Clinical-Community Relationships Evaluation Roadmap

The Clinical-Community Relationships Evaluation Roadmap is a resource for future research and evaluation of effective clinical-community resource relationships.  The Roadmap will be of use to funders, researchers, and program evaluators interested in primary care. The resource's investigators pose priority questions and recommendations for advancing research and developing clinical-community resource measures, based on an environmental scan of measures, a targeted literature review of research, an assessment of evidence gaps, and input from an expert panel.

While the Roadmap specifically addresses clinical-community resource relationships for selected clinical preventive services, the principles and questions offered may also apply to other clinical and non-clinical services. Thus, the Roadmap also may prove applicable to those interested in effective relationships and coordination between clinics and community organizations such as schools or providers of social services.


Prepared for:

Agency for Healthcare Research and Quality

U.S. Department of Health and Human Services

540 Gaither Road

Rockville, MD 20850

www.ahrq.gov

Contract No. HHSA290-2010-000021

Prism Order Number: HHSA29032003T

Task Order 3

Prepared by:

Oregon Rural Practice-based Research Network (ORPRN)

Oregon Health & Science University

3181 SW Sam Jackson Park Road

Portland, OR 97239-3098

Westat

1600 Research Boulevard

Rockville, Maryland 20850-3129

Authors:

David I. Buckley, M.D., M.P.H., ORPRN

Paul McGinnis, M.P.A., ORPRN

Lyle J. Fagnan, M.D., ORPRN

Russ Mardon, Ph.D., Westat

Maurice Johnson, Jr., M.P.H., Westat

Chris Dymek, Ed.D., Westat

Contents

Executive Summary

1. Introduction and Purpose

   1.1 Background

   1.2 Purpose and Scope of the Evaluation Roadmap

   1.3 The Importance of Context

2. Priority Questions and Recommendations

   2.1 Priority Questions

       2.1.1 How do the Characteristics of Primary Care Clinicians and Clinics, Patients, and Community Resources Influence the Effectiveness of Linkages for the Delivery of Clinical Preventive Services?

       2.1.2 How do Characteristics of the Clinician-Patient Relationship, the Patient-Community Resource Relationship, and the Clinical-Community Resource Relationship Influence the Effectiveness of Linkages for the Delivery of Clinical Preventive Services?

       2.1.3 How Does the Relative Importance and Influence of Clinics and Clinicians, Patients, and Community Resources, and their Mutual Interrelationships, Vary in Different Circumstances Or Contexts, Including the Delivery of Different Clinical Preventive Services?

       2.1.4 What are the Best Methods, Strategies and Settings for Studying and Improving Clinical-Community Resource Relationships for the Delivery of Clinical Preventive Services?

       2.1.5 What are the Best Measures for Evaluating the Effectiveness of Clinical- Community Resource Relationships for the Delivery of Clinical Preventive Services?

   2.2 Recommendations

       2.2.1 Researchers Should Use Complex Systems Approaches to Best Understand the Influence of Contextual Issues on the Effectiveness of Clinical-Community Resource Relationships for the Delivery of Clinical Preventive Services

       2.2.2 Research on Clinical-Community Resource Relationships Should be Designed to Flexibly Accommodate Variability in Primary Care Clinic, Patient, and Community Resource Characteristics, Including the Use of Tailored or Semi-Tailored Interventions

       2.2.3 Researchers and Program Evaluators Should Use and Develop Standard Measures of Relevant Characteristics of the Six Elements and Relationships That Influence the Effectiveness of Linkages for the Delivery of Clinical Preventive Services

       2.2.4 Research Into Clinical-Community Resource Relationships for the Delivery of Clinical Preventive Services Should be Relevant and Rigorously Designed, Using Deep Qualitative Methods as Well as Formal Quantitative Study Designs

       2.2.5 Research Findings Should be Reported More Thoroughly and in More Useful Formats

       2.2.6 Studies Should Include Assessments of the Feasibility and Sustainability of Interventions to Improve Clinical-Community Resource Relationships for the Delivery of Clinical Preventive Services, Including Effects on Clinics, Patients and Community Resources

       2.2.7 Future Research Could Consider the Conceptual Framework Developed for This Project as a Starting Point That Might be Further Refined

3. Conclusion

References

Appendixes

Appendices: Preliminary Work and Finding

Appendix A: Conceptual Framework

Appendix B.1: Evidence on Effectiveness

Appendix B.2: Use of Measures in Evaluation

Appendix C: Examples of Current State of Practice

Appendix D: Members of the CCRM Expert Panel

This document is in the public domain and may be used and reprinted with permission except those copyrighted materials that are clearly noted in the document. Further reproduction of those copyrighted materials is prohibited without the specific permission of copyright holders. 

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and the conclusions do not necessarily represent the views of AHRQ. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or of the U.S. Department of Health and Human Services.
Page last reviewed July 2013
Internet Citation: Clinical-Community Relationships Evaluation Roadmap. July 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/prevention-chronic-care/resources/clinical-community-relationships-eval-roadmap/index.html