A Review of 50 Years of International Literature on the External Environment of Building Practice-Based Research Networks (PBRNs).

Background: This article is the second part of a novel scoping review of the international literature that presents those key elements that underpin the foundational activities of Practice-Based Research Networks (PBRNs). In this article, we examine the external environment and the intersection between the internal and external environment domains.

Methods: We searched electronic databases, including MEDLINE (PubMed), OVID, CINAHL (EBSCOhost), Scopus, and SAGE for publications in English between 1/1/1965 and 9/15/2021. We also searched reference lists of selected publications, gray literature and other online sources. Inductive thematic analysis was applied to construct the main themes, subthemes, and key elements from a scoping review covering up to 10 years of reported experiences of each of the 98 PBRNs that met the inclusion criteria.

Results: In this study we present 2 main themes: "Stakeholders at the Intersection Between the Internal and External Environment" and the "External Environment." The first is linked to the subthemes "Patient and Community Stakeholders" and "Other Healthcare Stakeholders" and 11 key elements. The second relates to the subthemes "National Health System," "Institutional/Governmental Support, National/State Policy and Regulatory Environment" "Professional Organizations," "Leveraging Previous Research and PBRN Experience and Interacting with Other Networks" and "Health Information Technology (HIT) and HIT Vendors" and 21 key elements.

Conclusions: Despite variations in geography, time, and healthcare context, PBRNs shared many similar developmental experiences over the past 5 decades. Their external environment contributed significantly to their developmental trajectories during the first 10 years of their operation.