Issue link: https://www.massageandbodyworkdigital.com/i/1060121
44 m a s s a g e & b o d y w o r k j a n u a r y / f e b r u a r y 2 0 1 9 historical significance is the PBRN model. Medicine, particularly primary care, has developed and honed this model and shares its short history in an open access article by Larry Green, MD, and John Hickner, MD, in the Journal of the American Board of Family Medicine. 4 The model is one that several in complementary and integrative medicine generally, and massage therapy specifically, have sought to leverage in efforts to increase and improve practice- based research in their respective fields. EXAMPLES OF MASSAGE THERAPY-RELEVANT PBRNS Access is an essential research component that provides particularly challenging barriers to research conduct and completion. Specifically, the alignment of research acuity, study population, and, in some cases, intervention delivery is necessary for research to happen. Inaccessibility to any of these necessary components is a study completion deal breaker, but the natural alignment of these properties in a single setting is unusual. The PBRN model and approach provides a bridge between these components in a unique way and three PBRN examples of note exist related to complementary and integrative health generally and massage therapy specifically. The Practitioner Research and Collaboration Initiative (PRACI) is a relatively new PBRN established in 2014 and based in Australia. 5 PRACI consists of over 760 members from various complementary and integrative medicine fields, including massage therapy, naturopathy, reflexology, acupuncture, aromatherapy, yoga, and ayurveda. Massage therapists make up a majority of PRACI's membership (~58 percent), perhaps indicating a particularly strong interest by these therapists to take an engaged approach to research in their field. Resources, including published papers and descriptions of the research taking place through the PRACI PBRN, are available at their website (www.praci.com. au). While PRACI-based research may not include US-based massage therapists or patients/clients, the contextual similarities between Australia and the United States are certainly stronger than their differences, making PRACI and their efforts potentially important models. The massage-related findings and research coming out of PRACI efforts could provide valuable frameworks for which considerations or study approach could be replicated or based in the US massage therapist or patient populations. There are a handful of US-based massage related PBRN affiliated research studies and massage-specific PBRNs. The Kentucky Pain and Research Outcomes Study (KYPROS), highlighted in Somatic Research in the November/December 2017 and January/February 2018 issues of Massage & Bodywork magazine, included a PBRN approach and study design couched in the primary care setting. 6 Primary care providers who were part of the Kentucky Ambulatory Network PBRN referred their patients with chronic low-back pain to the KYPROS study team, who enrolled them into the study and paired them with community-based massage therapists for the intervention. 7 While not identified as such at the time, the cadre of community massage therapists affiliated with KYPROS made up an informal PBRN and served as the practice sites for the intervention. The two PBRN usage approaches in KYPROS addressed potential accessibility barriers by providing researchers access to both the patient population and community practicing therapists. This was particularly important considering the aim of the study was to understand real-world massage therapy effects for real-world, complex chronic low-back pain patients. In both cases, the networking aspect of the PBRNs provided the entry point to critical study design components (patients and intervention delivery), without which the study could not have been conducted. In addition, the community of practicing massage therapists had the opportunity to train in human subjects' protection and data collection, all the while serving as instrumental study personnel and well-representing the massage field in the academic research realm. The massage therapy field is ripe with interesting and important questions that educational and clinical practice settings provide the ideal laboratory for.