meeting, the informal formation of several regional and national research networks in specific areas, and

the development of training opportunities. Challenges have included the issues of sustaining communication, addressing a range of

networking and capacity-enhancement needs, cooperating in an environment that rewards competition, obtaining resources to

support a secretariat and research activities, and balancing the demands to foster research excellence with the needs to create

infrastructure and advocate for adequate research funding.

Lessons learned: The CRHRS has learned how to begin to support researchers with diverse interests and needs across sectors and

wide geographical areas, specifically by: (1) focusing on research development through creating and supporting trusting

connections among researchers; (2) building the science first, followed by infrastructure development; (3) making individual

researchers the nodes in the network; (4) being inclusive by accommodating a wide variety of researchers and researcher strengths;

(5) emphasizing social exchange, knowledge exchange, and mentoring in annual scientific meetings; (6) taking opportunities to

develop separate projects while finding ways to link them; (7) finding a balance between advancing the science and advocating for

adequate funding and appropriate peer review; (8) developing a network organizational structure that is both stable and flexible;

and (9) maintaining sustained visionary leadership.

Key words: Canada, capacity-building, network, research.

Context

Although there is a long history of research into the health of

rural Canadians, as well as a long history of international

research symposia and meetings on rural health issues

, the

rural health research community remains small and dispersed

across the country. Within the last decade, sparked largely

by the new research funding opportunities created by the

establishment of the Canadian Institutes of Health Research

(CIHR), there has been a concerted effort to develop more

substantial connections among rural health researchers from

many different disciplines and parts of Canada. The

Canadian Rural Health Research Society (CRHRS), created

by researchers as a means to establish a robust and well-

funded rural health research community, has developed as a

network of researchers in the four principal areas of rural

health research: (i) biomedical; (ii) clinical; (iii) health

services and policy; (iv)population and public health.

The development of this rural health research networked

community has not been without its challenges. The purpose

of this article is to discuss the development of the CRHRS as

well as the challenges and lessons learned about creating

networks and building capacity among rural and remote

health researchers.

Issue: research networks and

networking

Health research networks have been described as, ‘networks

of investigators who are equipped with tools to facilitate

collaboration and information sharing’

and whole systems

that ‘facilitate cultural change and grass-roots participation

in research’ that also enable ‘individual innovation, through

multidisciplinary participation’

. Approaches to research

networks differ, from highly coordinated endeavours to

loosely coupled connections of researchers and others who

maintain ‘various types of contacts, co-operation and

communication’

. Networks fulfil various purposes,

including overcoming fragmentation of research on a

particular topic

, improving multidisciplinary approaches to

pressing research problems

, linking researchers and

decisionmakers

, and increasing researcher competitiveness

nationally and internationally

6-10

Research networks are important in building research

capacity as well as influencing the development of

multidisciplinary teams to address complex research

questions

6,8

. It is not always clear what structures and

processes can best enhance and sustain researcher capacity

Key elements in successful networks include: a common,

clear vision with a modest number of goals

; proven,

charismatic leadership of an individual or individuals with a

deep understanding of all aspects of research in the field

; a

structure that suits the network’s goals and purpose

6,10,12

;

clear, effective processes of communication, coupled with

mechanisms to foster and sustain researcher engagement and

collaboration

11,12

; sufficient resources

provided in a

judicious and timely manner

; and ways of working that

reflect the intent and context of the network

9,11

. Networks

develop largely in response to contextual forces.

Rural health research

The pattern of rural health research development occurs in

relation to the role of rural health in the country’s health

agenda, the availability of national research funding, the

organization of health services, and the availability of

universities and researchers to rural communities. In the

USA, for instance, rural health research is largely health

policy driven and focuses on access issues

. As Hartley

notes, this is due primarily to three factors. First was the

establishment of the Federal Office of Rural Health Policy in

1987 that provided funding and capacity-building support for

research centres focused on rural issues. Second was the

National Rural Health Alliance, which began in 1978 as a

merger of two rural hospital and rural primary care

organizations, serves as an umbrella organization, and

advocates successfully for research dollars. Third was the

creation of issue networks, made up of federal/state

decisionmakers, clinicians and researchers, to lobby for

specific issues such as rural hospital policy.

In Australia, a number of rural health units were established

within state health departments in the late 1980s to focus on

policy related issues. The increase in regional universities,

the funding of university departments of rural health in each

state and the Northern Territory, as well as the establishment

of the rural clinical schools has resulted in an increase in

rural health research. Most research is focused on public

health and health services, however, and remains small in

scale

. At the same time, funding for research that is

specifically rural in nature remains limited

15,16

, and there are

continuing needs for capacity development and

communication among researchers dispersed over a vast

geographic area

In Canada, the development of rural health research has been

more researcher driven than policy driven, and hence is

uneven across the country. Provinces are responsible for the

provision of health and education, and interest in rural health

varies from province to province. Although there is an

increasing number and range of rural health research projects

and programs across the country

, there are few long-term

provincially-funded centres with a central mandate for rural

health research, such as Ontario’s Centre for Rural and

Northern Health Research (CRaNHR).

Developing a Canadian Rural

Health Research Network

By the late 1990s an increasing appreciation that specific

knowledge was required to address rural and remote health

needs in Canada

led to the emergence of a network that has

become the CRHRS. Developmental milestones, including

policy and organizational influences, are outlined (Fig 1).

Two rural health research conferences in 1998, one at the

University of Lethbridge

; the other at the University of

Saskatchewan

, provided opportunities for researchers from

a broad range of disciplines and research interests to meet

for the first time. Also in 1998, the national department of

health, Health Canada, formed the Office of Rural Health for

the purpose of putting a ‘rural lens’ on national health

issues

. Rural health research was the focus of two

proposals during the consultation phase of the development

of the Canadian Institutes of Health Research (CIHR)

21,22

Figure 1: Milestones in Canadian Rural Health Research Society networking.

University of Lethbridge

Alberta

September

“Health in Rural Settings

From the Ground Up”

University of Saskatchewan

Saskatchewan

October

“Rural Health and Safety in a

Changing World”

Saskatoon

Saskatchewan

Rural He

alth Research

Consortium Meeting

Ottawa

Ontario

October

Annual Conference

Rural Health Research

Consortium

Saskatoon

Saskatchewan

October

Annual Conference

Rural Health Research

Consortium

Health Canada

Office of Rural Health

Established

Prince George

British Columbia

October

“Rural and Remote

Health Research

The Quest for equitable

Health Status for all

Canadians”

MRC/CIHR

Funding obtained by

Consortium

Health Canada

Ministerial Advisory

Council on Rural

Health Established

1998

1999

2000

2001

Halifax

Nova Scotia

October

Annual Conference Rural

Health Research Consortium

Saskatoon

Saskatchewan

October

Annual Conference

with International

Symposium “Future of

Rural Peoples”

Sudbury

Onatrio

October

Annual Conference

with International

Rural Nurses Congress

Quebec City

Quebec

October

Annual Conference

with Canadian Society

for Circumpolar

Health

CRRHS

Receives CIHR Workshop

Funding and CIHR Rural

Initiatives funding

Canadian Rural

Health Research

Society

Established

CIHR

Initiatives

Rural Health

Canada Rural and

Remote Health Studies

Meeting

CIHR

Centre for Research

Development Canadian

Centre for Health and

Safety in Agriculture

Thunder Bay

Ontario

March

Canada Rural and Remote

Health Study(ies) (CRRHS)

Investigator Workshop

2002

2003

2004

2005

In 1999, two national meetings served to accelerate

connectedness. The University of Saskatchewan hosted a

meeting of 129 researchers from a wide variety of disciplines

from across Canada to explore whether specific

interdisciplinary cross-university research groupings might

be formed to seek funding for new research projects from the

emerging CIHR and other funding venues. The outcome was

the Canadian Rural Health Research Consortium

(Consortium) and the emergence of research groups in

nursing, the physical environment, and rural children’s

health. A month later, Health Canada’s Office of Rural

Health and the University of Northern British Columbia

hosted the National Rural Health Research Summit at which

researchers, rural residents and government representatives

further defined the area and recommended means of

supporting rural and remote health research

With the support of a Medical Research Council/CIHR

Opportunities grant, the Consortium met in April 2000 to

establish its mission, goals and 5 year targets. The

Consortium held its first national scientific conference in

October 2000 with 75 scientific abstracts and presentations.

Workshops at this meeting resulted in the identification of

nine key research areas, and requests for closer scientific

connections and project development, and advocacy for

increased funding for rural and remote health research.

The Canadian Rural Health Research

Society: a network of networks

Rather than a single network, rural and remote health

researchers have developed what can be considered a virtual

network of networks, which is enabling research capacity

development. The Consortium has become the Canadian

Rural Health Research Society (CRHRS), annual national

scientific meetings have continued, an inventory of research

training in rural health research has been created

, new

research groupings have emerged, and network members

have worked with CIHR and other funding agencies to hold

workshops and institutes, as well as to extend funding

opportunities.

The Society

Between 2001 and 2003 the Consortium evolved into the

CRHRS. As a national not-for-profit incorporated society,

the CRHRS aims to build interdisciplinary,

multidisciplinary, mutually supportive and community-

focused research networks that are responsive to the needs of

people living in rural and remote communities. The

Society’s activities are focused on researcher capacity-

building, networking, increasing the availability of funding

for rural health research, as well as knowledge translation

Connections among researchers have been fostered through

annual scientific meetings. The number of abstracts and

range of disciplines has increased each year. Joint

conferences have identified new areas of research and

expanded networks: in 2003, with the International

Symposium on the Future of Rural Peoples; in 2004 with the

International Rural Nurses Congress; in 2005 with the

Canadian Society for Circumpolar Health (CSCH); and in

2006 with the Canadian Centre for Health and Safety in

Agriculture, the National Collaborating Centre on Aboriginal

Health, The National Collaborating Centre on Environmental

Health, and the British Columbia Rural and Remote Health

Research Network, among others. The conferences have

served as the venue for research priority-setting and

networking on topics such as rural women’s health,

definitions of rural and rurality

working with large

databases, rural health professional education, research

ethics and aboriginal knowledge translation.

Research groupings

From the Consortium’s earliest meetings, structured

opportunities have been provided for researchers with

similar interests, from various universities and disciplines to

get together to explore the questions: what are the major

research issues in this area? What research questions could

be worked on?

One of the earliest networking results was in health services

and policy research, with the nursing group’s study, ‘The

Nature of Nursing Practice in Rural and Remote Canada’

This Canada-wide study, was conceived when the principal

researchers first met at the 1999 Saskatoon meeting, and

were later supported by a Medical Research Council/CIHR

Opportunities grant in 2000

. The physical environment

group, which also met at the 1999 meeting, was successful in

its 2002 application to CIHR Strategic Training Initiative in

Health Research (STIHR) Program for a multicentre training

grant, Public Health and the Agricultural Rural Ecosystem

Training Program (PHARE)

. In 2004, two CIHR Centres

for Research Development were funded: the Centre on the

Changing Physical and Social Landscape in Atlantic Rural

Canada

, and the Canadian Centre for Health and Safety in

Agriculture

, with its researcher network now numbering 66

scientists in 14 Canadian universities and other national and

international organizations. Most research within these

centres is in the areas of population and public health, and

health services and policy research, although increasingly

projects cross into biomedical research and genomics, on

topics such as mechanisms of lung inflammation related to

swine barn air

In March 2002, with the support of 8 CIHR Institutes,

37 researchers met in Thunder Bay, Ontario. Five additional

research groupings, in addition to the ones on rural nursing,

environmental health and rural children’s health, were

created. Subsequent proposals included a project on the links

between health status and community resiliency

, and an

evaluation of national information sources for developing a

baseline data set on the health of rural Canadians

. Other

research groupings, including one on children’s mental

health and a clinical research-focused group on chronic

disease management have been unable to garner a sufficient

critical mass of researchers to proceed.

A grant received by the Society’s co-leaders

, which

enabled the provision of small grants ($4000 – $5000), has

added substantial value. The grants allowed investigators of

varying levels of research maturity, and often with little

infrastructure available to them in their home universities, to

meet and prepare proposals for funding. Small grants, and

the networking they have funded, have enabled researchers

to achieve a critical mass across universities, to be successful

in national competition, and to compete on standards of

international excellence

34,35

Research training

Fostering research training has been a continuing theme.

During 2001 a Canada-wide survey of training opportunities

in rural and remote health research was undertaken

. The

relationships built among researchers through the CRHRS

and the research grant activities, have created new research

training opportunities, for example, the PHARE Program

through the rural health CIHR Centres for Research

Development located in Nova Scotia

and Saskatchewan

Summer institutes have been implemented in Ontario and

Newfoundland. No fewer than 22 students presented their

research at the 2005 conference and, with their mentors,

participated in a mentorship workshop.

Making supportive networks possible

CIHR funding has been central to fostering research

groupings, networking and capacity building among rural

and remote researchers

27,33

. The need for a Canada-wide scan

of research priorities, first raised by CRHRS researchers,

was taken up by the CIHR. In September 2001 a national

meeting organized by CIHR resulted in a proposed strategy

for rural and remote health in Canada within the context of

the CIHR

36,37

, and led to CIHR strategic competitions in

2002, 2003 and 2004. In 2002, the CIHR created a strategic

initiative across all 13 institutes, now the Special Joint

Initiative in Rural and Northern Health, to provide support

for the development of this strategic priority

. Funding for

this initiative was discontinued in 2006.

Challenges of network development and sustainability

The challenges faced by the CRHRS are characteristic of a

small research community with multiple disciplines, diverse

interests, and limited capacity, dispersed over a large

geographical area. Predominant among the challenges are

the following:

1. Sustaining communication among a small research

community with a range of disciplines and research

foci, spread over a vast geography.

2. Addressing a range of networking and capacity-

enhancing needs within the research community.

3. Engendering cooperation in a research environment

that rewards competition.

4. Resourcing a secretariat or service centre, and other

network supports.

5. Balancing the demands to foster research excellence

with the needs to build infrastructure and engage in

advocacy action to increase research funding for

rural health.

The rural health research community in Canada remains

small and widely dispersed, with few senior researchers. The

networking and capacity enhancing needs vary considerably

within the research community, and as excellence can be

defined in terms of competitive success, cooperation is

sometimes stifled.

Attempts to identify gaps and set priorities in rural health

research have met with limited success

36,37

. The list of

important topics for research has been far-ranging, and

researchers have been unable to reach consensus on focused

research priorities because of diverse needs, interests, and

disciplines. The broad range of research topics contrasts with

the approach in the USA or Australia, where health services

or health policy as drivers and funders of rural health

research have prompted more focused research priorities

13,14

In Canada, it is frequently challenging to create a critical

mass of researchers around a particular topic, or to offer

research training, except by finding non-traditional ways to

link with others across the country or internationally. A

Canadian strength however, is a multidimensional approach

to understanding the determinants of rural health taken by

groups of researchers examining complex issues related to

the health and economic sustainability of rural

communities

. The breadth of interests and disciplines

among the rural health research community has been central

to fostering larger multidisciplinary research groups.

Most rural and remote health researchers are located in small

universities where research resources are limited. Small

universities, often located in more rural or remote parts of

Canada, frequently have sustained, substantive linkages with

their surrounding communities. These links foster

community based research, alignment of research interests,

and the ability for research findings to directly impact health

programs and services

18,38,39

. It is these abilities that provide

groups of rural health researchers, often networking across

provinces, with the potential to compete successfully

nationally and internationally, particularly in the new

funding era which increasingly emphasizes the need to work

with the users of research for improved research uptake.

The targeted national support for rural health and rural health

research has been short-lived: Health Canada’s Office of

Rural Health has been dismantled and CIHR has ceased

strategic funding for rural health research. The decrease in

targeted funding has made networking and capacity-building

more challenging. Among the challenges is finding

appropriate publication outlets. CRHRS members have

edited special issues of other publications

, but efforts to

create a rural health research journal in Canada have not yet

been successful.

Finally, it is challenging for a small research community

with few resources to develop the necessary infrastructure,

while maintaining a balance between advancing the science

and advocating for adequate research funding. Network

members have been diligent in recommending colleagues to

serve on CIHR peer review committees, and institute

advisory boards, as well as regularly communicating with

CIHR about rural health research needs. The CRHRS, a non-

profit society funded by memberships, has sustained its

leadership, and maintained its secretariat and conference

planning endeavours by means of in-kind contributions by

members and their universities. Without a national focus on

rural health on the part of those responsible for research

funding and policy development, and a more central place of

rural health on provincial agendas across the country, the

sustenance and growth of research excellence and funding

opportunities cannot happen easily.

Lessons learned in network

development

In addressing the challenges, the CRHRS has learned how to

begin to support researchers with diverse interests and needs

across sectors and a wide geographical area, specifically by:

1. Focusing on research development through creating

and supporting trusting connections among

researchers.

2. Building the science first, followed by

infrastructure development.

3. Making individual researchers the nodes in the

network.

4. Being inclusive by accommodating a wide variety

of researchers and researcher strengths.

5. Emphasizing social exchange, knowledge

exchange, and mentoring in annual scientific

meetings.

6. Taking opportunities to develop separate projects

while finding ways to link them.

7. Finding a balance between advancing the science

and advocating for adequate funding and

appropriate peer review.

8. Developing a network organizational structure that

is both stable and flexible.

9. Maintaining sustained visionary leadership.

Unlike research networks, designed as infrastructures for

information and services

, the CRHRS has developed as a

fluid channel so that researchers may find best ways of

achieving their own goals of excellence in rural and remote

health research. In pursuing excellence, researchers have

created a variety of smaller, often overlapping knowledge

networks, communities of practice and soft networks

Building a network of networks has been an intertwined

process of researchers reaching out, taking the risk to trust

one another, building community-linked projects and

programs of excellence, receiving funding, developing new

knowledge, using the knowledge to train students, building

capacity, learning how to translate our knowledge to each

other and to our stakeholders and partners, and reaching out

in new ways.

Conclusions

The CRHRS has made strides in enabling inclusive networks

of researchers and communities to develop capacity

collectively. Challenges that remain are to find new ways to

link together population health, health promotion, and health

services researchers with clinical and biomedical researchers

to address the human and health ecosystem issues that are of

such importance in rural and remote communities. New

developments may see large, multidisciplinary research

teams working in partnerships with communities to address

the diverse health agenda of rural and remote Canada, while

being connected and competitive nationally and

internationally. The network of networks approach that has

characterized the development of rural and remote health

research in Canada may permit some innovative ways to

move to this next stage.

Acknowledgements

The authors would like to acknowledge the Canadian

Institutes of Health Research for funding the process leading

to the formation of the Canadian Rural Health Research

Society. The authors also wish to thank the efforts of

colleagues from across Canada who participated in and

supported the process that led to the formation and

incorporation of the Society.

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Supporting rural remote physicians to conduct a study and write a paper: Experience of Clinical Research Support Team (CRST)-Jichi

Article

Jul 2014
Rural Rem Health

Context: Jichi Medical University (JMU) is the only medical school in Japan that is devoted solely to producing rural and remote doctors. To support research activities of its graduates, mainly young graduates under obligatory rural service, JMU established a voluntary team, Clinical Research Support Team (CRST)-Jichi. Issues: CRST-Jichi consists of current and past JMU faculty members; all of them are specialists of certain medical fields and many are also graduates of JMU who have completed rural service. A client who asks the CRST for advice on study design or editing a paper emails the CRST to ask for support in conducting a study. Then, core members of the CRST assign the job to a registered specialist of the corresponding topic, who becomes a 'responsible supporter' and continues to support the client until a paper has been published. During the 3 years from July 2010, 12 English papers have been published in international peer-review journals, two Japanese papers in domestic journals, and 13 studies are in progress. Ninety-one percent of clients were satisfied with the service, and eighty-two percent considered their papers would not have been published if they had not used the service. Sense of commitment, existence of JMU-graduated specialists, and quick response were reported by clients as major strengths of CRST-Jichi. Lessons learned: The experience of CRST-Jichi can potentially be transferred to not only other Japanese medical schools with rural doctor production programs, which are now rapidly increasing as part of a national policy, but also rural medical education systems in other countries.

Consensus‐based framework for the growth and sustainability of rural health research

Article

Full-text available

Jun 2021

Exploring how to sustain 'place-based' rural health academic research for informing rural health systems: A qualitative investigation

Article

Full-text available

Aug 2020
Health Res Pol Syst

Background The field of rural health research is critical for informing health improvement in rural places but it involves researching in small teams and distributed sites that may have specific sustainability challenges. We aimed to evaluate this to inform how to sustain the field of rural health research. Methods We conducted In-depth semi-structured interviews of 50-70 minutes with 17 rural early career researchers who were from different research sites across rural Australia. Data were thematically coded. Results Seven sustainability challenges were noted, namely recognition, workload, networks, funding and strategic grants, organisational culture, job security, and career progression options. Rural researchers were poorly recognised for their work and researchers were not extended the same opportunities enjoyed by staff at main campuses. Unpredictable and high workloads stemmed from community demand and limited staff. Strategic grant opportunities failed to target the generalist, complex research in this field and the limited time researchers had for grant writing due to their demands within small academic teams. Limited collaboration with other sites increased dissatisfaction. In the face of strong commitment to rural ‘places’ and their enthusiasm for improving rural health, fixed-term contracts and limited career progression options were problematic for researchers and their families in continuing in these roles. Conclusion A comprehensive set of strategies is needed to address the sustainability of this field, recognising its value for rural self-determination and health equity. Hubs and networks could enable more cohesively planned, collaborative research, skills sharing, senior academic supervision and career development. Targeted funding, fit to the context and purpose of this field, is urgent. Inaction may fuel regular turnover, starting after a researcher’s first years, losing rich academic theoretical and contextual knowledge that is essential to address the health of rural populations.

Strategies to improve research capacity across European general practice: The views of members of EGPRN and Wonca Europe

Article

Full-text available

Jan 2019

Background: The effectiveness of any national healthcare system is highly correlated with the strength of primary care within that system. A strong research basis is essential for a firm and vibrant primary care system. General practitioners (GPs) are at the centre of most primary care systems. Objectives: To inform on actions required to increase research capacity in general practice, particularly in low capacity countries, we collected information from the members of the European General Practice Research Network (EGPRN) and the European World Organization of Family Doctors (Wonca). Methods: A qualitative design including eight semi-structured interviews and two discursive workshops were undertaken with members of EGPRN and Wonca Europe. Appreciative inquiry methods were utilized. Krueger’s (1994) framework analysis approach was used to analyse the data. Results: Research performance in general practice requires improvements in the following areas: visibility of research; knowledge acquisition; mentoring and exchange; networking and research networks; collaboration with industry, authorities and other stakeholders. Research capacity building (RCB) strategies need to be both flexible and financially supported. Leadership and collaboration are crucial. Conclusion: Members of the GP research community see the clear need for both national and international primary care research networks to facilitate appropriate RCB interventions. These interventions should be multifaceted, responding to needs at different levels and tailored to the context where they are to be implemented.

Collaborations between health services and educational institutions to develop research capacity in health services and health service staff: a systematic scoping review

Article

Full-text available

Nov 2024
BMC HEALTH SERV RES

Background Participation of health service staff in research improves health outcomes and adherence to clinical guidelines. To increase research participation, many health services seek to build research capacity which adds to the development of individual and organisational skills and abilities in order to conduct health research. Numerous approaches to research capacity building have been trialed with inter- and intra-institutional, or university-health service collaborative approaches being frequently described strategies. University-health service research collaborations have potential for high impact and mutual benefit, by harnessing respective strengths across both organisations. However, the range and scope of research capacity building approaches, including their relative value and success have not been consolidated. The aim of this review was to examine and describe the collaborative strategies employed by health services in conjunction with educational partners to enhance the research capability of health service staff. Methods The scoping review framework by Arksey and O’Malley was used to inform the review method. A systematic search was conducted of four major databases: Medline, CINAHL, Embase, and Cochrane, focusing on publications after 1995. Inclusion and exclusion criteria were established through iterative team discussions. The two-stage screening process and data extraction was managed in Covidence. Collaboration, Research Capacity, Health Services, and Health workforce were the primary concepts, contexts and populations guiding the search. Results Of the 1462 studies identified, 61 were selected for the review. These studies reported on partnerships between universities and health services with a specific focus on building research capacity of health service staff. Studies predominantly hailed from Australia, USA, UK, and Canada. Collaboration approaches varied and leveraged different activities to build research capacity included training, mentoring, shared funding, and networking. Training partnerships emerging as the most prevalent. Findings emphasised the importance of localisation in approaches, with some studies indicating the intrinsic value of such collaborations for both partners involved. Despite the emphasis on individual interventions like training and mentoring, team-level interventions were notably scarce. Conclusion This review highlights the diverse range of approaches in research capacity building collaborations between health services and educational partners. It advocates for a shared understanding of goals, highlighting the critical nature of relationship-building and the pivotal role of sustainable infrastructure in long-term collaboration success. Future directions should consider the tangible impacts of these models on clinical outcomes.

Single-Payer Reform and Rural Health in the United States: Lessons from Our Northern Neighbor

Article

Full-text available

Mar 2021

Jared Hirschfield

Single-payer health reform has secured its place in the mainstream American health policy debate, yet its implications for particular subpopulations or sectors of care remain understudied. Amidst many unanswered questions from policymakers and political pundits, rural health has emerged as one such area. This article explores rural Canada’s five-decade-long experience with a national publicly funded health insurance program as a valuable opportunity for cross-national learning. During March 2020, I conducted 13 semi-structured, elite stakeholder interviews with government officials, academic researchers, rural hospital executives, public health association leaders, rural health administrators, and representatives from provincial medical, hospital, and physician associations in Ontario. I found that a single-payer model confers notable advantages over a market-based model, including improved rural hospital viability and enhanced governmental authority to plan health services. However, despite these advantages, advances in Canadian rural health care have remained modest, and those that have occurred seem to be derived as much from a basic value commitment to tackling rural health issues as from the structure of Canada’s single-payer model itself. These results suggest that designing a national single-payer program in the United States that successfully ameliorates geographic health disparities will require a specific and concerted focus on addressing rural health issues. In the absence of such a focus, any single-payer program instituted in the U.S. risks inadequately meeting the pressing and unique health care needs of rural communities.

Lambert, S. D., Coumoundouros, C., Hulbert-Williams, N. J., Shaw, J., & Schaffler, J. (2020). Building the capacity for psycho-Oncology research: a survey of the research barriers and training needs within the International Psycho-Oncology Society. Journal of psychosocial oncology research and practice, 2(3), e023. https://doi.org/10.1097/OR9.0000000000000023

Article

Jul 2020

Background: The International Psycho-Oncology Society (IPOS) is a multidisciplinary professional network that aims to improve psychosocial care for individuals impacted by cancer. IPOS encourages research activity, recognizing that a high-quality evidence base is essential to provide best-practice, data-driven clinical care. This study aimed to determine the barriers to research involvement and the training needs and priorities of IPOS members, with the goal of facilitating the development of training resources tailored to the needs of IPOS members. Methods: A link to an online, cross-sectional survey was disseminated to all registered members of IPOS via email. The online survey platform SimpleSurvey was used, and questions included demographic characteristics and items related to research interests, involvement, and training needs. High priority research training needs were identified as research tasks respondents rated as highly important, yet possessed a low perceived skill level in. Results: Thirty-two percent of IPOS members (n = 142) completed the survey. Participants represented 49 countries and were at a variety of career stages. Overall, participants reported spending an average of 17.3 hours per week on research (range 0-80 hours per week), with 69% of respondents wanting to increase their research involvement. The main barriers to research participation included lack of research funding (80%) and lack of protected time (63%). IPOS members identified 5 high-priority training needs: preparing successful grant applications; preparing research budgets; community-based participatory research; working with decision makers; and finding collaborators or expert consultants. Participants suggested funding access, statistical advisors, and networking and mentorship opportunities as ways to enhance research involvement. Members preferred online training modules (39%) and mentorship programs (19%) as methods by which IPOS could provide research support. IPOS was viewed as being able to contribute to many aspects of research capacity building such as networking, training, and dissemination of research findings. Conclusions: IPOS has an important role in encouraging research capacity building among members. This survey provides an agenda for workshops and training opportunities. Mainly, for respondents it was less about training in research methods and more about training in how to prepare successful grant applications, including budgets, and receiving mentorship on this as well as having opportunities to collaborate with other researchers.

Using Consensus methods to build research capacity within community nursing in Wales

Conference Paper

Apr 2015

Carolyn Wallace

Symposium Title: Using Consensus methods to build research capacity within Community Nursing in Wales. The aim of this symposium is to describe how consensus methods have been used to build and sustain research capacity within community nursing in Wales. Community nursing is changing and in order to obtain best patient outcomes, practice needs to be underpinned by robust research based evidence. The Community Nursing Research Strategy for Wales aims to provide all community nurses and midwives in Wales with the opportunity to be involved in Research for the development of evidence based practice1. The term community nurse includes all nurses, midwives and health visitors working outside of the district general hospital including all areas of practice, research and education. This symposium will present three papers to illustrate how consensus methods have been used to build and sustain research capacity in order to obtain better outcomes for patients. Paper one, ‘Building and coordinating the Community Nursing Research strategy for Wales’ describes how nominal group technique was used to develop, build and coordinate the community nursing research strategy for Wales. As a result of the development of this strategy two further papers will be presented. Paper two, will illustrate Concept Mapping¹ in a mixed-method PhD study to develop a validated instrument for district nurses to identify community-based patients with complex needs. Finally, paper three ‘Using Consensus Methods to evaluate an Erasmus Intensive Learning Project’ uses consensus methods to evaluate an international Erasmus funded intensive learning project (February 16-March 1 2014) which developed different pedagogical models/practices to help students support patients/families become empowered, including empowerment photography. Paper one: ‘Building and coordinating the Community Nursing Research strategy for Wales using Nominal Group Technique’ This paper will demonstrate how the use of nominal group technique can be used to develop and coordinate a national community nursing research strategy (CNRS). The CNRS was developed in December 2011 and launched in March 2013. Its inception originated from Recommendation 22 of the Community Nursing Strategy for Wales2 which stated ‘The Welsh Assembly Government will invest in the funding of research that will develop the evidence base for community nursing interventions, evaluation methods and the appropriate numbers and skill mix for workforce planning’. Thirty two community nurse participants from practice, research, professional bodies, workforce planning and education attended a NGT workshop. The three key characteristics of nominal group technique were used, phase 1-prior discussions and decisions, phase 2- face to face contact with presentation of ideas, topic debate and topic rating, Phase 3- formal group feedback. The All Wales community nursing research priorities and themes were identified. This method has since been used repeatedly to identify ideas, pilot studies and future planning for example, Practices Nurses workforce needs. In August 2013 the CNRS coordinator was appointed and has developed the strategy into a model with four quadrants, an online virtual network, research portfolio database, application to practice, and leadership. The coordinator has developed this model and its standard operational policies including a Scorecard (metrix) to identify impact on practice and to ensure that the CNRS meets its outcomes. Measures include a target of 250 virtual members by March 2015, annual conference, publications, study income, national and international contacts, translating measures into new practices and products. This metrix will be presented at this conference. The Community Nursing Strategy for Wales was sponsored by the Marchioness of Bute and Lady St. David’s Fund. References: 1. Kenkre , J., Wallace, C., Davies, R., Bale, S., Thomas, S., (2013) Developing and implementing the community nursing research strategy for Wales. British Journal for Community Nursing 18(11) 561-566 [online] http://www.wspcr.ac.uk/resources/Developing%20and%20implementing%20the%20Community%20Nursing%20Research%20Strategy%20for%20Wales.pdf [accessed on 10/11/14] 2. Welsh Assembly Government (2009) A Community Nursing Strategy for Wales. Consultation Document. Paper authors: Principal Author: Dr Carolyn Wallace, Reader, USW UK/ Clinical Research Fellow, Wales School Primary Care Research, Cardiff, Wales; Prof. Joyce Kenkre Professor of Primary Care, USW. UK, Robyn Davies Manager of Wales School for Primary Care Research, Cardiff, Wales; Sue Bale is Visiting Professor, University of South Wales, Sue Thomas Primary Care and Independent Sector Adviser, RCN Wales, Cardiff, Wales and PhD Student, University of South Wales, UK. Paper Two : Using Concept Mapping in a mixed-method study to develop a patient assessment instrument for district nurses to identify community-based patient complexity Aim This describes the place of consensus methodology using Concept Mapping¹ in a mixed-method PhD study to develop a validated instrument for district nurses to identify community-based patients with complex need or who have changing need that may place them at risk of rapid deterioration. Background Complex patient need might impact on professional thinking and care provision2,3,4, whilst understanding patient complexity has important implications for the planning and design of community-based services5. Despite this, there is no validated instrument to capture the relationship between complexity of patient need and district nurse activity; neither is there currently a method to articulate the complexity of community-based patient care to managers or service planners. Concept Mapping enabled several stages of instrument development to be addressed, including; theory development, items design, and items selection6. Method 5 face-to-face consensus workshops were held and 29 nurses were asked “what specific information should a district nurse record as part of an assessment of patient complexity?” in order to identify the necessary items for inclusion in the instrument. The results were mapped to an existing taxonomy7 to establish whether this contained the identified items and would be suitable for use. Results Results demonstrate that it is inadequate to consider clinical features alone in an assessment of complex patient need. Amendments were made to the existing taxonomy to reflect gaps found during the mapping exercise and the amended instrument is now known as the Patient Complexity Instrument. Conclusion Concept Mapping offered a mixed-methods approach to identifying factors considered essential for district nursing assessment of patient complexity. The stage of scale development is currently being addressed by using Rasch analysis8 of patient assessment data collected by district nurses. References 1. Kane M & Trochim W (2007) Concept Mapping for Planning and Evaluation. Sage Publications 2. NHS Wales & Welsh Government (2012) Working differently - Working together: A workforce and organisational development framework. Welsh Government, Cardiff 3. Kathol R, Perez R & Cohen J (2010) The Integrated Case Management Manual; Assisting Complex Patients Regain Physical and Mental Health. Springer Publishing Company, New York 4. Wade D (2011) Complexity, case-mix and rehabilitation: the importance of a holistic model of illness (Ed). Clinical Rehabilitation. Vol. 25, 387-395 5. Shippee N, Shah N, May C, Mair F & Montori V (2012) Cumulative complexity: a functional, patient-centred model of patient complexity can improve research and practice. Journal of Clinical Epidemiology. Vol. 65, 1041-1051 6. Wilson M (2005) Constructing Measures: An Item Response Modelling Approach. Psychology Press. 7. Wyatt M (2012) ANGEL Taxonomy: a cognitive model for assessment, decision making and planning in complex care. Technical Briefing Document. www.complexcarewales.org. 8. Bond T & Fox C (2007) Applying the Rasch Model: Fundamental Measurement in the Human Sciences (2nd ed.) Routledge Principal Author: Sue Thomas. PhD Student & RCBC Fellow, University of South Wales; Dr Carolyn Wallace, Reader, USW UK; Dr Paul Jarvis, Research fellow, USW, UK ; Dr Ruth Davis, Independent Consultant, Cardiff, UK.

Institution-to-Institution Mentoring to Build Capacity in 24 Local US Health Departments: Best Practices and Lessons Learned

Article

Full-text available

Oct 2014

Introduction Institutional mentoring may be a useful capacity-building model to support local health departments facing public health challenges. The New York City Department of Health and Mental Hygiene conducted a qualitative evaluation of an institutional mentoring program designed to increase capacity of health departments seeking to address chronic disease prevention. The mentoring program included 2 program models, a one-to-one model and a collaborative model, developed and implemented for 24 Communities Putting Prevention to Work grantee communities nationwide. Methods We conducted semi-structured telephone interviews to assess grantees’ perspectives on the effectiveness of the mentoring program in supporting their work. Two interviews were conducted with key informants from each participating community. Three evaluators coded and analyzed data using ATLAS.ti software and using grounded theory to identify emerging themes. Results We completed 90 interviews with 44 mentees. We identified 7 key program strengths: learning from the New York City health department’s experience, adapting resources to local needs, incorporating new approaches and sharing strategies, developing the mentor–mentee relationship, creating momentum for action, establishing regular communication, and encouraging peer interaction. Conclusion Participants overwhelmingly indicated that the mentoring program’s key strengths improved their capacity to address chronic disease prevention in their communities. We recommend dissemination of the results achieved, emphasizing the need to adapt the institutional mentoring model to local needs to achieve successful outcomes. We also recommend future research to consider whether a hybrid programmatic model that includes regular one-on-one communication and in-person conferences could be used as a standard framework for institutional mentoring.

Capacity Building in a New Clinical Trials Network Through Inter-Network Collaboration

Article

Apr 2021

Rural Health Research: Are We Beyond the Crossroads?

Article

Full-text available

Jan 2005

Judith C Kulig

Networks and their Role in Enhancing Research Impact in Alberta

Article

Full-text available

Judy Birdsell

Networking and Capacity Building: The Role of Regional Research Networks in Africa

Article

Full-text available

Dec 2001

Fredrik Söderbaum

This article seeks to contribute to a more nuanced understanding of the much neglected study of regional research networks (RRNs) and their influence on capacity building in Africa. As a point of departure some conceptual ambiguities and inconsistencies in the field are addressed, with emphasis on the concepts of networking, network and organisation. This discussion serves as an inroad the construction of four ideal types of RRNs in Africa: (i) regional research associations; (ii) regional research organisations; (iii) regional research centres; and (iv) regional research programmes and projects. Thereafter some links between various types of RRNs and capacity building are dicussed. Then some negative consequences for networking and capacity building of the way donors operate are also discussed. A main argument developed is that RRNs should be integrated within a holistic, systems-oriented approach to research capacity building. The challenge for future research is to uncover the comparative advantages of various types of RRNs per se but also when RRNs are promoting synergy effects with other levels of research capacity building.

The Innovation Systems Research Network: a Canadian experiment in knowledge management

Article

Full-text available

Apr 2005

The Innovation Systems Research Network is a collaborative Canadian initiative to undertake and disseminate research results concerning the diverse nature of regional and local innovation systems across the country. The network was established on the premise that, because of their diversity, regional innovation systems in Canada could not be treated as similar, and that single nation-wide innovation policies would not be successful. This project is, itself, an experiment in research management, in that, because of its regional focus in a geographically diverse federation, it is organized as a federation of regional innovation studies networks. A consequence is that the network has been productive and has provided opportunities for graduate students to meet their peers (and future colleagues) across the country. Copyright , Beech Tree Publishing.

The Fifth International Symposium âFuture of Rural Peoples: Rural Economy, Healthy People, Environment, Rural Communitiesâ

Article

Jan 2005
J Agr Saf Health

James A. Dosman

The Innovation Systems Research Network: A Canadian Experiment in Knowledge Management

Article

Apr 2005

Network Literature Review: Conceptualizing and Evaluating Networks

Article

Carey Hill

RTRC Implementation Group NIH Roadmap/Re-Engineering the Clinical Research Enterprise

Article

Rural Health Research in Canada: At the Crossroads

Article

Oct 2000
AUST J RURAL HEALTH

Raymond W Pong

Rural health research in Canada is at the crossroads. Jolted by the establishment of the Canadian Institutes of Health Research, rural health researchers are trying hard to overcome past benign neglect and the lack of cohesion and collaboration within the rural health research community. Although there is considerable catching-up to do, rural health research in Canada has a firm foundation. Backed by a growing network of rural health research centres, researchers are searching for ways to work together in order to advance rural health research and the health and wellbeing of rural Canadians.

Rural Health Research: Have we Turned the Corner?

Article