Clinical & Health Services Research

Research to study the health characteristics and clinical manifestations of health conditions among populations that experience health disparities. Furthermore, this type of research pursues the identification of the most effective methods to screen, diagnose, treat, and/or manage health conditions, especially those associated with the highest rates of morbidity and mortality. The ultimate goal is to improve health/clinical outcomes and reduce health disparities within the health care context.

Population-Focused Clinical Research Within the Context of Health Care

Research to understand the health characteristics and the various population-specific clinical presentations and/or manifestations of health conditions and their complications, as well as their similarities and differences compared to other populations. Research examples include but are not limited to:

• Identifying appropriate screening or diagnostic criteria to determine disease risk based on clinical presentation of health conditions and their complications and other factors.
• Delineating tailored screening, diagnosis, and disease management methods or biomarkers based on the clinical presentation of health conditions and their complications across the life course.
• Evaluating screening and diagnostic thresholds and treatment response.

Health Disparities Within the Context of Health Care Settings

Research to understand and address etiologies of health disparities within the context of clinical care and health services. Research examples include but are not limited to studies that:

• Assess the effectiveness and implementation of evidence-based guidelines for screening, diagnosis, and clinical care for health conditions with high prevalence by age and sex along the life course, and for persons with multiple coexisting chronic conditions (including rural health care settings).
• Assess access and quality of care (including continuity of care), the timeliness and effectiveness of referral to specialty care, and/or the timeliness and effectiveness of emergency medical care response and the resulting health outcomes in low-income settings.
• Study the reduction of preventable visits to the emergency department, hospitalizations, and in-hospital complications and/or mortality.
• Study the relationship between specific quantifiable social determinants of health and clinical outcomes.
• Develop new or evaluate existing strategies to integrate genetics and/or genomics or social care into clinical practice.
• Study patient safety and adverse events.
  
   

Implementation and Dissemination Research in Health Care Settings

Research to: 

1. To understand challenges and facilitators to the adoption of and/or adherence to evidence-based practices, interventions, and policies within clinical system processes.
2. To develop and evaluate strategies to enhance successful adoption, adherence, feasibility, and sustainability of evidence-based practices, and solution-oriented interventions.

Research should incorporate elements of scalability and sustainability, particularly in low-resource clinical and community settings.

Research examples include but are not limited to studies that:

• Develop and evaluate strategies to improve adherence to evidence-based screening guidelines in low-resource clinical and community settings.
• Develop and evaluate the implementation of artificial intelligence algorithms, predicting the success of medical care within home-based settings, such as palliative or hospital-at-home.
• Develop and evaluate strategies to implement de-prescribing strategies within long-term care settings.

Research to understand how patient-clinician- health care system interactions affect clinical outcomes and health and health care disparities. Objectives are to:

1. Understand patient-clinician, clinician-clinician, clinician-health care system and/or patient-health care system engagement and shared decision-making.
2. Understand patient-clinician communication and/or the patient-clinician relationship.
3. Develop, test and evaluate interventions that enhance patient-clinician-health care system interactions and their impact on health/clinical outcomes and the reduction of health and health care disparities.
   
    

Patient-Clinician/Health Care System Communication

Research to:

1. Understand the nature and patterns of communication between patients and points of contact (clinical and non-clinical) at different levels within the health care system.
2. Develop interventions to facilitate effective bidirectional communication between patient and clinician, and shared decision-making between health care systems and patients and their families.
3. Evaluate the effect of interventions on quality of care and health/clinical outcomes, and on reducing health and health care disparities.

Research examples include but are not limited to studies that:

• Evaluate effective integration of patient communication preferences in clinical encounters.
• Assess how patients’ preferences for shared decision-making impacts communication with clinicians.
• Delineate pathways of communication for patients with disabilities that interfere with typical spoken communication.
  
   

Patient Engagement and/or Partnership in Care

Research within clinical settings or in the community offered in conjunction with clinical care to:

• Understand factors in clinical care that facilitate or challenge patient agency, engagement, and/or partnership across the continuum of care.
• Develop interventions to enhance agency, engagement, and/or partnership and evaluate the effect of these interventions on clinical outcomes and/or health and health care disparities.

Research examples include but are not limited studies to:

• Develop, test, and evaluate patient self-management interventions.
• Assess the impact of different health information technologies on health education interventions.
• Determine which patients are most likely to benefit from self-management or supported interventions.

Clinician-Clinician/Healthcare Team Interactions and Wellbeing

Research to:

• Understand care team structure and processes that impact care decisions, clinical care processes, access to quality care, and health and health care disparities.
• Develop and evaluate interventions to improve team-based care delivery and interprofessional competencies.
• Develop and evaluate interventions or address challenges in care coordination, communication, and collaboration.
• Understand and address the needs of the health care workforce, including workforce supply, distribution and competencies, as well as burnout, and resilience.

Research examples include but are not limited to studies that:

• Assess care team structure and processes that promote comprehensive care coordination, effective care transitions, and continuity of care.
• Develop and evaluate interventions to address clinician burnout.

Research to identify patterns of healthcare utilization, quality, and outcomes, as well as to identify social, environmental, and other determinants of health care utilization patterns and health/clinical outcomes and their contributions to health and health care disparities across the life course. 

This type of research may include longitudinal studies, natural experiments, and predictive or simulation modelling. The use of advanced analytics may include data mining, machine learning, and artificial intelligence. 

 

Research to understand how health care system factors influence health/clinical outcomes.

Health Care System Organization and Coordination

Research that examines how the structure and organization of health care delivery affects health service access, utilization, and clinical outcomes.

Research examples include but are not limited to studies that:

• Evaluate or design interventions involving different units or levels of health care coordination within a single health care system or across multiple health care systems.
• Assess the components of existing or newly designed health care models.
• Evaluate the effectiveness of various strategies to increase the supply of and access to clinicians in rural geographic areas.
• Develop and test coordination and collaboration tools and/or modalities using health information technology or telemedicine.

Interventions to Improve Quality of Care

Research to develop and/or evaluate interventions to advance health outcomes, improve access to care, quality of care, and clinical outcomes.

Research examples include but are not limited to studies that:

• Optimally define and assess the integration of specific and quantifiable social determinants of health in electronic health records or social care into clinical practice.
• Assess the impact of telemedicine on continuity of care, treatment adherence, and/or clinical outcomes.
• Assess the effects of in-home medical services (including pharmacy) on clinical outcomes.

Research to understand health care utilization and outcomes in association with services and treatment provided in community-based settings (outside of traditional health care systems) for populations that experience health and/or health care disparities. Studies that explore community health systems and/or academic partnerships. Studies that seek to understand the medical neighborhood and interactions between health care systems and community-based settings.

Health Care Delivery in Behavioral Health Settings

Research to understand and/or improve formal care for populations that experience health and/or health care disparities in community based mental health, drug treatment, and related settings, including clinics, private practice settings, residential treatment facilities, and detoxification centers.

Health Care Delivery in Long-Term, Palliative, or End-of-Life Care Settings

Research to understand or improve formal health care provided to populations that experience health and/or health care disparities in nursing homes, rehabilitation centers, assisted-living facilities, hospice settings, long-term care facilities, ambulatory or home-based palliative care, and in home-based long-term health care.

Health Care Delivery in Non-Healthcare Settings

Research to understand or improve formal health care provided to populations that experience health and/or health care disparities in school-based health centers, the workplace, and criminal justice settings. This does not include health promotion activities that may be delivered by non-medical personnel in those or other settings (for example, health fairs).