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Introduction

Geographic, racial, and ethnic disparities in health and health care and the need for health care systems to accommodate increasingly diverse patient populations are a matter of national importance. As solutions are sought, it becomes more important to involve the areas and groups most affected by the disparities. They need to be empowered and equipped with the skills, tools, and funding to contribute to the development of research-based solutions. The Agency for Healthcare Research and Quality (AHRQ) sponsored the development of this guide to help research organizations and institutions improve their health services research capacity and competitiveness for grant and contract funding.

Health Services Research: A Definition

Health services research is a “multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to health care, the quality and cost of health care, and ultimately, our health and well-being.”ⁱ

Applied health services research provides data, evidence, and tools to make health care affordable, safe, effective, equitable, accessible, and patient-centered. For example, products stemming from health services research serve to enable providers and patients to make better decisions. They also can be used to design health care benefits and inform policy.

Health services researchers come from a variety of disciplinary backgrounds. The workforce includes an array of professionals and disciplinary perspectives, including fields such as:

• Medicine, nursing, dentistry, pharmacy, and allied health.
• Social and behavioral sciences.
• Epidemiology and biostatistics.
• Engineering.
• Health care policy, research, administration, and management.

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Background and Purpose of the Guide

AHRQ's mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.^a AHRQ achieves this mission by supporting the conduct, dissemination, and use of high-quality health services research and by supporting the development of researchers and research infrastructure.

AHRQ has supported health services research infrastructure development through two programs — the Minority Research Infrastructure Support Program (MRISP) and the Building Research Infrastructure and Capacity (BRIC) Program. These programs focus on improving the research capacity and competitiveness of institutions that predominantly serve racial/ethnic minorities or are located in geographic areas that have had historically low levels of AHRQ funding. Both programs were launched in FY 2001.

In 2006, AHRQ funded an evaluation of the programs by the American Institutes for Research (AIR). The evaluation was conducted to determine the extent to which, and ways in which, program grantees had strengthened their institutional research infrastructures and enhanced the capabilities of their individual faculty and staff members in relation to their ability to undertake health services research. After completing this research, AHRQ and AIR developed this guide to synthesize and share what has been learned. Our intent is to help organizations and institutions develop and enhance their ability to plan and conduct health services research and obtain funding for their research.

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Intended Audience

This guide is intended to meet the needs of a variety of organizations and institutions seeking to build their health services research capacity, including both public- and private-sector institutions. It can serve as a resource for organizations with limited experience conducting health services research and organizations that have some experience in the field but are seeking to further develop or strengthen their infrastructure. In particular, this guide may serve as a resource for:

• Administrators and directors of organizations that would like to develop or expand their organization's health services research program.
• Department leaders and program directors with limited research experience interested in creating or expanding a health services research program for their students or staff.
• Individual researchers seeking to create a program or collaborative group of health services researchers.

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Organization of the Guide

This guide provides a user-friendly, step-by-step approach to planning, implementing, and sustaining a health services research infrastructure. These steps do not have to be taken in sequential order.

The guide describes six steps for establishing an effective, sustainable research infrastructure (Figure 1).

1. Conduct an assessment.
2. Cultivate a supportive research culture.
3. Plan for infrastructure support.
4. Communicate with funding agencies and other researchers and share findings.
5. Evaluate the infrastructure.
6. Plan for sustainability.

Figure 1. Layout of the guide

Each step concludes with a section entitled “Maximizing Success.” This section describes strategies for overcoming those challenges that organizations faced when implementing that step.

^a For more information about the Agency for Healthcare Research and Quality, visit the Agency's Web site at www.ahrq.gov.

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