From Competition to Collaboration: How a Multi-Firm Research Coalition Is Realizing Rigorous Facility Evaluation at Parkland Hospital.

This case study presents the process of developing a multi-entity Research Coalition to evaluate the new Parkland Hospital. The field of evidence-based design has made progress in systematically investigating relationships between healthcare facility design and a range of human outcomes. Yet healthcare facility evaluation is not typically included in the scope of building contracts. Lack of clear responsibility for evaluation and limited funding have been long-term barriers that the industry has yet to overcome. Firms engaged in design research at Parkland Hospital agreed with hospital representatives to collaborate on an integrated facility evaluation. Each participating entity contributed resources toward the effort. To formalize shared goals and priorities, the group developed a Research Coalition Charter. Goals included streamlining evaluation efforts to minimize burden on the hospital, leveraging multiple expertise areas to vet research aims and approaches, contributing knowledge to inform healthcare design, and innovating a model for multi-firm collaboration. The Coalition also developed guidelines for sharing data and disseminating research findings. To date, the Research Coalition has achieved key milestones including institutional review board exemption, data use and research collaboration agreements, and data collection. The research aims encompass patient and staff outcomes hypothesized to improve in the new facility. Both primary and secondary data are being analyzed to test the hypotheses. Publications of findings are forthcoming. Collaborative research among competitors may be a viable approach to realizing evaluation that is critical to learning for healthcare facility decision makers and design practitioners.

Building a sustainable comprehensive Women's Health Program: the Michigan model.

The Women's Health Program at the University of Michigan was established in 1993 and has developed into a successful, federally supported program that links clinical research and education activities across the University. It has focused on human resource capacity building, sustainable financial support and infrastructure, and adaptability to change and opportunities. Widely accepted standards, demonstrated value, committed leaders/champions, and participatory culture have contributed to its success and are important to its future.

Recruitment of women research participants: the Women's Health Registry at the University of Michigan.

OBJECTIVE: The goal was to develop the Women's Health Registry, a research participant database that prospectively collects detailed information on potential research subjects to assist in linking them with open research protocols and to assess investigator use and satisfaction with this Registry. METHODS: The Women's Health Registry was launched in 1999. Women aged > or =18 years were recruited to enroll in a database of women with interest in research participation and to complete a health questionnaire. Women's health researchers with IRB-approved projects were encouraged to apply for access to the Registry participants. In 2003, the first 15 investigators to use the Women's Health Registry were asked to participate in a standardized open-ended interview to assess investigator satisfaction with this recruitment tool. RESULTS: The Women's Health Registry is currently populated with 2436 women: 36.8% aged 18-34, 39.9% aged 35-54, 16.8% aged 55-69, and 6.4% aged > or =70 years. Of these women, 84% are Caucasian and 8.5% are African American. Structured interviews with 13 of the 15 investigators contacted revealed that 36.4% of the total subject enrollment recruited by these investigators was recruited from the Women's Health Registry. In addition, Registry participants were more likely to enroll in their research protocols than women contacted through other methods. Most of the investigators' expectations from the Women's Health Registry were met, except for access to menopausal women. CONCLUSIONS: The Women's Health Registry was successfully developed, and the goal of linking women with appropriate protocols was met with significant investigator satisfaction.

Perceptions of clinical research participation among African American women.

BACKGROUND: Recruiting minority women into clinical research remains a significant challenge to conducting ethnically representative research. The main objective of this Office on Women's Health, DHHS-funded e-health database evaluation project was to examine African American women 's thoughts and perceptions about the clinical research process and about participation in the University of Michigan Women's Health Registry research database. METHODS: Thirty-one African American women were recruited from the community to participate in a total of five 90-minute focus group discussions. All sessions were audiotaped and transcribed verbatim. Thematic content analysis was used to identify relevant themes about participation in clinical research and the Women's Health Registry. RESULTS: Ten common trends were identified. (1) Information about the Women's Health Registry is not reaching the community. (2) Research is perceived as biased to benefit Caucasians. (3) Community involvement by the research team is critical for trust to develop. (4) Research directly relevant to African Americans or their community will encourage participation. (5) Researchers should use existing networks and advertise in appropriate locations. (6) The community needs more information concerning research. (7) Compensation is important. (8) Research that addresses a personal or family medical problem encourages involvement. (9) Minority representation on the research team is a motivator to participation. (10) There is limited time for healthcare-related activities. CONCLUSIONS: Successful recruitment strategies for African American women should feature community-based, culturally appropriate approaches. Online research databases for subject recruitment will likely be successful only if implemented within a broader community-oriented program.