ArticleAnnals of family medicine
Declining Participation in Primary Care Quality Improvement Research: A Qualitative Study.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Federal Investment in Primary Care Transformation: A Systematic Review and Qualitative Analysis.JAMA health forum · 2025Pooled it
- Article
- Learning Health System Implementation: Building a Hub-and-Spoke Model for Hypertension Management Through the QI Hub.Journal of general internal medicine · 2026Article
- Co-creation and interprofessional collaborative practice for the local management of osteoporosis: a qualitative study in primary healthcare.Family practice · 2026Article
- Heart Healthy Ohio Initiative: A Statewide Cooperative to Improve Cardiovascular Risk.Journal of general internal medicine · 2026Article
- Health workers' perspectives on barriers and opportunities to optimising quality improvement implementation in urban health facilities in Lilongwe, Malawi.BMJ open quality · 2025Article
- Article
- Practical strategies for achieving system change in the US: lessons and insights from the CONQUEST quality improvement programme.Primary health care research & development · 2025Review
- Design of INSPIRE: Evaluation of the effectiveness of practice facilitation on implementation of screening, brief interventions, referral to treatment and medication for unhealthy alcohol use identification and treatment in primary care.Contemporary clinical trials communications · 2025Article
- Acceptability of Components for a Mandatory Quality Improvement Framework: A Survey Among Swiss General Practitioners.Health services insights · 2025Article
- A Resident-Led Quality Improvement Project in a Community Based Hospital Emergency Department - The Benefits of Simplified Plan-Do-Study-Act/Patient-Safety Quality Improvement Projects Regardless of Staffing Levels.Spartan medical research journal · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
purposeThere are numerous supportive quality improvement (QI) projects to facilitate the implementation of evidence-based practices in primary care, but recruiting physician practices to join these projects is challenging, costly, and time consuming. We aimed to identify factors leading primary care practices to decline participation in QI projects, and strategies to improve the feasibility and attractiveness of QI projects in the future.
methodsFor this qualitative study, we contacted 109 representatives of practices that had declined participation in 1 of 4 Agency for Healthcare Research and Quality-funded EvidenceNOW projects. The representatives were invited to participate in a 15-minute interview or complete a 5-question questionnaire. Thematic analysis was used to organize and characterize findings.
resultsRepresentatives from 31 practices (28.4% of those contacted) responded. Overwhelmingly, respondents indicated that staff turnover, staffing shortages, and general time constraints, exacerbated by the pandemic, prevented participation in the QI projects. Challenges with electronic health records, an expectation of greater financial compensation for participation, and confidence in the practices' current care practices were secondary reasons for declining participation. Tying participation to value-based programs and offering greater compensation were identified as strategies to facilitate recruitment. None of the respondents' recommendations, however, addressed the primary issues of staffing challenges and time constraints.
conclusionsStaffing challenges and general time constraints, exacerbated by the pandemic, are compromising primary care practices' ability to engage in QI research projects. To encourage participation, policy makers should consider direct supports for primary care, which may also help to alleviate burnout.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.