Frequently Asked Questions
What are the aims of the ACORN project?
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 (including NHMRC/ARC).
What type of research questions can ACORN address?
One of the key strengths of the ACORN project is its inclusive and accommodating design. 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.
ACORN will help to address many potential 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?
What is the design of the ACORN project?
ACORN is the first national-scale Practice-Based Research Network (PBRN) project to focus upon chiropractic care in Australia. ACORN will involve three distinct stages (over the initial three years of funding):
Stage One: Preparation, design and promotion of ACORN project
Stage Two: Practitioner database recruitment and distribution of questionnaire and establishment of the Expression of Interest (EOI) process for sub-studies.
Stage Three: Approval, delivery and publication of sub-studies, maintenance of practitioner database and preparation for external research grant funding.
More details regarding the design and stages of the ACORN project will be available here shortly.
What is a practice-based research network (PBRN)?
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.
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 with responsibility for administration of the network and at least one support staff;
- An advisory board that solicits input from communities of patients served by the PBRN clinicians.
Where can I learn more about Practice-Based Research Networks (PBRNs)?
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 a couple of papers 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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Relevant Questions for CPD:
1. The experience of PBRNs has been that less translation is required to apply research to practice when clinicians are involved in which three (3) processes?
2. What have successful PBRNs recognised as necessary in order for researchers and clinicians to choose to work together for an extended period of time?
3. With regards to the issue of translating research into practice what failure do the authors identify as attracting increasing concern over the last few years?
4. How long on average is it estimated to take to turn 14% of original research findings into changes in care that benefit patients?
5. What feature makes primary care PBRNs well positioned to address the need for more relevant research and for better ways to translate research into practice?
A more recent paper can provide further information by Green LA, Hickner J. A Short history of Primary Care Practice-based Research Networks: From Concept to Essential Research Laboratories. Journal of the American Board of Family Medicine 2006; 19(1): 1-10. Article freely accessible at:
Why is ACORN adopting a PBRN design and can this design include efficacy and safety research?
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.
The 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.
Why is ACORN so important?
As a PBRN project, ACORN contributes some very important benefits to the future of chiropractic in Australia. ACORN will facilitate a broad, coordinated program of research activity which not only addresses many research questions but also builds research capacity in chiropractic. ACORN will enable clinicians to directly and personally contribute to the creation of new knowledge and the advancement of clinical insights. It will also make it easier for researchers to conduct investigations by utilising the ACORN infrastructure and established database and network. Most importantly, findings from ACORN will also help improve the quality of care provided to patients.
How can chiropractors participate in the ACORN project?
The participation of practising chiropractors is essential to the delivery and success of the ACORN project. All practising chiropractors across Australia will be invited to participate in the ACORN practitioner survey and to join the ACORN practitioner database. An ACORN invitation pack comprising information sheet, questionnaire and database consent form will be sent (via email and post) to all practising chiropractors across Australia in early 2015. Completion and submission of the questionnaire and consent form can be via either email or mail (prepaid addressed envelope will be provided). The invitation to participate will remain open for a number of weeks and reminders to participate will be administered over this period.
What are the benefits for chiropractors who participate in the ACORN project?
If you are a chiropractor practising in Australia we urge you to participate in the ACORN project. Your recruitment and participation on both the practitioner survey and database are vital to the delivery and success of the project and your participation will help ensure:
the impact and validity of the ACORN project findings are maximised (the more chiropactors who participate, the greater the scientific rigour and impact of the project findings);
that your specific practice profile and experiences are counted in the ACORN project findings;
that you can actively contribute to and support ongoing sub-studies focusing upon specific topics and play your role in shaping the future research direction and outcomes of chiropractic-focused investigations.
What will happen to the data collected by the ACORN practitioner questionnaire?
Upon receipt of returned completed questionnaires, all data will be entered into a secure password protected computer file. All information will be analysed and reported in a de-identified manner. Subsequent publications presenting data from the practitioner questionnaire will communicate group data and no individual chiropractor will be identifiable from the publications arising from the project.
What will happen if I choose to become part of the ACORN practitioner database?
If you agree to be included in the ACORN practitioner database, your details will be entered into the password protected database and your responses to the accompanying ACORN practitioner questionnaire will be stored. Such information will inform the recruitment and engagement for further sub-studies on specific topics and issues in chiropractic care. To clarify: your consent to be included in the practitioner database does not automatically lead to your involvement in any future sub-studies. Your involvement in future sub-studies will be entirely at your discretion and you will be able to decide to participate or not participate in future sub-studies on a study-by-study basis and with no consequence to you.
As a consenting participant on the ACORN practitioner database you will receive ACORN project newsletters and updates regarding different stages of the project.
How will the details of those included in the ACORN practitioner database be protected?
All personal information contained on the practitioner database will be securely password stored and kept strictly confidential to the ACORN Chief Investigators in line with ethics approval granted by the UTS Human Ethics Committee.
How else can chiropractors support and help the ACORN project?
In addition to completing and returning the ACORN practitioner questionnaire and consenting to join the ACORN practitioner database, chiropractors can also help ACORN by simply spreading the word about the project and its benefits to others who may be eligible to participate within their immediate practice and wider networks. Please do feel free to pass on a link to this website to others who may be interested, to encourage colleagues to explore the details of ACORN and consider being participants in the project, and to suggest these colleagues do the same within their own networks too.
What if I require further clarification or information about ACORN and my possible participation?
If you still have questions or would like to discuss the ACORN project in more detail please email Professor Jon Adams (email@example.com). We will endeavour to respond to your enquiry as soon as possible. More information is in the ACORN Information Sheet (PDF, 152kB).
What are the opportunities for researchers to utilise the ACORN project?
There is an important and essential opportunity for all interested researchers (beyond the ACORN-ARCCIM UTS team) to participate and draw upon the ACORN project. ACORN is at its heart an inclusive and collaborative initiative and there are excellent opportunities and benefits for those interested in conducting rigorous chiropractic research to engage with and utilise the project. The invitation to collaborate and utilise the ACORN project is open to early-career and senior researchers, clinicians who may wish to partner in research activity as well as PhD students and potential PhD candidates looking to examine a specific area of chiropractic.
What are the benefits for researchers utilising the ACORN project?
Drawing upon and utilising the ACORN project to conduct further research has a number of significant benefits. Such utilisation of the ACORN infrastructure and platform will provide an opportunity to:
- Maximise cost efficiency and time savings particularly regarding project start-up (including recruitment and access);
- Build upon the established ACORN branding and marketing activities;
- Draw upon an established large-scale national network of committed practitioners aiding coverage, recruitment and retention of participants and strengthening the validity and impact of your research;
- Gain additional expert advice and input from the ACORN Chief Investigators (as required and/or requested).
How do researchers utilise the ACORN project?
A core feature of the ACORN programme is to facilitate and promote ‘sub-studies’ initiated and led by researchers external to the ACORN project team. External research teams can recruit sub-groups of practitioners within the ACORN network (and/or their patients) that are most suitable to addressing the specific focus and research question(s) of interest. The ACORN project facilitates sub-studies which can utilise both quantitative and qualitative methods as well as observational and experimental approaches to research.
An Expression of Interest (EOI) process has been designed to help manage sub-study proposals. EOI submissions are encouraged from clinicians, researchers, potential funders and others. Both national and international investigators are welcomed. EOI submissions will be subject to scientific review by the ACORN Project Steering Committee to ensure quality, rigour, fit and other important criteria.
Please note: all possible Sub-study EOI lead investigators are required to first discuss their proposal and study-idea with either Prof Jon Adams (firstname.lastname@example.org) or Prof David Sibbritt (email@example.com). Below you will find links to both the official ACORN Sub-study EOI Application Form and the ACORN Sub-study proposal guidelines:
ACORN is also focused upon research capacity building. Masters and PhD students and/or supervisors of such students (where applicable) are also very much welcomed and are strongly encouraged to contact the ACORN Project Chief Investigators (either Prof Jon Adams or Prof David Sibbritt) if they wish to enquire re: drawing upon the ACORN national practitioner database for recruitment purposes. The student does NOT have to enrol at UTS and may be enrolled at another university. Potential Masters and PhD students who wish to enrol at UTS as part of the ACORN study may contact either Prof Jon Adams or Prof David Sibbritt for further information.