A PRIMARY CARE RESEARCH AGENDA ACCORDING TO PROS
Alyna Chien, Tumaini Coker, Lillian Choi, Reed Lowrie, Eric Slora, Paul Bodnar, Richard Wasserman, Julie Mohr.. University of Chicago, Chicago, IL; Dept of Research, AAP, Elk Grove, IL; University of Vermont, Burlington, VT.

BACKGROUND: Although most medical care is provided in community settings, most research is conducted in academic centers. In light of the importance of translating research into practice, little work has been done to enlist community practitioners in determining important areas of research at the outset. Community practitioners involved in practice-based research networks are in a good position to provide insight into the primary care research process.

OBJECTIVE: To describe what pediatric primary care practitioners involved in the Pediatric Research in Office Settings (PROS) research network rank as important yet inadequately addressed topics in pediatric primary care research.

DESIGN/METHODS: In 2003, all 1693 active PROS practitioners were asked to "briefly list three important pediatric clinical and/or practice primary care issues that you feel are important and have, to your knowledge, been inadequately addressed by previous primary care research." Three independent researchers reviewed the written answers to this question using the constant comparative method of qualitative analysis. The text was coded through an iterative process, and discrepancies were reconciled by consensus. Several categories and themes emerged from the analysis.

RESULTS: The survey response rate was 51%. Practitioners identified 48 categories in need of further research. The 6 highest ranked categories (identified by 46% of respondents) were: anticipatory guidance, obesity, well child care, ADHD, child psychiatry, and practice management. Within these categories, practitioners sought research on: (1) how to provide effective counseling as a part of anticipatory guidance; (2) how to treat obesity; (3) the effectiveness of well child care; (4) continuing management of ADHD; (5) the primary care provider's role in caring for children with mental illness; and (6) how to best organize a practice to deliver care.

CONCLUSIONS: In addition to an interest in disease management per se, pediatric primary care practitioners desire further research on patient communication and how to organize systems of care. These latter categories of investigation are relatively understudied and under-funded in the current research milieu. Meeting the research needs of primary care practitioners will require a refocusing of the existing research infrastructure.