Skip to main content

Advertisement

SpringerLink
Log in

Revisiting Practice-Based Research Networks as a Platform for Mental Health Services Research

  • Original Paper
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

Practice-based research networks (PBRNs)—collaborations of practice settings that work together to generate research knowledge—are underused in mental health services research. This article proposes an agenda for mental health services research that uses a variety of PBRN structures and that focuses on what really happens in practice, the effectiveness of practice innovations in real world care, the challenges of implementing evidence supported interventions, modification of clinician behavior, and assessment of the effect of mental health policy changes on practice. The challenges of conducting research within PBRNs are substantial, including difficulties in maintaining positive member relations, securing ongoing funding, sustaining productivity, overcoming IRB entanglements and achieving both scientific excellence in recruitment and measurement validity and utility for practitioner members. However, the awareness of these challenges allows researchers and practitioners to build networks that creatively overcome them and that infuse mental health services research with heavy doses of the realities of everyday clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Allattar, M., Harrington, J. J., Mitchell, C. M., & Sloane, P. (2007). Sleep problems in primary care: A North Carolina family practice research network (NC-FP-RN) study. Journal of the American Board of Family Medicine, 20, 365–374. doi:10.3122/jabfm.2007.04.060153.

    Article  Google Scholar 

  • Arbuckle, J., Gameroff, M. J., Marcus, S. C., West, J. C., Wilk, J., & Olfson, M. (2008). Psychiatric opinion and antipsychotic selection in the management of schizophrenia. Psychiatric Services (Washington, DC), 59, 561–565. doi:10.1176/appi.ps.59.5.561.

    Google Scholar 

  • Barkham, M., Margison, F., Leach, C., Lucock, M., Mellor-Clark, J., Evans, C., et al. (2001). Service profiling and outcomes benchmarking using the CORE-OM: Toward practice-based evidence in the psychological therapies. Journal of Consulting and Clinical Psychology, 69, 184–196. doi:10.1037/0022-006X.69.2.184.

    Article  PubMed  CAS  Google Scholar 

  • Baxley, E. G., & Stanek, M. (2007). The AAMC Academic Chronic Care Collaborative: Family medicine’s participation and lessons learned. Annals of Family Medicine, 5(2), 183–184. doi:10.1370/afm.688.

    Article  PubMed  Google Scholar 

  • Bickman, L. (2008). A measurement feedback system is necessary to improve mental health outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 1114–1119. doi:10.1097/CHI.0b013e3181825af8.

    Article  Google Scholar 

  • Bickman, L., Reimer, M., Breda, C., & Kelley, S. D. (2006). CFIT: A system to provide a continuous quality improvement infrastructure through organizational responsiveness, measurement, training and feedback. Report on Emotional & Behavioral Disorders in Youth, 6(86–87), 93–94.

    Google Scholar 

  • Blanco, C., Olfson, M., Stein, D. J., Simpson, H. B., Gameroff, M. J., & Narrow, W. H. (2006). Treatment of obsessive-compulsive disorder by US psychiatrists. The Journal of Clinical Psychiatry, 67(94), 6–951.

    Google Scholar 

  • Borkovec, T. D. (2002). Training clinic research and the possibility of a national training clinics practice research network. Behavior Therapist, 25, 98–103.

    Google Scholar 

  • Borkovec, T. D., Echemedia, R. J., Ragusea, S. A., & Ruiz, M. (2001). The Pennsylvania practice research network and future possibilities for clinically meaningful and scientifically rigorous psychotherapy effectiveness research. Clinical Psychology: Science and Practice, 8, 155–167. doi:10.1093/clipsy/8.2.155.

    Article  Google Scholar 

  • Cardarelli, R., Seater, M., & Palmarozzi, E. (2007). Overcoming obstacles to implementing a primary care research framework. Osteopathic Medicine and Primary Care, 1(4), 1–7.

    PubMed  Google Scholar 

  • Castonguay, L. G., Boswell, J. F., Zack, S., Montellese, J., Baker, S., Boutselis, M. et al. (2007). Helpful and hindering events in psychotherapy: A practice research network study. Paper presented at the annual meeting of the Society for Psychotherapy Research. Madison, Wisconsin.

  • Clothier, H. J. (2005). An evaluation of the Australian sentinel practice research network surveillance for influenza-like illness. Communicable Diseases Intelligence, 29, 231–247.

    PubMed  Google Scholar 

  • Compton, M. T., Riudisch, B. E., Weiss, P. S., & Kaslow, N. J. (2005). Predictors of psychiatrist reported treatment-compliance problems among patients in routine US psychiatric care. Psychiatry Research, 137, 29–36. doi:10.1016/j.psychres.2005.07.009.

    Article  PubMed  Google Scholar 

  • Cox, K., Mahone, I., & Merwin, E. (2008). Improving the quality of rural nursing care. Annual Review of Nursing Research, 26, 175–194.

    PubMed  Google Scholar 

  • Davis, D. A., Thomson, M. A., Oxman, A. D., & Haynes, R. B. (1995). Changing physician performance: A systematic review of the effect of continuing medical education strategies. Journal of the American Medical Association, 274, 700–705. doi:10.1001/jama.274.9.700.

    Article  PubMed  CAS  Google Scholar 

  • Del Mar, C., & Askew, D. (2004). Building family/general practice research capacity. Annals of Family Medicine, 2, 535–540. doi:10.1370/afm.146.

    Google Scholar 

  • Deshefy-Longhi, T., Swartz, M. K., & Grey, M. (2002). Establishing a practice-based research network of advanced practice registered nurses in southern New England. Nursing Outlook, 50, 127–131. doi:10.1067/mno.2002.123527.

    Article  PubMed  Google Scholar 

  • Fagnan, L. J., Morris, C., Shipman, S. A., Holub, J., King, A., & Angier, H. (2007). Characterizing a practice-based research network: Oregon rural practice-based research network (ORPRN) survey tools. Journal of the American Board of Family Medicine, 20(2), 204–219. doi:10.3122/jabfm.2007.02.060140.

    Article  PubMed  Google Scholar 

  • Garland, A. F., Hurlburt, M. S., & Hawley, K. M. (2006a). Examining psychotherapy processes in a services research context. Clinical Psychology: Science and Practice, 13, 30–46. doi:10.1111/j.1468-2850.2006.00004.x.

    Article  Google Scholar 

  • Garland, A. F., Plemmons, D., & Koontz, L. (2006b). Research-practice partnerships in mental health: Lessons from participants. Administration and Policy in Mental Health, 33, 517–528. doi:10.1007/s10488-006-0062-2.

    Article  PubMed  Google Scholar 

  • Garland, A. F., Hawley, K. M., Brookman-Frazee, L., & Hurlburt, M. S. (2008). Identifying common elements of evidence-based psychosocial treatments for children’s disruptive behavior problems. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 505–514. doi:10.1097/CHI.0b013e31816765c2.

    Article  PubMed  Google Scholar 

  • Genel, M., & Dobs, A. (2003). Translating clinical research into practice: Practice-based research networks-a promising solution. Journal of Investigative Medicine, 51(2), 64–71. doi:10.2310/6650.2003.34179.

    Article  PubMed  Google Scholar 

  • Goldberg, H. I., Wagner, E. H., Fihn, S. D., Martin, D. P., Horowitz, C. R., et al. (1998). A randomized controlled trial of CQI teams and academic detailing: Can they alter compliance with guidelines? Journal on Quality Improvement, 24, 130–142.

    CAS  Google Scholar 

  • Graham, D. G., Spano, M. S., Stewart, T. V., Staton, E. W., Meers, A., & Pace, W. D. (2007a). Strategies for planning and launching PBRN research studies: A project of the Academy of Family Physicians National Research Network (AAFP NRN). Journal of the American Board of Family Medicine, 20, 220–228. doi:10.3122/jabfm.2007.02.060103.

    Article  PubMed  Google Scholar 

  • Graham, D. G., Spano, M. S., & Manning, B. (2007b). The IRB challenge for practice-based research: Strategies of the American Academy of Family Physicians National Research Network (AAFP NRN). Journal of the American Board of Family Medicine, 20, 181–187. doi:10.3122/jabfm.2007.02.060110.

    Article  PubMed  Google Scholar 

  • Green, L. A., & Dovey, S. M. (2001). Practice based primary care research networks. British Medical Journal, 322, 567–568. doi:10.1136/bmj.322.7286.567.

    Article  PubMed  CAS  Google Scholar 

  • Green, L. A., & Hickner, J. (2005). A short history of primary care practice-based research networks: From concept to essential research laboratories. Journal of the American Board of Family Medicine, 19(1), 1–10. doi:10.3122/jabfm.19.1.1.

    Article  Google Scholar 

  • Green, L. A., Simmons, R. L., Reed, F. M., Warren, P. S., & Morrison, J. D. (1978). A family medicine information system: The beginning of a network for practicing and resident family physicians. The Journal of Family Practice, 7, 567–576.

    PubMed  CAS  Google Scholar 

  • Green, L. A., White, L. L., Barry, H. C., Nease, D. E., & Hudson, B. L. (2005). Infrastructure requirements for practice-based research networks. Annals of Family Medicine, 3(S1), S5–S11. doi:10.1370/afm.299.

    Article  PubMed  Google Scholar 

  • Han, D. L. (2000). Physician opportunity costs for performing practice-based research. The Journal of Family Practice, 49(11), 983–984.

    Google Scholar 

  • Herbeck, D. M., West, J. C., Ruditis, I., Duffy, F. F., Fitek, D. J., Bell, C. C., et al. (2004). Variations in use of second-generation antipsychotic medication by race among adult psychiatric patients. Psychiatric Services (Washington, DC), 55, 677–684. doi:10.1176/appi.ps.55.6.677.

    Google Scholar 

  • Horowitz, C. R., Goldberg, H. I., Martin, D. P., Wagner, E. H., et al. (1996). Conducting a randomized controlled trial of CQI and academic detailing to implement clinical guidelines. Journal on Quality Improvement, 22, 734–750.

    CAS  Google Scholar 

  • Institute of Medicine. (2006). Improving the quality of health care for mental and substance abuse conditions. Washington, DC: National Academies Press.

    Google Scholar 

  • Inventory and Evaluation of Clinical Research Networks Executive Summary. (2006). Retrieved January 23, 2009, from www.clinicalresearchnetworks.org/documents%5CPSum.pdf.

  • Kelleher, K. J., Moore, C. D., Childs, G. E., Angelilli, M. L., & Comer, D. M. (1999). Patient race and ethnicity in primary care management of child behavior problems: A report from PROS and ASPN, pediatric research in office settings, ambulatory sentinel practice network. Medical Care, 37, 1092–1104. doi:10.1097/00005650-199911000-00002.

    Article  PubMed  CAS  Google Scholar 

  • Kendall, P. C., & Hudson, J. L. (2001). Participating in a roundtable discussion on the science of psychotherapy research. Clinical Psychology: Science and Practice, 8, 184–185. doi:10.1093/clipsy/8.2.184.

    Article  Google Scholar 

  • Kho, A., Zafar, A., & Tierney, W. (2007). Information technology in PBRNs: The Indiana University Medical Group Research Network (IUMG ResNet) experience. Journal of the American Board of Family Medicine, 20(2), 196–203. doi:10.3122/jabfm.2007.02.060114.

    Article  PubMed  Google Scholar 

  • Kolko, D. (2006). Studying usual care in child and adolescent therapy: It’s anything but routine. Clinical Psychology: Science and Practice, 13, 47–52. doi:10.1111/j.1468-2850.2006.00005.x.

    Article  Google Scholar 

  • Kreyenbuhl, J., Marcus, S. C., West, J. C., Wilk, J., & Olfson, M. (2007). Adding or switching antipsychotic medications in treatment refractory schizophrenia. Psychiatric Services (Washington, DC), 58, 983–989. doi:10.1176/appi.ps.58.7.983.

    Google Scholar 

  • Lambert, M. J., Hansen, N. B., & Finch, A. E. (2001). Patient-focused research: Using patient outcome data to enhance treatment effects. Journal of Consulting and Clinical Psychology, 69, 159–172. doi:10.1037/0022-006X.69.2.159.

    Article  PubMed  CAS  Google Scholar 

  • Lambert, M. J., Harmon, C., Slade, K., Whipple, J. L., & Hawkins, E. J. (2005). Providing feedback to psychotherapists on their patient’s progress: Clinical results and practice suggestions. Journal of Clinical Psychology, 61, 165–174. doi:10.1002/jclp.20113.

    Article  PubMed  Google Scholar 

  • LeBailey, S., Ariza, A., Bayldon, B., & Binns, H. (2003). The origin and evolution of a regional pediatric practice-based research network: Practical and methodological lessons from the pediatric practice research group. Current Problems in Pediatric and Adolescent Health Care, 33, 124–134. doi:10.1067/mps.2003.13.

    Article  Google Scholar 

  • Lindbloom, E. J., Ewigman, B. G., & Hickner, J. M. (2004). Practice-based research networks: The laboratories of primary care research. Medical Care, 42(S4), III-45–III-49. doi:10.1097/01.mlr.0000119397.65643.d4.

    Google Scholar 

  • Love, M. M., Pearce, K. A., Williamson, A., Barron, M. A., & Shelton, B. J. (2005). Patients, practices, and relationships: Challenges and lessons learned from the Kentucky Ambulatory Network (KAN) CaRESS clinical trial. Journal of the American Board of Family Medicine, 19, 75–84. doi:10.3122/jabfm.19.1.75.

    Article  Google Scholar 

  • Montoya, I. D., Svikis, D., Marcus, S. C., Suarez, A., Tanielian, T., & Pincus, H. A. (2000). Psychiatric care of patients with depression and comorbid substance use disorders. The Journal of Clinical Psychiatry, 61, 698–705.

    PubMed  CAS  Google Scholar 

  • Montoya, I. D., Herbeck, D. M., Svikis, D. S., & Pincus, H. A. (2005). Identification and treatment of patients with nicotine problems in routine clinical psychiatry practice. The American Journal on Addictions, 14, 441–454. doi:10.1080/10550490500247123.

    Article  PubMed  Google Scholar 

  • Morris, J. (2007). Characteristics and clinical practices of rural marriage and family therapists. Journal of Marriage and Family Therapy, 33, 439–442. doi:10.1111/j.1752-0606.2007.00043.x.

    Article  Google Scholar 

  • Neale, A. V., & Schwartz, K. L. (2004). Ethics feature: A primer of the HIPAA privacy rule for practice-based researchers. Department of Family Medicine, 46, 1–465.

    Google Scholar 

  • Norquist, G. S. (2001). Practice research networks: Promises and pitfalls. Clinical Psychologist, 8, 173–175.

    Google Scholar 

  • Northey, W. F. (2002). Characteristics and clinical practices of marriage and family therapists: A national survey. Journal of Marriage and Family Therapy, 28, 487–494. doi:10.1111/j.1752-0606.2002.tb00373.x.

    Article  Google Scholar 

  • Northey, W. F. (2005). Studying marriage and family therapists in the 21st century: Methodological and technological issues. Journal of Marriage and Family Therapy, 31, 99–105. doi:10.1111/j.1752-0606.2005.tb01546.x.

    Article  Google Scholar 

  • Nutting, P. A., & Stange, K. C. (1998). Practice-based research. In R. B. Taylor (Ed.), Family Medicine: Principles and practice (5th ed.). New York: Springer.

    Google Scholar 

  • Nutting, P. A., Beasley, J. W., & Werner, J. J. (1999). Practice-based research networks answer primary care questions. Journal of the American Medical Association, 281, 686–688. doi:10.1001/jama.281.8.686.

    Article  PubMed  CAS  Google Scholar 

  • Ornstein, S. M. (2001). Translating research into practice using electronic medical records—The PPRNet-TRIP project: Primary and secondary prevention of coronary heart disease and stroke. Topics in Health Information Management, 22, 52–58.

    PubMed  CAS  Google Scholar 

  • Parry, G., Castonguay, L., Borkovec, T., & Wolf, A. W. (2009). Practice research networks and psychological services research in the UK and USA. Chapter to appear in Michael Barkham & Gillian E Hardy (eds) A core approach to delivering practice-based evidence. John Wiley (in press).

  • Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health and Mental Health Services Research, 36, 24–34. doi:10.1007/s10488-008-0197-4.

    Article  PubMed  Google Scholar 

  • Pulcini, J., Sheetz, A., & DeSisto, M. (2008). Establishing a practice-based research network: Lessons from the Massachusetts experience. The Journal of School Health, 78, 172–174. doi:10.1111/j.1746-1561.2007.00280.x.

    Article  PubMed  Google Scholar 

  • Resick, P. A., & Schnicke, M. K. (1993). Cognitive processing therapy for rape victims. Newbury Park, CA: Sage.

    Google Scholar 

  • Ruiz, M. A., Pincus, A. L., Borkovex, T. D., Echemendia, R. J., Castonguay, L. C., & Ragusea, S. A. (2004). Validity of the inventory of personal problems for predicting treatment outcome: An investigation with the Pennsylvania practice research network. Journal of Personality Assessment, 83, 213–222. doi:10.1207/s15327752jpa8303_05.

    Article  PubMed  Google Scholar 

  • Ship, J. A., Curro, F. A., Caufield, P. W., Dasanayake, A. P., Lindblad, A., Thompson, V. P., et al. (2006). Practicing dentistry using findings from clinical research: You are closer than you think. The Journal of the American Dental Association, 137, 1488–1491.

    PubMed  Google Scholar 

  • Smith, H. B., Sexton, T. H., & Bradley, L. J. (2005). Research into practice, practice into research. Counselling & Psychotherapy Research, 5, 285–290. doi:10.1080/14733140500510549.

    Article  Google Scholar 

  • Smith, M. J. W., Whitaker, T., & Weismiller, T. (2006). Social workers in the substance abuse treatment field: A snapshot of service activities. Health and Social Work, 31, 109–115.

    Google Scholar 

  • Tierney, W. M., Oppernheimer, C. C., Hudson, B. L., Benz, J., Finn, A., Hickner, J. M., et al. (2007). A national survey of primary care practice-based research networks. Annals of Family Medicine, 5(3), 242–250. doi:10.1370/afm.699.

    Article  PubMed  Google Scholar 

  • US Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. Washington, DC: Office of the Surgeon General, Department of Health and Human Services.

  • US Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity—A supplement to mental health: A report of the surgeon general. Rockville, MD: US Department of Health and Human Services, Public Health Service, Office of the Surgeon General.

  • Van Weel, C., Smith, H., & Beasley, J. W. (2000). Family practice research networks: Experiences from 3 countries. The Journal of Family Practice, 49, 938–943.

    PubMed  Google Scholar 

  • Vinokur, A. D., van Ryn, M., Gramlich, E. M., & Price, R. H. (1991). Long-term follow-up and benefit-cost analysis of the jobs program: A preventive intervention for the unemployed. The Journal of Applied Psychology, 76, 213–219. doi:10.1037/0021-9010.76.2.213.

    Article  PubMed  CAS  Google Scholar 

  • Vinson, D. C., Eldern, N., Werner, J. J., Vorel, L. A., & Nutting, P. A. (2000). Alcohol-related discussions in primary care: A report from ASPN Ambulatory Sentinel Practice Network. The Journal of Family Practice, 49, 28–33.

    PubMed  CAS  Google Scholar 

  • Wasserman, R. C., Slora, E. J., Bocain, A. B., Fleming, G. V., Baker, A. E., Pedlow, S. E., et al. (1998). Pediatric research in office settings: A national practice-based research network to improve children’s health care. Pediatrics, 102, 1350–1357. doi:10.1542/peds.102.6.1350.

    Article  PubMed  CAS  Google Scholar 

  • West, J. C., Zarin, D. A., Peterson, B. D., & Pincus, H. A. (1998). Assessing the feasibility of recruiting a randomly selected sample of psychiatrists to participate in a national practice-based research network. Social Psychiatry and Psychiatric Epidemiology, 33, 620–623. doi:10.1007/s001270050102.

    Article  PubMed  CAS  Google Scholar 

  • West, J. C., Wilk, J. E., Oflson, M., Rae, D. S., Marcus, S., Narrow, W. E., et al. (2005). Patterns and quality of treatment for patients with schizophrenia in routine psychiatric practice. Psychiatric Services (Washington, DC), 56, 283–291. doi:10.1176/appi.ps.56.3.283.

    Google Scholar 

  • West, J. C., Wilk, J. E., Muszynski, I. L., Rae, D. S., Rubio-Stipec, M., Alter, C. L., et al. (2007). Medication access and continuity: The experiences of dual eligible psychiatric patients during the first 4 months of the medicare prescription drug benefit. The American Journal of Psychiatry, 164, 789–796. doi:10.1176/appi.ajp.164.5.789.

    Article  PubMed  Google Scholar 

  • Westfall, J. M., Mold, J., & Fagnan, L. (2007). Practice-based research—”Blue highways” on the NIH roadmap. Journal of the American Medical Association, 297(4), 403–405. doi:10.1001/jama.297.4.403.

    Article  PubMed  CAS  Google Scholar 

  • Wilk, J. E., West, J. C., Narrow, W. E., Rae, D. S., & Regier, D. A. (2005). Access to psychiatrists in the public sector and in managed health plans. Psychiatric Services (Washington, DC), 56, 408–410. doi:10.1176/appi.ps.56.4.408.

    Google Scholar 

  • Wolf, L. E., Croughan, M., & Lo, B. (2002). The challenges of IRB review and human subjects protections in practice-based research. Medical Care, 40, 521–529. doi:10.1097/00005650-200206000-00009.

    Article  PubMed  Google Scholar 

  • Wolf, L. E., Walden, J. F., & Lo, B. (2005). Human subjects issues and IRB review in practice-based research. Annals of Family Medicine, 3, S30–S37. doi:10.1370/afm.302.

    Article  PubMed  Google Scholar 

  • Zarin, D. A., Pincus, H. A., West, J. C., & McIntyre, J. S. (1997). Practice-based research in psychiatry. American Journal of Psychiatry, 154, 1199–1208.

    PubMed  CAS  Google Scholar 

  • Zarin, D. A., Young, J. L., & West, J. C. (2005). Challenges to evidence-based medicine: A comparison of patients and treatments in a randomized controlled trial with patients and treatments in a practice research network. Social Psychiatry and Psychiatric Epidemiology, 40, 27–35.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was funded from a grant from the National Institute of Mental Health (P30MH068579).

Author information

Authors and Affiliations

  1. George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA

    J. Curtis McMillen

  2. Center for Mental Health Services Research, Washington University in St. Louis, St. Louis, MO, USA

    J. Curtis McMillen, Shannon L. Lenze & Kristin M. Hawley

  3. Department of Psychological Sciences, University of Missouri, Columbia, MO, USA

    Kristin M. Hawley

  4. Department of Social Work, University of Missouri, Columbia, MO, USA

    Victoria A. Osborne

  5. Program in Public Health, University of Missouri, Columbia, MO, USA

    Victoria A. Osborne

Authors
  1. J. Curtis McMillen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shannon L. Lenze
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kristin M. Hawley
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Victoria A. Osborne
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Curtis McMillen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Curtis McMillen, J., Lenze, S.L., Hawley, K.M. et al. Revisiting Practice-Based Research Networks as a Platform for Mental Health Services Research. Adm Policy Ment Health 36, 308–321 (2009). https://doi.org/10.1007/s10488-009-0222-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-009-0222-2

Keywords

Search

Navigation