The Research Environment and Reward Preferences of Primary Care Practitioners in the Shanghai General Practice Research Network: a Mixed Methods Study

Background Practice-based research networks (PBRN) enable collaborative primary care research. In China, since 2023, healthcare reforms emphasizing community-based primary care have spurred PBRN development. However, the research environment and incentives for primary care practitioners (PCPs) to belong to these networks remain under-explored. Objective This study investigates the research environment and support needed by PCPs in the Shanghai General Practice Research Network (SGPRN) to maximize PBRN development in China. Methods This study employed a mixed-methods explanatory sequential design. The quantitative component involved an online survey of 145 PCPs from the SGPRN, selected through purposive sampling, who expressed interest in research activities. The survey collected data on their background, research capabilities, research environment, and preferred incentives for participating in PBRN-organized research. Descriptive statistical analysis and the Kano Model were used to analyze and categorize the data. The qualitative component involved one focus group discussion and 21 semi-structured interviews with 24 PCPs from the survey sample, selected to validate and complement the quantitative findings. Interview data were analyzed iteratively using a qualitative descriptive approach. Quantitative and qualitative data were integrated through joint display and meta-synthesis. Results Most PCPs (84.83%) reported a supportive research environment, with 68.97% integrating research with clinical practice. However, only 42.75% had sufficient research time, and 50.34% access to collaborators. Qualitative findings revealed limited professional support and fragmented time as key barriers. Incentives required included opportunities to acquire research skills, leading personally relevant studies, securing primary authorship, and accessing shared data, all contingent on transparent collaboration and trust. All these preferences aligned with institutional performance-driven policies. Conclusion The SGPRN research environment is currently neutral to slightly favorable, strongly driven by performance-oriented policies. PCPs participate in PBRN research primarily to enhance their research expertise and achieve publication-driven career advancement. Despite these motivations, China's PBRN need to draw on international strategies, enhancing research training, fostering collaborative platforms, and prioritizing practice-oriented, high-quality research to improve patient care, while aligning with local general practitioners' professional aspirations for advancing the discipline and clinical practice, to reconcile and overcome the limitations of output-focused, impractical research policies.