Table 1 A fourteen-year federally-funded program of research to understand primary care practice change

Direct Observation of Primary Care (DOPC)

NCI

R01 CA60862

(PI, Stange)

1994–1997

Cross-sectional descriptive study of 4454 patient visits to 138 physicians from 84 practices in Ohio using surveys, chart audits and direct observation of visits

Prevention and Competing Demands in Primary Care (P & CD)

AHRQ

R01 HS08776

(PI, Crabtree)

1996–1999

Ethnographic comparative case studies of 18 practices in Nebraska using participant observation and depth and key informant interviews

Study To Enhance Prevention by Understanding Practice (STEP-UP)

NCI

2R01 CA60862

(PI, Stange)

1999–2000

Group randomized intervention trial of 80 Ohio practices using a facilitator to help practices select and tailor strategies from a cancer prevention toolkit.

Insights from Multimethod Practice Assessment of Change over Time (IMPACT)

NCI

3R01 CA60862

(PI, Stange)

2001–2004

Secondary data of STEP-UP to understand why some practices made substantial changes and others none, and to create a theoretical change model.

Using Learning Teams for Reflective Adaptation (ULTRA)

NHLBI

R01 HL70800

(PI, Crabtree)

2002–2008

Group randomized intervention trial of 60 NJ and PA practices using the IMPACT model and a facilitated a "Reflective Adaptive Process" (RAP) to enhance relationships and cardiovascular disease care.