This is the introductory paper in a collection of four papers on the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance, a pan-Canadian research initiative that was funded by the Canadian Institutes of Health Research in September of 2017. Here, we introduce the SPOR enterprise in Canada, provide a rationale for the creation of the SPOR Evidence Alliance, provide information on the mandate and approach, and describe how the SPOR Evidence Alliance adds to the health research ecosystem in Canada and beyond.
This is the introductory paper of a collection of papers that focus on the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance. The SPOR Evidence Alliance is a pan-Canadian research initiative to increase the engagement of patients and public in the design, development, and implementation of health research. It was funded by the Canadian Institutes of Health Research (CIHR) in September of 2017 (SPOR Evidence Alliance n.d.-g; Tricco 2017). The collection consists of the following papers: this introductory overview, an article outlining the governance structure of the SPOR Evidence Alliance (Lunny et al. 2021), an article providing information on the research services it has provided for decision-makers in Canada and beyond (Zarin et al. 2021), and a final article that focuses on evaluating patient engagement within this initiative (Li et al. 2021). This paper introduces the overall SPOR enterprise in Canada, provides a rationale for the creation of the SPOR Evidence Alliance within the SPOR enterprise with information on its mandate and approach, and describes how the SPOR Evidence Alliance adds to the health research ecosystem in Canada and beyond.
What is SPOR?
The SPOR enterprise is a national strategy facilitated by the CIHR and launched in Canada in September of 2011 (Collier 2011) with funding from the federal government to develop and implement the strategy. The vision and goals of SPOR were developed under the leadership of CIHR with guidance from a 12-member advisory board drawn from across Canada and a series of consultations with federal, territorial, and provincial government officials; academic and health care organizations; health charities; agencies; and professional associations and colleges as well as provincial health research funding agencies (Canadian Institutes of Health Research 2011). These extensive consultations revealed gaps and opportunities for improvement in the capacity, coordination, and funding of patient-oriented research in Canada. The SPOR initiative was “…designed to help provinces and territories meet the challenge of delivering high-quality, cost-effective health care by ensuring that the right patient receives the right treatment at the right time” (cihr-irsc.gc.ca/e/44000.html). CIHR’s proposed definition of definition of a patient is “…overarching and inclusive of individuals with personal experience of a health issue and informal caregivers, including family and friends” (Canadian Institutes of Health Research n.d.-d). “Patient-oriented research” is defined as “…a continuum of research, from initial studies in humans to comparative effectiveness and outcomes research, and the integration of this research into the health care system and clinical practice” (Canadian Institutes of Health Research 2011).
SPOR consists of multiple collaborative research networks that exist nationally (Supplementary Material S1). Current networks include provincial and territorial SUPPORT Units (Support for People and Patient-Oriented Research and Trials) who to act as local conveners of researchers, policymakers, politicians, health care providers, and patients to address pressing health care issues (Canadian Institutes of Health Research n.d.-g); innovative Clinical Trials (iCT) platforms to increase Canadian competitiveness in iCT research (Canadian Institutes of Health Research n.d.-c), the SPOR Canadian Data Platform to improve access to health data for health services research in Canada (Health Data Research Network Canada n.d.), the SPOR National Training Entity to facilitate capacity-building in patient-oriented research across Canada (Canadian Institutes of Health Research n.d.-f), and the SPOR Evidence Alliance (SPOR Evidence Alliance n.d.-g); the latter is the focus of this paper. These entities were strategically funded to bolster patient-oriented research in Canada.
The SPOR initiative was designed to act as a catalyst to engage patients as partners in research through various mechanisms, such as facilitating research, funding research, and supporting synergies between patients and other decision-makers (such as health care providers, health care managers, policymakers) in research (Canadian Institutes of Health Research n.d.-a). The guiding principles of SPOR include involving decision-makers (such as patient and public partners, health care providers, health care managers, policymakers) in all aspects of research (e.g., from question formulation, through the research conduct to dissemination as a coauthor on the completed research); 1:1 matched funding with nonfederal government partners; use of a multi-disciplinary approach; and use of an outcome-driven, performance measurement, and evaluation approach. The SPOR contends that integrating patients, health care providers, and other decision-makers in research will ensure that research focuses on relevant questions and that results are used to inform changes in policy and practice (Canadian Institutes of Health Research n.d.-a) and initiate changes to improve health outcomes.