Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
Mudd, L.M., X. Pham, S. Nechuta, Michael R. Elliott, James M. Lepkowski, N. Paneth, and C. Michigan Alliance Natl. 2008. "Prenatal care and delivery room staff attitudes toward research and the National Children's Study." Maternal and Child Health Journal, 12(6): 684-691.
Objectives The cooperation of healthcare personnel is essential for implementing clinical research, yet little is known about the willingness of staff to facilitate research. This study assessed attitudes of prenatal clinic and delivery room (DR) staff toward facilitation of research, with a particular focus on the National Children's Study (NCS). Methods Staff from seven sampled prenatal clinics (N = 82) and all three DRs in Kent County, MI (N = 169) completed anonymous surveys assessing willingness to recruit patients (clinic) or collect biological specimens (DR), desired incentives, and barriers to research in general and the NCS specifically. Results Clinic staff included 36 office workers, 29 nurses, 11 medical assistants and 6 physicians/physician assistants. DR staff included 127 nurses, 19 support staff, 11 physicians and 10 technicians. Clinic staff would hand out brochures (72%) and describe studies (65%), but only 44% wanted outside research staff to recruit patients. Non-White staff were 4.1 times more likely (95% CI. 1.2-14.1) to permit outside staff to recruit. DR staff would collect placentas (84%) and cord blood (77%), and preferred DR staff to perform the collections. In both settings, financial incentives were not required or were modest. Lack of time was the most reported research barrier, followed by patient flow and lack of space. A small fraction of healthcare workers reported refusal to facilitate research tasks. Conclusions Careful planning of research with all clinic and DR staff will be necessary for successful execution of the NCS or other large-scale clinical research studies.