Barriers and solutions to developing and maintaining research networks during a pandemic: An example from the iELEVATE perinatal network

Abstract

Introduction: To improve maternal health outcomes, increased diversity is needed among pregnant people in research studies and community surveillance. To expand the pool, we sought to develop a network encompassing academic and community obstetrics clinics. Typical challenges in developing a network include site identification, contracting, onboarding sites, staff engagement, participant recruitment, funding, and institutional review board approvals. While not insurmountable, these challenges became magnified as we built a research network during a global pandemic. Our objective is to describe the framework utilized to resolve pandemic-related issues.

Methods: We developed a framework for site-specific adaptation of the generalized study protocol. Twice monthly video meetings were held between the lead academic sites to identify local challenges and to generate ideas for solutions. We identified site and participant recruitment challenges and then implemented solutions tailored to the local workflow. These solutions included the use of an electronic consent and videoconferences with local clinic leadership and staff. The processes for network development and maintenance changed to address issues related to the COVID-19 pandemic. However, aspects of the sample processing/storage and data collection elements were held constant between sites.

Results: Adapting our consenting approach enabled maintaining study enrollment during the pandemic. The pandemic amplified issues related to contracting, onboarding, and IRB approval. Maintaining continuity in sample management and clinical data collection allowed for pooling of information between sites.

Conclusions: Adaptability is key to maintaining network sites. Rapidly changing guidelines for beginning and continuing research during the pandemic required frequent intra- and inter-institutional communication to navigate.

Keywords: COVID-19; Clinical research; pandemic; research network; sample collection.

Fig. 1.

Academic and community practices comprise the iELEVATE perinatal research network. The University of Iowa, University of Minnesota, and the University of Alabama at Birmingham (purple) originated the network and recruited area community practice sites (blue) to join the network to provide greater diversity and inclusion of pregnant patients.

Fig. 2.

Timeline of institution responses to pandemic. Academic and community practice sites had varying responses to the pandemic in regard to allowing research to proceed.

Fig. 3.

Divergence in COVID response. The differences in COVID protocols between institutions resulted in changes to recruitment strategies in order for continued progress to be made.