A Qualitative Assessment of Factors That Influence Emergency Medical Services Partnerships in Prehospital Research

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ACADEMIC EMERGENCY MEDICINE 2012; 19:161–173 © 2012 by the Society for Academic Emergency Medicine
Abstract

Objectives:  Recent efforts to increase emergency medical services (EMS) prehospital research productivity by focusing on reducing systems‐related barriers to research participation have had limited effect. The objective of this study was to explore the barriers and motivators to participating in research at the agency and provider levels and to solicit suggestions for improving the success of prehospital research projects.

Methods:  The authors conducted a qualitative exploratory study of EMS personnel using focus group and focused interview methodology. EMS personnel affiliated with the Pediatric Emergency Care Applied Research Network (PECARN) hospitals were selected for participation using a purposive sampling plan. Exploratory questioning identified identified factors that influence participation in research and suggestions for ensuring successful research partnerships. Through iterative coding and analysis, the factors and suggestions that emerged from the data were organized into a behavioral change planning model.

Results:  Fourteen focus groups were conducted, involving 88 EMS prehospital providers from 11 agencies. Thirty‐five in‐depth interviews with EMS administrators and researchers were also conducted. This sample was representative of prehospital personnel servicing the PECARN catchment area and was sufficient for analytical saturation. From the transcripts, the authors identified 17 barriers and 12 motivators to EMS personnel participation in research. Central to these data were patient safety, clarity of research purpose, benefits, liability, professionalism, research training, communication with the research team, reputation, administrators’ support, and organizational culture. Interviewees also made 29 suggestions for increasing EMS personnel participation in research. During data analysis, the PRECEDE/PROCEED planning model was chosen for behavioral change to organize the data. Important to this model, factors and suggestions were mapped into those that predispose (knowledge, attitudes, and beliefs), reinforce (social support and norms), and/or enable (organizational) the participation in prehospital research.

Conclusions:  This study identified factors that influence the participation of EMS personnel in research and gathered suggestions for improvement. These findings were organized into the PRECEDE/PROCEED planning model that may help researchers successfully plan, implement, and complete prehospital research projects. The authors provide guidance to improve the research process including directly involving EMS providers throughout, a strong theme that emerged from the data. Future work is needed to determine the validity of this model and to assess if these findings are generalizable across prehospital settings other than those affiliated with PECARN.

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1553-2712.2011.01283.x

Affiliations: 1: From the Department of Pediatrics, Division of Emergency Medicine, Washington University in St. Louis School of Medicine, and St. Louis Children’s Hospital (JCL, VK), St. Louis, MO; the School of Public Health, Saint Louis University (DPS), St. Louis, MO; the Department of Emergency Medicine, Medical College of Wisconsin (EBL), Milwaukee, WI; the Department of Pediatrics, Division of Emergency Medicine, University of Utah School of Medicine, and Primary Children’s Medical Center (KMA), Salt Lake City, UT; the Department of Pediatrics, Division of Emergency Medicine, Johns Hopkins School of Medicine, and Johns Hopkins Children’s Center (JA), Baltimore, MD; the Department of Pediatrics, Division of Emergency Medicine, George Washington School of Medicine, and Children’s National Medical Center (KB), Washington DC; the Department of Pediatrics, Division of Emergency Medicine, University of Rochester, and University of Rochester Medical Center (LBC), Rochester, NY; the Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Maryland School of Medicine (RL), Baltimore, MD; the Department of Pediatrics, Division of Emergency Medicine, State University of New York at Buffalo, and Women and Children’s Hospital of Buffalo (KAL), Buffalo, NY; the Department of Pediatrics, Division of Emergency Medicine, Washington University in St. Louis School of Medicine, and St. Louis Children’s Hospital (DMJ), St. Louis, MO. 2: From the Department of Pediatrics, Division of Emergency Medicine, Washington University in St. Louis School of Medicine, and St. Louis Children’s Hospital (JCL, VK), St. Louis, MO; the School of Public Health, Saint Louis University (DPS), St. Louis, MO; the Department of Emergency Medicine, Medical College of Wisconsin (EBL), Milwaukee, WI; the Department of Pediatrics, Division of Emergency Medicine, University of Utah School of Medicine, and Primary Children’s Medical Center (KMA), Salt Lake City, UT; the Department of Pediatrics, Division of Emergency Medicine, Johns Hopkins School of Medicine, and Johns Hopkins Children’s Center (JA), Baltimore, MD; the Department of Pediatrics, Division of Emergency Medicine, George Washington School of Medicine, and Children’s National Medical Center (KB), Washington DC; the Department of Pediatrics, Division of Emergency Medicine, University of Rochester, and University of Rochester Medical Center (LBC), Rochester, NY; the Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Maryland School of Medicine (RL), Baltimore, MD; the Department of Pediatrics, Division of Emergency Medicine, State University of New York at Buffalo, and Women and Children’s Hospital of Buffalo (KAL), Buffalo, NY; the Department of Pediatrics, Division of Emergency Medicine, Washington University in St. Louis School of Medicine, and St. Louis Children’s Hospital (DMJ), St. Louis, MO.

Publication date: February 1, 2012

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