Bringing Research Into the Real World of Health Care

I look forward to next week’s NIH Pragmatic Trials Collaboratory virtual 2-day workshop: “Going From Zero to 100: Generating Evidence Through Pragmatic Research To Address Pressing Healthcare Issues,” taking place on July 15 and 16. 

I am thrilled that the director of the National Institutes of Health (NIH), Monica M. Bertagnolli, M.D., will deliver the workshop’s keynote address, speaking on a topic she is passionate about: bringing the benefits of medical research to the people who need it the most. She will talk about an exciting new NIH initiative, Communities Advancing Research Equity for Health™ (CARE for Health™), which I am pleased to co-chair with Joni Rutter, Ph.D., director of the National Center for Advancing Translational Sciences, and Debara Tucci, M.D., M.S., M.B.A., director of the National Institute on Deafness and Other Communication Disorders.

CARE for Health zeroes in on a long-standing challenge—bringing clinical research opportunities to primary care settings. I know these challenges personally. In the 1980s, I was a primary care provider in an underserved and mostly Spanish-speaking community. Patients were charged on a sliding scale, though we rarely had patients who didn’t proudly pay the $10 basic cost. The experience gave me an appreciation of just how difficult it is to deliver health care to people who face an array of embedded hurdles, such as language barriers, financial stresses, transportation challenges, and the inability to take time away from work. For the care team, our limited resources and heavy caseload meant that we were always struggling to keep up with double-booked appointments and stacks of phone messages, with little opportunity to spend more than a few minutes with each patient. 

In primary care clinics that struggle to deliver the most basic and vital care, the thought of participating in a clinical trial can sound simply ridiculous—adding burden to an already overstretched staff. But it is precisely in these types of settings where we need research to happen, and that’s why the CARE for Health program is so important. Unless research happens in the actual setting where care is delivered, we will not learn how best to optimize that care—pure and simple. It is therefore vital that we remove barriers to research participation and bring scientific studies into primary care settings that serve underrepresented communities and those most impacted by health disparities. A shared goal of CARE for Health and the NIH Pragmatic Trials Collaboratory is to seamlessly weave innovative and rigorous science into routine clinical care, so that research is sustainable and research findings can be used to change clinical practice for the better. 

By expanding the capacity to bring research into primary care settings specifically, we’ll add an important piece of infrastructure for better understanding of whole person health. Primary care settings offer a unique vantage point of the patient experience across the continuum of health, prevention, illness, recovery, and health restoration. Driven by Dr. Bertagnolli’s passion for meeting people in diverse health settings, the CARE for Health program is poised to offer a more holistic understanding of how interventions can work best in the real world for individuals, families, and communities. 

I hope all those interested in learning more about pragmatic trials will register for the workshop. Its rich discussions will help equip the research community to contribute to an important and growing body of knowledge drawn from the real world.