Bursaries, writing grants and fellowships: a strategy to develop research capacity in primary health care

Abstract

Background: General practitioners and other primary health care professionals are often the first point of contact for patients requiring health care. Identifying, understanding and linking current evidence to best practice can be challenging and requires at least a basic understanding of research principles and methodologies. However, not all primary health care professionals are trained in research or have research experience. With the aim of enhancing research skills and developing a research culture in primary health care, University Departments of General Practice and Rural Health have been supported since 2000 by the Australian Government funded 'Primary Health Care Research Evaluation and Development (PHCRED) Strategy'. A small grant funding scheme to support primary health care practitioners was implemented through the PHCRED program at Flinders University in South Australia between 2002 and 2005. The scheme incorporated academic mentors and three types of funding support: bursaries, writing grants and research fellowships. This article describes outcomes of the funding scheme and contributes to the debate surrounding the effectiveness of funding schemes as a means of building research capacity.

Methods: Funding recipients who had completed their research were invited to participate in a semi-structured 40-minute telephone interview. Feedback was sought on acquisition of research skills, publication outcomes, development of research capacity, confidence and interest in research, and perception of research. Data were also collected on demographics, research topics, and time needed to complete planned activities.

Results: The funding scheme supported 24 bursaries, 11 writing grants, and three research fellows. Nearly half (47%) of all grant recipients were allied health professionals, followed by general practitioners (21%). The majority (70%) were novice and early career researchers. Eighty-nine percent of the grant recipients were interviewed. Capacity, confidence, and level of research skills in ten core areas were generally considered to have improved as a result of the award. More than half (53%) had presented their research and 32% had published or submitted an article in a peer-reviewed journal.

Conclusion: A small grant and mentoring scheme through a University Department can effectively enhance research skills, confidence, output, and interest in research of primary health care practitioners.

Figure 1

Grant holders' professions and research topic areas. The graph provides an overview of all Flinders PHCRED funding holders' (n = 38) professions (yellow) and research topic areas (blue) investigated between 2002 and 2005. Nearly half of the funding holders were allied health professionals (47%), followed by 21% of general practitioners, and other primary health care professionals. Research projects undertaken covered general practice topics (42%), and allied health topics (34%) including nutrition and mental health.

Figure 2

Main outcomes of grant activities. The main outcomes of all bursary holders' (orange, n = 24), writing grant holders' (green, n = 11), and research fellows' (purple, n = 3) research projects are summarised. A variety of study designs were supported by the bursaries including a pilot randomised controlled trial, a retrospective case study, focus group research, questionnaire and interview surveys, literature reviews, systematic reviews, and grant applications. Most bursary holders disseminated their findings in a comprehensive report (n = 7), or submitted a manuscript for publication to a peer-reviewed journal (total n = 6: study + publication (n = 4), systematic reviews (n = 2)). Two-thirds (n = 7) of writing grant holders achieved the main purpose of the writing grant, namely the preparation of a manuscript for submission to a peer-reviewed journal. At time of the interview, 2 of the 7 writing grant articles were under review and one paper had been published. All research fellows (n = 3) planned, conducted, analysed their research project. Two fellows had prepared at least one manuscript for peer-reviewed publication and one fellow applied for a PhD scholarship at the end of their positions (0.2–0.5 FTE).

Figure 3

Median research experience PRIOR and AFTER grant activity, a) of all surveyed funding recipients (n = 34), b) of bursary holders (n = 21), c) of writing grant holders (n = 11), d) of research fellows (n = 3). The 'research spider' [7, 10] was used to assess grant holders' research experience before (red) and after (blue) the supported research activity. The level of experience was measured using a five point scale ranging from 1 (no experience) to 5 (very experienced). The median research skill levels of all surveyed funding recipients (n = 34) increased for 9 out 10 skill areas (a). Research skill development by category of grant funding is shown for bursary holders (b), writing grant holders (c), and research fellows (d). Writing skills increased by up to 2 points in all categories.

Figure 4

Impact of grant activity on funding holders' capacity, confidence and interest in pursuing research. Median impact scores of the supported research activities on participants' capacity, confidence and interest are shown by type of funding, writing grants (green), bursaries (orange), and researcher fellows (purple). The level of impact was measured using a five point scale ranging from 1 (no impact) to 5 (substantial impact). Median impact levels correlated directly to type of funding across all areas, with the writing grants' ($500) impact rating lowest, bursaries ($5,000) in-between, and research fellow positions (0.2–0.5 FTE over 1 year) rating highest. All grant holders indicated that the funding scheme had high impact on their interest to pursue research in the future (median = 4 ± 1.5).

Figure 5

Time span for completion of bursary and writing grant activities. Time taken from award of the bursaries (orange) and writing grants (green) to completion of the funded activity are summarised for all of Flinders PHCRED bursary and writing grant holders (n = 35) supported between 2002 and 2005. Overall, the majority of bursary holders (84%) and writing grant holders (82%) completed their projects within a two year time frame.