Integration of improvement and implementation science in practice-based research networks: a longitudinal, comparative case study
Open accessAbstract
Background Implementation science (IS) and quality improvement (QI) inhabit distinct areas of scholarly literature, but are often blended in practice. Because practice-based research networks (PBRNs) draw from both traditions, their experience could inform opportunities for strategic IS-QI alignment. Objective To systematically examine IS, QI, and IS/QI projects conducted within a PBRN over time to identify similarities, differences, and synergies. Design Longitudinal, comparative case study of projects conducted in the Oregon Rural Practice-based Research Network (ORPRN) from January 2007 to January 2019. Approach We reviewed documents and conducted staff interviews. We classified projects as IS, QI, IS/QI, or other using established criteria. We abstracted project details (e.g., objective, setting, theoretical framework) and used qualitative synthesis to compare projects by classification and to identify the contributions of IS and QI within the same project. Key results Almost 30% (26/99) of ORPRN's projects included IS or QI elements; 54% (14/26) were classified as IS/QI. All 26 projects used an evidence-based intervention and shared many similarities in relation to objective and setting. Over half of the IS and IS/QI projects used randomized designs and theoretical frameworks, while no QI projects did. Projects displayed an upward trend in complexity over time. Project used a similar number of practice change strategies; however, projects classified as IS predominantly employed education/training while all IS/QI and most QI projects used practice facilitation. Projects including IS/QI elements demonstrated the following contributions: QI provides the mechanism by which the principles of IS are operationalized in order to support local practice change and IS in turn provides theories to inform implementation and evaluation to produce generalizable knowledge. Conclusions Our review of projects conducted over a 12-year period in one PBRN demonstrates key synergies for IS and QI. Strategic alignment of IS/QI within projects may help improve care quality and bridge the research-practice gap.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., Proctor, E. K., & Kirchner, J. E. (2015) · Implementation Science · doi:10.1186/s13012-015-0209-1 · Cited by 4,963 · see citing works
Making sense of implementation theories, models and frameworks
Nilsen, P. (2015) · Implementation Science · doi:10.1186/s13012-015-0242-0 · Cited by 4,447 · see citing works
Harvey, G., & Kitson, A. (2015) · Implementation Science · doi:10.1186/s13012-016-0398-2 · Cited by 1,271 · see citing works
Practice-based research--“Blue Highways” on the NIH roadmap
Westfall, J. M., Mold, J., & Fagnan, L. (2007) · JAMA · doi:10.1001/jama.297.4.403 · Cited by 1,209 · see citing works
A systematic review of empirical studies examining mechanisms of implementation in health
Lewis, C. C., Boyd, M. R., Walsh-Bailey, C., Lyon, A. R., Beidas, R., Mittman, B., Aarons, G. A., Weiner, B. J., & Chambers, D. A. (2020) · Implementation Science · doi:10.1186/s13012-020-00983-3 · Cited by 363 · see citing works
Green, L. A., & Hickner, J. (2006) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.19.1.1 · Cited by 187 · cited 2× · see citing works
“Study topic Preventive services* 9 (35) 2 (50) 5 (63) 2 (14) Care delivery models 9 (35) 1 (25) 2 (25) 6 (43) Specific disease 3 (12) 0 (0) 0 (0) 3 (21) Geriatric topics 3 (12) 0 (0) 0 (0) 3 (21) Medication management 2 (8) 1 (25) 1 (13) 0 (0) Study length—mean (range) 3.”
Hickner, J., & Green, L. A. (2015) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2015.05.150227 · Cited by 42 · see citing works
Riley-Behringer, M., Davis, M. M., Werner, J. J., Fagnan, L. J., & Stange, K. C. (2017) · Journal of Clinical and Translational Science · doi:10.1017/cts.2017.305 · Cited by 12 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Structure, function, and productivity from the National Dental Practice-Based Research Network.
Gilbert, G. H., Fellows, J. L., Allareddy, V., Cochran, D. L., Cunha-Cruz, J., Gordan, V. V., McBurnie, M. A., Meyerowitz, C., Mungia, R., Rindal, D. B., et al. (2022) · Journal of Clinical and Translational Science · doi:10.1017/cts.2022.421 · Cited by 54 · see citing works
“Practice-based research networks (PBRNs) offer unique advantages to clinical research and quality improvement [1-6], primarily because they bring practice-relevant topics onto the research agenda and are conducted in “real-world,” nonacademic clinical settings where almost all of the population receives its health car…”
BackgroundDavis, M. M., Coury, J., Larson, J. H., Gunn, R., Towey, E. G., Ketelhut, A., Patzel, M., Ramsey, K., & Coronado, G. D. (2022) · The Journal of Rural Health · doi:10.1111/jrh.12685 · Cited by 23 · see citing works
Self-citationData Challenges in Identifying Patients Due for Colorectal Cancer Screening in Rural Clinics
Petrik, A., Coury, J. K., Larson, J., Badicke, B., Coronado, G., & Davis, M. M. (2023) · Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2022.220216r1 · Cited by 14 · see citing works
Self-citationSingh, M. A., Sanchez, V., Kenzie, E. S., Sullivan, E., McCormack, J. L., Larson, J. H., Robbins, A., Weekley, T., Hatch, B., Dickinson, C., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0269635 · Cited by 12 · see citing works
Self-citationKenzie, E. S., Wakeland, W. W., Jetter, A. J., Lich, K., Seater, M., & Davis, M. M. (2024) · Systems research and behavioral science · doi:10.1002/sres.3030 · Cited by 10 · see citing works
Self-citationDavis, M. M., Coury, J., Sanchez, V., Kenzie, E. S., Larson, J. H., Barnes, C., McCormack, J. L., Durr, R. L., Weekley, T., Robbins, A., et al. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11870-8 · Cited by 10 · see citing works
“ORPRN is an established practice-based research network [45, 46].”
Self-citationCoury, J. K., Coronado, G. D., Myers, E., Patzel, M., Thompson, J. H., Whidden-Rivera, C., & Davis, M. M. (2024) · Progress in Community Health Partnerships Research Education and Action · doi:10.1353/cpr.2024.a922329 · Cited by 6
“We also ask about the best way to deliver outreach alerts or reminders to this population and how to encourage CRC screening in light of COVID-19.”
BackgroundSelf-citationMorgan, A., Hendricks, M. A., Ibrahimi, S. E., Hallvik, S., Hatch, B., Dickinson, C., Wright, D., & Fischer, M. (2021) · Drugs in Context · doi:10.7573/dic.2021-7-5 · Cited by 6 · see citing works
Self-citationAn introduction to implementation science in rehabilitation medicine
Roseen, E. J., Welch, S. A., Stout, N. L., Bean, J. F., Friedly, J. L., & Mittman, B. S. (2025) · PM&R · doi:10.1002/pmrj.70040 · Cited by 5 · see citing works
“104,105 110 – 113 Learning health systems, which routinely gather information on patient reported outcomes in rehabilitative medicine settings, can also facilitate collaborations between implementation and improvement scientists that result in rapid, efficient implementation of evidence-based…”
Draper-Rodi, J., Fawkes, C., & Bailey, D. (2025) · Scientific Reports · doi:10.1038/s41598-025-11527-4 · Cited by 4 · see citing works
“They are a useful tool to invite clinicians in day-to-day practice to contribute to national research agenda and improvement initiatives 9,10 .”
Kenzie, E. S., Campbell, J., Seater, M., Singh, M. A., Robbins, A., & Davis, M. M. (2025) · Journal of Clinical and Translational Science · doi:10.1017/cts.2025.26 · Cited by 4
“Established in 2002, the Oregon Rural Practice-based Research Network (ORPRN) is a network of over 360 primary care clinics dedicated to practice-based and community research [13].”
Self-citationHatch, B., Kenzie, E. S., Ramalingam, N. S., Sullivan, E., Barnes, C., Elder, N., & Davis, M. M. (2023) · PLoS ONE · doi:10.1371/journal.pone.0287553 · Cited by 4 · see citing works
“ORPRN is an established practice-based research network of 296 clinics (nearly half of Oregon primary care clinics) [33] that conducts research, education and quality improvement projects with clinics and communities across the state in both rural and urban areas [34, 35].”
BackgroundSelf-citationDavis, M. M., Coury, J., Nagykaldi, Z., Coa, K. I., Badicke, B., Quiñones, A. R., Michaels, L., Krist, A., Bierman, A. S., & Dorr, D. (2026) · Learning Health Systems · doi:10.1002/lrh2.70073 · Cited by 2 · see citing works
Self-citationBarnes, C., Kenzie, E. S., Thomas, T., Weekley, T., Sánchez, V., Hatch, B., & Davis, M. N. (2026) · Implementation Science Communications · doi:10.1186/s43058-026-00895-1 · Cited by 2 · see citing works
“As discussed in prior research, practices from both quality improvement and implementation science could be useful for operational-izing strategies to fit local contexts [20, 30, 31].”
Self-citationTierney-Hendricks, C., Schliep, M. E., Sun, M., Gochyyev, P., & Carter, C. (2024) · PM & R : the journal of injury, function, and rehabilitation · doi:10.1002/pmrj.13250 · Cited by 2 · see citing works
“20 In 2017, an inter-professional group of OT and SLP clinicians established a standardized assessment protocol for cognitive rehabilitation in outpatient care.”
Badicke, B., Coury, J. K., Myers, E., Petrik, A., Larson, J. H., Bhadra, S., Coronado, G. D., & Davis, M. M. (2024) · Journal of Primary Care & Community Health · doi:10.1177/21501319241259915 · Cited by 2 · see citing works
Self-citationAdvancing Oral Health through Practice-Based Research
Feldman, C., Fredericks-Younger, J., Fine, D., Markowitz, K., & Sabato, E. H. (2023) · The Journal of the American Dental Association (1939) · doi:10.1016/j.adaj.2023.03.006 · Cited by 2 · see citing works
Kenzie, E. S., Seater, M., Barnes, C., Weekley, T., Sánchez, V., Coury, J., Hatch, B., & Davis, M. M. (2026) · Implementation Science Communications · doi:10.1186/s43058-026-00909-y · Cited by 1 · see citing works
“This approach could also be expanded to examine adaptation of implementation strategies and refine our understanding of implementation strategies as bundles of activities versus individual behaviors [39].”
Self-citationXie, C., Franklin, P. D., Walunas, T. L., & Beidas, R. (2025) · Learning Health Systems · doi:10.1002/lrh2.70043 · Cited by 1 · see citing works
Handyside, L., Cameron, J., & Freeman, C. R. (2025) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2025.10.004 · Cited by 1 · see citing works
Bailey, D., Fawkes, C., & Draper-Rodi, J. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-095191 · Cited by 1 · see citing works
Bailey, D., Fawkes, C., Carnes, D., & Draper-Rodi, J. (2024) · International Journal of Osteopathic Medicine · doi:10.1016/j.ijosm.2024.100742 · Cited by 1 · see citing works
Golden, S. E., Young, A., Sun, C. J., Mayeda, M., Katz, D. A., Weg, M. V. V., Gundle, K. R., & Bailey, S. R. (2023) · Journal of Smoking Cessation · doi:10.1155/2023/3399001 · Cited by 1
“We recruited non-VA PCPs through email contact by colleagues at the Oregon Rural Practice-based Research Network, a practice-based research network that conducts research and quality improvement projects with clinics across the state [12].”
MethodCostea, V.-A., Young, A., Byrnes, A., Eames, S., Meloncelli, N. J. L., Eriksson, L., Bäck, A., Hasson, H., Mudge, A., & Bergström, A. (2026) · Implementation Research and Practice · doi:10.1177/26334895261499601
Arizmendi-Barrera, K. A., Arrieta, J., Tinoco, T. N., Chahal, P., & Barker, P. (2026) · BMJ Quality & Safety · doi:10.1136/bmjqs-2025-019903
“17 In a 12 year review of 99 projects of a large practice-based research network, only 30% included elements of both implementation and improvement science.”
Hatch, B. A., Valenzuela, S., Dickinson, C., Barnes, C., Ramalingam, N., Marino, M., Fagnan, L. J., Goodman, S., & Carney, P. A. (2025) · BMC Primary Care · doi:10.1186/s12875-025-03076-6
“During the intervention phase of the project, clinics were recruited from the Oregon Rural Practice-based Research Network (ORPRN), a practice-based research network established in 2002 open to all Oregon primary care clinics [23].”
Self-citationDoolin, J. W., Dias, S. L., Cronin, C. M., Dizon, D. S., Hazard-Jenkins, H. W., Bian, J. J., Wong, S. L., Schrag, D., Paudel, R., Osarogiagbon, R. U., et al. (2025) · Journal for Healthcare Quality · doi:10.1097/jhq.0000000000000478
Morgan-Barsamian, A. R., Ibrahimi, S. E., Hendricks, M. A., Blalock, K. L., Stack, E., Wyss, R., Hatch, B. A., Sanchez, V., & Fischer, M. A. (2025) · Journal of Primary Care & Community Health · doi:10.1177/21501319251375393
- Authors
- Davis, M. M., Gunn, R., Kenzie, E., Dickinson, C., Conway, C., Chau, A., Michaels, L., Brantley, S., Check, D. K., & Elder, N.
- Affiliations
- Oregon Health & Science University (US)
- Duke University (US)
- Corresponding author
- Davis, Melinda M.
- ORCID
- Venue
- Journal of General Internal Medicine
- Published
- 2021-04-14
- Volume
- 36
- Issue
- 6
- Pages
- 1503-1513
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC8175491
- OpenAlex
- W3154145957
- Cited by
- 34
- References
- 0
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 8 · 2023: 6 · 2022: 4 · 2021: 2
- FWCI
- 5.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Gordon and Betty Moore Foundation
- Informed Medical Decisions Foundation
- Patient-Centered Outcomes Research Institute
- Agency for Healthcare Research and Quality (R18 HS027080)
- National Institute on Disability and Rehabilitation Research
- National Cancer Institute (K07CA211971)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Keywords
- implementation science, quality improvement, practice-based research networks, rural primary care, research-practice gap, practice facilitation, education and training, evidence-based interventions, implementation theory
- MeSH terms
- Implementation Science, Humans, Oregon, Quality of Health Care, Quality Improvement
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
