Introduction to ACORN

iStock_000027805606_FullThe Australian Chiropractic Research Network (ACORN) Project is the largest, most ambitious research initiative of its type to be undertaken worldwide. ACORN invites all Australian chiropractors to partner in the production of practice-relevant knowledge by responding to the first national practitioner questionnaire and also by consenting to be listed on the ACORN Practice-Based Research Network (PBRN) practitioner database with a view to potentially participating in future ACORN sub-studies.

We are proud and pleased to announce that the ACORN Project has been approved by the leading international agency for PBRN scholarship – the US-based Agency for Healthcare Research and Quality (AHRQ) – as a registered PBRN Study.

This is an important moment for the Australian chiropractic profession in terms of both evidence-base and research development and all chiropractors and interested researchers have an opportunity to be at the heart of positive change through contributing to the ACORN project. The ACORN PBRN, funded by the Chiropractors’ Association of Australia, is independently designed, led and conducted by an experienced team of critical health researchers at the Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney. ACORN is a nationwide project undertaken with the full profession in mind. The recruitment and involvement of all practising chiropractors across Australia and the collaboration of all interested researchers in Australia and internationally is actively encouraged.

 

We encourage all practitioners, researchers and others with an interest in chiropractic-related enquiry to check out the pages of this website. While initial recruitment of registered chiropractors is now closed (please see news item on this website for update on the impressive response rate achieved), there will be ongoing opportunity for any chiropractors who have not participated to date to join the ACORN Project in the future. This website will be regularly updated with news, project developments and other resources. Please direct any enquiries regarding future recruitment to Professor Jon Adams (email: jon.adams@uts.edu.au).

ARCCIM: A World-Leading Public Health and Health Services Research Centre

Click on the video below for a brief introduction to ARCCIM by Professor Jon Adams

Click here to visit the official UTS: ARCCIM webpage for details of the full program and initiatives led and conducted by this world-leading research centre.

The Aims of the ACORN PBRN

ACORN has a number of related aims, these are to:

  • Produce extensive, quality research output (evidence-base) focused upon chiropractic care (including a focus upon efficacy, effectiveness, safety and affordability);
  • Establish a sustainable, national research resource (national database) for chiropractic in Australia;
  • Ensure a closer relationship between research output and the needs of chiropractors and patients;
  • Develop extensive partnerships and collaborations across the chiropractic research and practice community and beyond;
  • Develop national research capacity in chiropractic (especially via facilitating PhDs);
  • Provide a solid platform for future applications for external funding.

One of the key strengths of the ACORN project is its inclusive and accommodating acorndesign. At the heart of the ACORN project is an ability to facilitate many collaborations between and across researchers and practitioners as well as the employment of a wide range of research approaches and methods to answer a diverse range of related yet distinct research questions including:

      • How cost-efficient is chiropractic? How much do patients spend on their chiropractic care (alongside other care)? And to what extent is affordability a factor in patient decision-making regarding chiropractic?
      • How effective is chiropractic and what range of benefits do patients gain from their chiropractic care?
      • What is the safety and risk of chiropractic care?
      • What influences patient decision-making regarding chiropractic consultations and follow-up care?

A Brief Overview of the ACORN PBRN Design

The Agency for Healthcare Research and Quality (AHRQ) defines a practice-based research network (PBRN) as a group with at least 15 ambulatory practices and/or 15 clinicians devoted principally to the primary care of patients, affiliated with each other (and often with an academic or professional organization) in order to investigate questions related to community based practice.A PBRN helps address issues of disconnect between research activity and practice reality sometimes experienced in health care research. A PBRN such as the ACORN Project is designed to ensure the research questions and analyses produced are grounded in and therefore are sensitive to the realities of daily routine care.

The defining characteristics of a PBRN include:

        •  A mission and statement of purpose including an ongoing commitment to research;
        • Channels for communication among network participants;
        • A Director/Chief Investigator with responsibility for administration of the network and at least one support staff;
        • An advisory board that solicits input from communities of patients/practitioners served by the PBRN.

The ACORN Project is built upon a Sub-Study Model of PBRN design whereby initial recruitment and data collection focuses upon the practitioner population. The PBRN practitioner database then acts as a sustainable resource providing a platform (national in the case of ACORN) for further research investigations. This Sub-Study Model provides excellent flexibility helping facilitate coordinated ongoing research and capacity building.

A PBRN design such as that employed by the ACORN project is ideally matched to the current research needs of Australian chiropractic. In particular, the PBRN design of ACORN affords a  broad focus essential to establishing a national, coordinated platform of evidence critical to informing further detailed, specific sub-studies. This is particularly important for Australian chiropractic given the current lack of information around daily care, clinical activity and other important issues. Significantly, such coordinated platform evidence is also vital to contextualising and strengthening the impact of clinically-focused investigations, effectively helping bridge the gap between findings from clinical trials and other related designs and the realities of practitioners’ everyday care.

acornThe broad research focus of a PBRN design allows the ACORN project to accommodate and address investigation of a vast number of issues important to chiropractors, the profession, patients and the Australian health care system more generally. The ACORN project design will accommodate both qualitative and quantitative research and examination of the efficacy, effectiveness, safety and cost evaluation of aspects of chiropractic.

PBRNs have been employed to help build an evidence-base in a number of health care fields around the world. Here we provide links to literature which will help explain this approach to research design.

Rindal D, Flottemesch T, Durand E, Godlevsky O, Schmidt A, Gilbert G, et al. Practice change toward better adherence to evidence-based treatment for early dental decay in the National Dental PBRN. Implementation Science 2014, 9:117.
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