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9. The Dental Practice-Based Research Network

Background: Practice-based research networks (PBRNs) are consortia of practices committed to improving clinical practice. Operating internationally since 2005, the Dental Practice-Based Research Network (DPBRN) is a collaborative effort of Kaiser Permanente Northwest/Permanente Dental Associates in Portland, Oregon; Health Partners of Minneapolis, Minnesota; University of Alabama at Birmingham; University of Copenhagen; Alabama Dental Practice Research Network; and clinicians and patients in Oregon, Washington, Minnesota, Florida, Alabama, Georgia, Mississippi, Norway, Sweden, and Denmark.

Methods: DPBRN began by obtaining patient input during feasibility/pilot testing of certain studies, then progressed to a study that formally included patient perceptions, and later made plans for a community advisory board. Additionally, patient representatives serve on an advisory committee managed by the main funder of DPBRN activities, the National Institute of Dental and Craniofacial Research.

Results: As different parties became familiar with each other’s priorities, they were able to establish common ground and carry out successful collaborations. DPBRN has provided a context in which researchers and community clinicians collaborate as equals, and in keeping with the basic principles of CBPR, it engages patients as well. DPBRN practitioner-investigators and their patients have contributed to research at each stage of its development, leading to improvements in study designs and customization of protocols to fit daily clinical practice. At the time of publication, 19 studies had been completed or were ongoing. The studies include a broad range of topic areas, enrollments, and study designs.

Comments: DPBRN practitioners and patients from diverse settings are partnering with academic clinical scientists to improve daily clinical practice and meet the needs of clinicians and their patients. PBRNs can improve clinical practice by engaging in studies that are of direct interest to clinicians and their patients and by incorporating findings from these studies into practice. Patients’ acceptance of these studies has been very high.

Applications of Principles of Community Engagement: The DPBRN exemplifies several principles of community engagement. For example, community practitioners are coming together with academicians to develop and answer relevant research questions that can directly affect daily clinical practice. By engaging dentists in private practice, the network is able to reach the site of dental care for concentrated groups of patients and to conduct research that spans the geographic, cultural, social, and rural/urban diversity of different patient populations. This ability to connect with different groups is congruent with the diversity required by Principle 6. Researchers are partnering with the DPBRN in a way that allows for practitioners in the community, who traditionally are outside of academic institutions, to participate in all stages of research (Principle 5). This can not only close the gap between academic and community practices but also empower the dentists to name the research questions and participate in the quest for solutions. This acknowledges Principle 4, which reminds researchers that no external entity can bestow on a community the power to act in its own self-interest.

References

Gilbert GH, Williams OD, Rindal DB, Pihlstrom DJ, Benjamin PL, Wallace MC. The creation and development of the dental practice-based research network. Journal of the American Dental Association 2008;139(1):74-81.

Makhija S, Gilbert GH, Rindal DB, Benjamin PL, Richman JS, Pihlstrom DJ. Dentists in practice-based research networks have much in common with dentists at large: evidence from the Dental Practice-Based Research Network. General Dentistry 2009;57(3):270-275.

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