T4 Dissemination and Implementation Research in Health: This existing course features training in theories, conceptual models, and practical application of D&I methods. It provides an introduction to dissemination and implementation (D&I) research and practice in the context of health (i.e., translational research in health). Topics include the importance and language of D&I science; designs, methods, and measures; differences and similarities across clinical, public health, and policy settings; selected tools for D&I research and practice; and future issues. Evaluation is based on weekly written assignments; oral presentations of a D&I project and a final written report describing this D&I project. The 2017 revised version of Dissemination and Implementation Research in Health edited by Brownson, Colditz, and Proctor is the primary text for the course. Scholars lead journal clubs discussing recent journal articles in order to supplement this reading.
T4 Designs and Mixed Methods in Implementation Research: This course provides an in-depth examination of study designs, comparative effectiveness, and qualitative, quantitative and mixed methods approaches to dissemination and implementation research. The focus is application to health care and public health settings. At the end of the course, learners will be able to:
- Describe the major pragmatic, comparative effectiveness and hybrid designs and their application to D&I research studies.
- Identify appropriate methods and designs for different types of research questions and desired outcomes.
- Explain why and how mixed methods designs may be used in health-related research.
- Complete a D & I research proposal, applying concepts learned in the course.
Designing for Dissemination and Sustainability: This new course proposed for the summer of 2019 will focus explicitly on integrated and iterative use of mixed methods D&I models, measures, and strategies across the different phases of research to maximize potential for dissemination and sustainability. Details are being finalized but emphasis will be placed on:
- Using D&I models (e.g., CFIR, Knowledge to Action, Diffusion Theory; PRECEDE PROCEED; Dynamic Sustainability Framework) in the planning and operationalization of programs
- Engaging patients, families, and stakeholders
- Pragmatic designs for typical and low resource settings
- Identifying what are core program components and what can be adapted to guide development of dissemination tool kits.
Seminars Series Examples:
Health Economics: This seminar series features four content lectures and a wrap up session tying the presentations together and providing feedback on the scholar assignments applying economic perspectives and cost methods to their D&I research projects. The four content lectures were delivered over the span of one month and included the following topics: replication costs (D Ritzwoller), US value frameworks (J Campbell), using economic evaluation alongside randomized clinical trials (M Whittington), and micro-costing (M Gritz).
Shared Decision Making: The Science of Patient-Centered Decisions: The shared decision making seminar series runs from October 2018 through April 2019. Although the seminar series consists of 60 minute monthly lectures that can be attended by anyone, the scholars exclusively participate in a final wrap up session with the seminar leads, Daniel Matlock, MD and Channing Tate, PhDc. Topics include: an overview of shared decision making (D Matlock & C Knoepke), the psychology (L Scherer) and emotion (G Chapman) of shared decision making and its practical application in ICDs/LVads (D Matlock & L Allen), hospice and palliative care (C Tate, M Reblin, & H Lum), and colon and lung cancers (T Caverly & C Lewis).
Dissemination and Implementation Issues in Health Disparities: This seminar, to be lead by Edward Havranek, MD is proposed for Fall of 2019 will include D&I strategies for and issues in low resource settings, cultural competence, and ongoing stakeholder engagement throughout the phases of research. Emphasis is also placed on cultural adaptation issues, health literacy implications, and global health and dissemination to low and middle income countries.
Evaluation and Measurement Issues in T4 Science: This seminar series includes training in evaluability, (32-34) mixed methods and multi-level assessment methods, and evaluation of important, but often neglected implementation outcomes such as reach, adaptation, fidelity, appropriateness, and maintenance/generalizability of programs.
T4 aspects of Precision Medicine: Discussion of the history of and key concepts in precision medicine with focus on issues related to HLBS conditions; use of big data; complexities of EHR data; integration of genomic, environmental, geospatial, and behavioral data; patient engagement and ethical issues.
Current Issues, Developments and Controversies in Dissemination & Implementation: This seminar will focus on recent D&I journal articles and journal club-like discussions; key controversies; new and developing research methods (e.g., natural experiments, (35, 36) hybrid designs (37, 38) and collaborating with T1-T3 scientists. This six-month long seminar will include presentations by primary mentors on their own T4 science and HLBS work with emphasis on evolving questions and methods.
Workshops are developed by and feature both local faculty and outside national D&I leaders, including our advisory committee members. During their second year, scholars will be co-host/planners of one workshop in an area of special interest.
Adherence in HLBS Interventions: Will address issues related to patients’ acceptance of and adherence with recommendations for self-care activities and follow-up, including patient-provider communication and basic behavioral economic principles.
Cost Effectiveness and Return on Investment: Training in understanding and assessing costs, cost-effectiveness and return on investment from the stakeholder and public health perspective.
De-implementation: Introduction to the importance and state of the field of de-implementation (39) strategies and emerging issues involved in helping organizations to discontinue harmful, ineffective, or non-evidence-based practices.(40-42)
Fidelity and Adaptation: Will address definitions, key issues, and assessment methods related to fidelity and adaptations, achieving balance between fidelity and adaptation,(43, 44) the importance of documentation of adaptations, and examples drawing upon recent RWJ and VA funded research investigations.
Total Trainee Academic work:
|courses in the first year
|seminars- (likely one at time, but may overlap, as some of the series may anywhere from 1-9 months long
|Workshop per year that trainees help to organize/present during their second year
|Core lectures (60-90 minutes each)
|WIP and D&I team meeting
|Mini-courses and faculty development lectures shared with the PCRF and SCORE fellowships, including a grant writing spring course (optional for scholars and should be decided with mentors)