Since 2015, the Foundation for Physical Therapy Research has supported CoHSTAR, the Center on Health Services Training and Research, first funded through a five-year, $2.5 million grant, generously contributed by the American Physical Therapy Association and others. Given CoHSTAR’s success, the funding was extended for five additional years, providing $3.75 million in total support. This funding aims to demonstrate the value of physical therapist services. Over the past 9 years, CoHSTAR has nurtured researchers in health services and implementation science through postdoctoral fellowships, faculty fellowships, visiting scientist positions, pilot studies, annual institutes, and workshops in grant writing. We recently caught up with Linda Resnik, Director, and principal investigator for CoHSTAR, to get an overview of its achievements and impacts as of year nine. The following interview has been edited for length and clarity.

In a nutshell, what is CoHSTAR’s goal?

Our mission is clear: to train physical therapists and other rehabilitation professionals, in health services research to inform practice, care delivery, and policy.

Why was CoHSTAR needed? 

CoHSTAR was established to address the critical need for training and funding opportunities for physical therapists in health services research. Recognizing the lack of data on the effectiveness, comparative effectiveness, and cost effectiveness of physical therapy, as well as disparities in access, the Foundation initiated a major fundraising campaign. Health services research, considered the basic science of the healthcare system, aims to identify and assess gaps in quality and implement solutions. However, the specialized methods used in health services research, drawn from disciplines like epidemiology and economics, were not typically taught in rehabilitation science programs. CoHSTAR aimed to bridge this gap by providing specialized training for physical therapists to conduct this crucial research.

How has CoHSTAR impacted physical therapy research and practice?

We’ve successfully achieved our goals of training researchers and fostering physical therapy-relevant health services research. To date, we’ve trained four post-doctoral fellows and 20 faculty fellows and funded 20 pilot studies. Together this CoHSTAR community has generated over 400 peer-reviewed publications, 300 research presentations, and garnered 50 additional grants. Moreover, we’ve facilitated connections between researchers and health systems to improve practice patterns and implement evidence-based practices. CoHSTAR has also served as a launching pad for initiatives like LeaRRN, an NIH-funded rehabilitation research resource center, and now, LeaHD, a new AHRQ-funded center that expands training opportunities even further.

Tell us more about your most recent follow-on funding.

Learning Health Systems training to Improve disability and chronic condition care, or LeaHD, is a newly funded 5-year center grant that aims to enhance health-related quality of life for individuals with disabilities and chronic conditions. LeaHD researchers will focus on improving rehabilitative care and long term services and supports.  LeaHD offers didactic and experiential training for learning health researchers. The success of LeaRRn and LeaHD and CoHSTAR trainees demonstrates the foresight the Foundation had years ago in recognizing the importance of supporting physical therapy-relevant health service research.

Why did you want to be the Principal Investigator for CoHSTAR?

As the only physical therapist health services researcher based at Brown University, I was among the few physical therapists I knew who had training in this arena, and I was eager to get more colleagues involved in HSR. The Foundation’s request for applications (RFA) was remarkably detailed and well-conceived and provided clear blueprint for our center application. I worked with a team of colleagues including Alan Jette PT, PhD, MPH, FAPTA, Anthony Delitto, PT, PhD, FAPTA, Kelly Fitzgerald, PT, PhD, FAPTA, Vince Mor, PhD and Mary Slavin, PT, PhD, to respond to the RFA. Together, we developed the proposal and discussed roles and responsibilities. We came to the consensus that I would serve in the principal investigator (PI) role, because I was at the appropriate career stage, and possessed the necessary expertise to lead effectively. This original team then became the CoHSTAR Executive Committee (EC). Over the years, as Drs. Jette, Delitto and Fitzgerald stepped off the EC, we have welcomed new members including Janet Freburger, PT, PhD Christine McDonough PT, PhD and Theresa Shireman, PhD. The success of CoHSTAR can be attributed to the collective efforts of the Executive Committee and the invaluable guidance we received from our Advisory Committee.

What are you most proud of as the CoHSTAR PI?

I am most proud of our trainees! Our trainees include four post-doctoral fellows and twenty faculty fellows.  We have three fellows who will be in training until the end of the funding period. I am also proud of our annual grant writing workshops, which evolved from shorter sessions during our annual institutes to a comprehensive workshop called WISH, held at APTA headquarters. WISH has proven highly effective in refining ideas and helping attendees secure additional funding.

Furthermore, I am very proud to have offered annual institutes covering timely and important topics, such as quality strategies, implementation science, and payment models for rehabilitation and chronic conditions. Despite recent virtual formats, these institutes have seen substantial attendance, fostered multidisciplinary networks, and enhanced knowledge and capacity in physical therapy research.

What would you say is the biggest lesson you’ve learned as the PI?
I learned how to create and lead a successful training center. The Foundation’s defined vision which was laid out in the initial RFA helped guide us to create a strong infrastructure. The lessons I’ve learned from CoHSTAR have served me well in that I have been able to compete for and win additional, large, federally funded training center grants.

What kind of advice would you give to an early-career physical therapy researcher?

As a physical therapist health services researcher, I believe it’s crucial for individuals entering this field to seek out training environments rich in research expertise and mentorship to support their growth and success.

Any final thoughts you’d like to share?

We’ve made significant progress in advancing the understanding of the importance of health services research for improving practice and providing evidence for rehabilitation. However, I believe there’s still much more to be done. I’m committed to continuing to provide opportunities for researchers in this field, and I’m pleased to know that the Foundation shares this commitment and will be providing small grants for health services research in the future.