• Anna Dania, Zsolt Nagykaldi, Ari Haaranen, MurisJean W MJWMFrom CAPHRI Institute, Maastricht University (AD); University of Oklahoma Health Sciences Center, Oklahoma City, OK (ZN); University of Eastern Finland (AH); University of Exeter Medical School, Exeter, England (PHE); University of Eastern, Philip H Evans, Pekka Mäntyselkä, and Chris van Weel.
• From CAPHRI Institute, Maastricht University (AD); University of Oklahoma Health Sciences Center, Oklahoma City, OK (ZN); University of Eastern Finland (AH); University of Exeter Medical School, Exeter, England (PHE); University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (PM); Radboud Institute of Health Sciences, Nijmegen, the Netherlands, Radboud University Nijmegen, and Australian National University (CVW). a.dania@maastrichtuniversity.nl.
• J Am Board Fam Med. 2022 Jul 1; 35 (4): 762-792.

BackgroundThis article is the second part of a novel scoping review of the international literature that presents those key elements that underpin the foundational activities of Practice-Based Research Networks (PBRNs). In this article, we examine the external environment and the intersection between the internal and external environment domains.MethodsWe searched electronic databases, including MEDLINE (PubMed), OVID, CINAHL (EBSCOhost), Scopus, and SAGE for publications in English between 1/1/1965 and 9/15/2021. We also searched reference lists of selected publications, gray literature and other online sources. Inductive thematic analysis was applied to construct the main themes, subthemes, and key elements from a scoping review covering up to 10 years of reported experiences of each of the 98 PBRNs that met the inclusion criteria.ResultsIn this study we present 2 main themes: "Stakeholders at the Intersection Between the Internal and External Environment" and the "External Environment." The first is linked to the subthemes "Patient and Community Stakeholders" and "Other Healthcare Stakeholders" and 11 key elements. The second relates to the subthemes "National Health System," "Institutional/Governmental Support, National/State Policy and Regulatory Environment" "Professional Organizations," "Leveraging Previous Research and PBRN Experience and Interacting with Other Networks" and "Health Information Technology (HIT) and HIT Vendors" and 21 key elements.ConclusionsDespite variations in geography, time, and healthcare context, PBRNs shared many similar developmental experiences over the past 5 decades. Their external environment contributed significantly to their developmental trajectories during the first 10 years of their operation.© Copyright 2022 by the American Board of Family Medicine.

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