Introduction: Practice-based research continues to evolve and has become a major methodology for many pragmatic studies. While early practice-based network projects were usually short term, current studies often introduce or compare practice innovations that require long-term evaluation. That change requires that practice sites remain engaged in research work for up to 5 years, a time that can allow for a significant "voltage drop," or decline in active participation.
Methods: Over the past 15 years we have developed and adapted several strategies to facilitate and encourage the continued active engagement of practices in practice-based research network studies of up to 5 years' duration. The concepts, details, evaluation, and results (when available) of the strategies are described.
Results: Eight strategies that enhance practice sites' attention to enrollment, data collection and continued use of the implemented practice change are described.
Conclusion: The loss of momentum, or "voltage drop," that happens in longer-term practice-based research network studies can be addressed using multiple strategies.
Keywords: Methods; Practice-based Research Network; Program Effectiveness; Randomized Controlled Clinical Trials; Training.