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Bukenya J, Kebede D, Mwambi H, Pate M, Adongo P, Berhane Y, Canavan CR, Chirwa T, Fawole OI, Guwatudde D, Jackson E, Madzorera I, Moshabela M, Oduola AMJ, Sunguya B, Sall A, Raji T, Fawzi W. The future of public health doctoral education in Africa: transforming higher education institutions to enhance research and practice. Lancet Public Health 2024:S2468-2667(24)00056-2. [PMID: 38735302 DOI: 10.1016/s2468-2667(24)00056-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/14/2024]
Abstract
The African Union and the Africa Centers for Disease Control and Prevention issued a Call to Action in 2022 for Africa's New Public Health Order that underscored the need for increased capacity in the public health workforce. Additional domestic and global investments in public health workforce development are central to achieving the aspirations of Agenda 2063 of the African Union, which aims to build and accelerate the implementation of continental frameworks for equitable, people-centred growth and development. Recognising the crucial role of higher education and research, we assessed the capabilities of public health doctoral training in schools and programmes of public health in Africa across three conceptual components: instructional, institutional, and external. Six inter-related and actionable recommendations were derived to advance doctoral training, research, and practice capacity within and between universities. These can be achieved through equitable partnerships between universities, research centres, and national, regional, and global public health institutions.
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Affiliation(s)
- Justine Bukenya
- School of Public Health, Makerere University, Kampala, Uganda.
| | - Derege Kebede
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Henry Mwambi
- School of Mathematics, Statistics, and Computer Science, Durban, South Africa
| | - Muhammed Pate
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Philip Adongo
- School of Public Health, University of Ghana, Accra, Ghana; Association of Schools of Public Health in Africa, Accra, Ghana
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Chelsey R Canavan
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Tobias Chirwa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Olufunmilayo I Fawole
- Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - David Guwatudde
- School of Public Health, Makerere University, Kampala, Uganda
| | - Elizabeth Jackson
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Isabel Madzorera
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Mosa Moshabela
- Vice Chancellor's Office, University of KwaZulu-Natal, Durban, South Africa
| | - Ayoade M J Oduola
- University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria
| | - Bruno Sunguya
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Tajudeen Raji
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Wafaie Fawzi
- Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
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Fulmer EB, Rasool A, Jackson SL, Vaughan M, Luo F. A National Approach to Promoting Health Equity in Cardiovascular Disease Prevention: Implementation Science Strengths, Opportunities, and a Changing Chronic Disease Context. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:190-194. [PMID: 38190045 PMCID: PMC11132923 DOI: 10.1007/s11121-023-01585-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 01/09/2024]
Abstract
In the USA, structural racism contributes to higher rates of cardiovascular disease (CVD) including hypertension, heart disease, and stroke among African American persons. Evidence-based interventions (EBIs), which include programs, policies, and practices, can help mitigate health inequities, but have historically been underutilized or misapplied among communities experiencing discrimination and exclusion. This commentary on the special issue of Prevention Science, "Advancing the Adaptability of Chronic Disease Prevention and Management Through Implementation Science," describes the Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention's (DHDSP's) efforts to support implementation practice and highlights several studies in the issue that align with DHDSP's methods and mission. This work includes EBI identification, scale, and spread as well as health services and policy research. We conclude that implementation practice to enhance CVD health equity will require greater coordination with diverse implementation science partners as well as continued innovation and capacity building to ensure meaningful community engagement throughout EBI development, translation, dissemination, and implementation.
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Affiliation(s)
- Erika B Fulmer
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Highway, Building 107, Atlanta, GA, 30341, USA.
| | - Aysha Rasool
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Highway, Building 107, Atlanta, GA, 30341, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Sandra L Jackson
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Highway, Building 107, Atlanta, GA, 30341, USA
| | - Marla Vaughan
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Highway, Building 107, Atlanta, GA, 30341, USA
| | - Feijun Luo
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Highway, Building 107, Atlanta, GA, 30341, USA
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Smith JD, Naoom SF, Saldana L, Shantharam S, Smith TA, Kohr JM. Preventing and Managing Chronic Disease Through Implementation Science: Editor's Introduction to the Supplemental Issue. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:1-9. [PMID: 38038892 PMCID: PMC11132927 DOI: 10.1007/s11121-023-01617-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Justin D Smith
- Department of Population Health Sciences, Division of Health Systems Innovation and Research, Spencer Fox Eccles School of Medicine at the University of Utah, 295 Chipeta Way, 84108, Salt Lake City, UT, USA.
| | | | - Lisa Saldana
- Chestnut Health Systems, Lighthouse Institute, Eugene, OR, USA
| | - Sharada Shantharam
- Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention, Atlanta, GA, USA
| | | | - Jennifer M Kohr
- Centers for Disease Control and Prevention, Performance and Evaluation Office, Atlanta, GA, USA
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Brooks SP, Alba C, Thomson D, Davison SN, Storey K. Partnership-building considerations for implementation science in learning health systems: a case study of the Implementation Science Collaborative in Alberta, Canada. FRONTIERS IN HEALTH SERVICES 2024; 4:1327395. [PMID: 38433991 PMCID: PMC10904619 DOI: 10.3389/frhs.2024.1327395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024]
Abstract
Introduction Implementation of health innovations is inherently collaborative, requiring trans-sectoral partnerships between implementation researchers, innovation teams, and implementation practitioners. Implementation science has been shown to improve implementation successes; however, challenges that hinder partnerships to advance implementation science continue to persist. Using a whole-system approach to assess and respond to implementation science partnership barriers may shed light on effective responses. Methods We conducted a case study of Alberta's learning health system, using semi-structured group and individual interviews to create a nuanced understanding of the considerations required for implementation research collaborations. We interviewed 53 participants representing 21 offices in the health system, academia, professional associations, and government who regularly plan, evaluate, and/or study health system implementation initiatives in Alberta. Using the Partnership Model for Research Capacity Building, we identified current facilitators and challenges for partnerships for conducting and using implementation science, at different levels of Alberta's health-research ecosystem. Results Alberta's healthcare system is well set up to readily embed intervention effectiveness and efficacy research. Infrastructure was also in place to strengthen implementation practice. However, weaknesses around exchanging knowledge and skills, providing feedback and mentoring, and accommodating diversity affected the ability of both individuals and teams to build implementation science capacity. Without this capacity, teams could not participate in embedded implementation research collaborations. We report the response of the Alberta Strategy for Patient-Oriented Research SUPPORT Unit to these barriers to provide practical guidance on various program options to strengthen individual- and organization-level implementation science capacity. Discussion This study applied a whole-system approach to assess factors across Alberta's health-research ecosystem, which affect partnerships to advance implementation science. Our findings illustrated that partnership considerations go beyond interpersonal factors and include system-wide considerations. With the results, health organization leaders have (1) a method for assessing organizational capability to readily embed implementation research and (2) a catalog of potential responses to create conditions to readily engage with implementation science in their day-to-day implementation processes.
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Affiliation(s)
- Stephanie P. Brooks
- Learning Health System Team, Alberta SPOR SUPPORT Unit, Department of Medicine, University of Alberta, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Cody Alba
- Learning Health System Team, Alberta SPOR SUPPORT Unit, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Denise Thomson
- Learning Health System Team, Alberta SPOR SUPPORT Unit, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Sara N. Davison
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Walker AE, Totzkay D, Scarneo-Miller SE, Claydon EA, Olfert MD. Application of the Theory of Planned Behaviour to inform development of a Dissemination and Implementation science training for nutrition practitioners. Public Health Nutr 2023; 26:3202-3210. [PMID: 37947187 PMCID: PMC10755436 DOI: 10.1017/s1368980023002525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 10/24/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To determine nutrition practitioners' attitudes, behavioural control and normative beliefs to best inform the development and formulation of a nutrition-specific Dissemination and Implementation (D&I) science training. DESIGN A cross-sectional survey aimed to assess Theory of Planned Behaviour (TPB) constructs and intention to use D&I science. A validated TPB questionnaire assessed constructs including perceived behavioural control, subjective, injunctive and descriptive normative beliefs, attitudes and intention to use D&I science. For analysis, Spearman's ρ, Kruskal-Wallis and Steel-Dwass tests were conducted for quantitative variables. SETTING Online, 26-item Qualtrics survey. PARTICIPANTS Cross-sectional sample of members (n 70) affiliated with the Society for Nutrition Education and Behaviour listserv. RESULTS The major finding from this study was a significant positive correlation between perceived behavioural control score and intention (r = 0·315, P = 0·0119). CONCLUSIONS D&I training interventions could formulate learning and teaching strategies to target perceived behavioural control (self-efficacy, knowledge and ability) to enhance intention. For example, application and experience-based learning techniques trainings could be strategies to increase knowledge and abilities.
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Affiliation(s)
- Ayron E Walker
- Nutrition and Health Care Management, Beaver College of Health Sciences, Appalachian State University, 1179 State Farm Rd, Boone, NC28607, USA
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources and Design, West Virginia University, Morgantown, WV, USA
| | - Daniel Totzkay
- Department of Communication Studies, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV, USA
| | | | - Elizabeth A Claydon
- Department of Social & Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources and Design, West Virginia University, Morgantown, WV, USA
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Ramaswamy R, Bogdewic S, Williams CR, Deganus S, Bonzi GA, Boakye J, Koranteng E, Mensah R, Amanor A, Bryce F, Owen MD. Implementation matters: assessing the effectiveness and sustainment of an obstetric triage program at a high-volume facility in Ghana. Implement Sci Commun 2023; 4:138. [PMID: 37968768 PMCID: PMC10647175 DOI: 10.1186/s43058-023-00527-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/03/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Maternal mortality remains stubbornly high in Ghana. Current national efforts are focused on improving the quality of care offered in health facilities. Obstetric triage is one intervention that has been proposed to improve the timeliness and appropriateness of care, two key elements of quality. In this study, we describe and evaluate a theory-based implementation approach to introduce obstetric triage into Tema General Hospital, a high-volume maternity hospital in Greater Accra, that blends concepts from implementation science and quality improvement. This implementation project was a first attempt to scale this intervention into a new facility, following initial development in the Greater Accra Regional Hospital (formerly Ridge Hospital) in Accra. METHODS This was a retrospective mixed-methods evaluation of two stages of implementation: active implementation and sustainment. We triangulated monitoring data captured during active implementation with clinical outcome data (timeliness of first assessment, accuracy of diagnosis, and appropriateness of care plan) from direct observation or patient obstetric triage assessment forms at baseline, at the completion of the active implementation stage, and following a 12-month "washout" period with no contact between hospital staff and the purveyor organization. Finally, we assessed embeddedness of the new triage procedures using the NoMad, a quantitative assessment of constructs from normalization process theory (NPT). RESULTS Patient waiting time decreased substantially during the study. At baseline, the median arrival-to-assessment waiting time was 70.5 min (IQR: 30.0-443.0 min). Waiting time decreased to 6.0 min (IQR: 3.0-15.0 min) following active implementation and to 5.0 min (IQR: 2.0-10.0 min) during the sustainment period. Accuracy of diagnosis was high at the end of active implementation (75.7% correct) and improved during the sustainment period (to 77.9%). The appropriateness of care plans also improved during the sustainment period (from 66.0 to 78.9%). Per NoMad data, hospital staff generally perceive obstetric triage to be well integrated into the facility. CONCLUSIONS This theory-based implementation approach proved to be successful in introducing a novel obstetric triage concept to a busy high-volume hospital, despite resource constraints and a short implementation window. Results proved long-lasting, suggesting this approach has high potential for engendering sustainability in other facilities as well. Our approach will be useful to other initiatives that aim to utilize program data to create and test implementation theories.
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Affiliation(s)
- Rohit Ramaswamy
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Stephanie Bogdewic
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caitllin R Williams
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sylvia Deganus
- Tema General Hospital, Ghana Health Service, Tema, Ghana
| | | | - Joana Boakye
- Tema General Hospital, Ghana Health Service, Tema, Ghana
| | | | | | - Alice Amanor
- Tema General Hospital, Ghana Health Service, Tema, Ghana
| | | | - Medge D Owen
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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Castle N, Kunwar S, Khanal L, Oot L, Elkes K, Shrestha S, Joshi A, Rai P, Bhattarai S, Karmacharya BM. Using the Journey to Health and Immunization (JTHI) Framework to Engage Stakeholders in Identifying Behavioral and Social Drivers of Routine Immunization in Nepal. Vaccines (Basel) 2023; 11:1709. [PMID: 38006041 PMCID: PMC10675610 DOI: 10.3390/vaccines11111709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Although the Government of Nepal has achieved high and sustained childhood vaccination coverage, reaching under-immunized and zero-dose children requires different approaches. Behavioral science offers promise in better understanding the drivers of vaccination and development of more effective programs; however, the application of behavioral science to immunization programs in Nepal is nascent. Through the Behavioral Science Immunization Network, JSI, UNICEF Nepal, and Dhulikhel Hospital-Kathmandu University School of Medical Sciences established a Behavioral Science Center to engage a diverse group of stakeholders in increasing the capacity of practitioners to use behavioral science in immunization programming. As a result of the engagement during formative research, government stakeholders requested and applied tools from behavioral science to solve different immunization challenges. Of particular value was the use of the Journey to Health and Immunization framework, which helped stakeholders identify behavioral and social drivers of zero-dose communities in Kathmandu. Our experience in Nepal demonstrates that there is strong demand for approaches and tools from behavioral science to use in relation to immunization and that this type of engagement model is effective for generating demand for and strengthening capacity to use behavioral science approaches.
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Affiliation(s)
- Nicole Castle
- JSI Research & Training Institute, Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, USA; (L.O.); (K.E.)
| | - Surakshya Kunwar
- Department of Public Health, Dhulikhel Hospital-Kathmandu University School of Medical Sciences, Dhulikhel 45200, Nepal; (A.J.); (P.R.); (B.M.K.)
| | | | - Lisa Oot
- JSI Research & Training Institute, Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, USA; (L.O.); (K.E.)
| | - Katharine Elkes
- JSI Research & Training Institute, Inc., 2733 Crystal Drive, 4th Floor, Arlington, VA 22202, USA; (L.O.); (K.E.)
| | - Swechhya Shrestha
- UNICEF Nepal, UN House, Pulchowk, Kathmandu P.O. Box 1187, Nepal; (S.S.); (S.B.)
| | - Anjali Joshi
- Department of Public Health, Dhulikhel Hospital-Kathmandu University School of Medical Sciences, Dhulikhel 45200, Nepal; (A.J.); (P.R.); (B.M.K.)
| | - Prasanna Rai
- Department of Public Health, Dhulikhel Hospital-Kathmandu University School of Medical Sciences, Dhulikhel 45200, Nepal; (A.J.); (P.R.); (B.M.K.)
| | - Sanju Bhattarai
- UNICEF Nepal, UN House, Pulchowk, Kathmandu P.O. Box 1187, Nepal; (S.S.); (S.B.)
| | - Biraj Man Karmacharya
- Department of Public Health, Dhulikhel Hospital-Kathmandu University School of Medical Sciences, Dhulikhel 45200, Nepal; (A.J.); (P.R.); (B.M.K.)
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Romero V, Donaldson H. Human-centred design thinking and public health education: A scoping review. Health Promot J Austr 2023. [PMID: 37643841 DOI: 10.1002/hpja.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023] Open
Abstract
ISSUE ADDRESSED Human-centred design thinking (HCDT) is gaining traction to develop appropriate public health interventions. The HCDT process helps frame problems with intention and encourages experimentation through collaboration. Public health graduates need an expanded toolkit to solve both the complex known problems of today, and the adaptability to solve the unknown problems of tomorrow. But how is the health promotion workforce being prepared with this innovation capability? This scoping review aims to provide a pedagogical understanding of teaching HCDT in public health education. METHODS The Arksey & O'Malley framework is used to structure this review. Peer-reviewed articles written from 2000 to 2023 across eight databases were analysed. The data extracted included: author/year, setting, aim/purpose, participants, HCDT framework, HCDT methods, outcomes and challenges. RESULTS Nine relevant publications were included from a total of 208 records. The first reported use of HCDT in public health and health promotion teaching was in 2015. Teaching inspiration drew from established HCDT frameworks: d.school and IDEO which promote the iterative process of empathy/inspiration, ideation and testing/implementation. CONCLUSIONS HCDT has been used for both designing public health curricula and for teaching students to apply it in their practice. First, HCDT methods can be used to problem-solve teaching and learning issues such as creating inviting learning environments and designing an HCDT unit. Second, the teaching of HCDT can prepare and equip the public health workforce to solve problems requiring tailored solutions from an empathetic and iterative stance working as a team. The teaching and practice of HCDT exemplifies the process of social innovation in health promotion. SO WHAT?: As an emerging field, future studies and applications should include clarifying and evaluating the HCDT stages used. More publications will enable a fuller understanding and potentially advocate the necessity of teaching and learning HCDT in public health and health promotion.
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Affiliation(s)
- Vivian Romero
- Central Queensland University, Melbourne, Victoria, Australia
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Harvey G, Rycroft-Malone J, Seers K, Wilson P, Cassidy C, Embrett M, Hu J, Pearson M, Semenic S, Zhao J, Graham ID. Connecting the science and practice of implementation - applying the lens of context to inform study design in implementation research. FRONTIERS IN HEALTH SERVICES 2023; 3:1162762. [PMID: 37484830 PMCID: PMC10361069 DOI: 10.3389/frhs.2023.1162762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023]
Abstract
The saying "horses for courses" refers to the idea that different people and things possess different skills or qualities that are appropriate in different situations. In this paper, we apply the analogy of "horses for courses" to stimulate a debate about how and why we need to get better at selecting appropriate implementation research methods that take account of the context in which implementation occurs. To ensure that implementation research achieves its intended purpose of enhancing the uptake of research-informed evidence in policy and practice, we start from a position that implementation research should be explicitly connected to implementation practice. Building on our collective experience as implementation researchers, implementation practitioners (users of implementation research), implementation facilitators and implementation educators and subsequent deliberations with an international, inter-disciplinary group involved in practising and studying implementation, we present a discussion paper with practical suggestions that aim to inform more practice-relevant implementation research.
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Affiliation(s)
- Gillian Harvey
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Jo Rycroft-Malone
- Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Kate Seers
- Warwick Medical School, Faculty of Science, University of Warwick, Coventry, United Kingdom
| | - Paul Wilson
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, United Kingdom
| | - Christine Cassidy
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Mark Embrett
- Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Jiale Hu
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States
| | - Mark Pearson
- Wolfson Palliative Care Research Centre, Hull York Medical School, Hull, United Kingdom
| | - Sonia Semenic
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Junqiang Zhao
- Centre for Research on Health and Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Ian D. Graham
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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Walker AE, Olfert MD, Scarneo-Miller SE, Totzkay D, Claydon EA. Nutrition-Specific Dissemination and Implementation Science Training Development and Feedback. AMERICAN JOURNAL OF HEALTH EDUCATION 2023. [DOI: 10.1080/19325037.2023.2164942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Aldridge WA, Roppolo RH, Brown J, Bumbarger BK, Boothroyd RI. Mechanisms of change in external implementation support: A conceptual model and case examples to guide research and practice. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231179761. [PMID: 37790181 PMCID: PMC10291867 DOI: 10.1177/26334895231179761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Background External implementation support (EIS) is a well-recognized feature of implementation science and practice, often under related terms such as technical assistance and implementation facilitation. Existing models of EIS have gaps related to addressing practice outcomes at both individual and organizational levels, connecting practice activities to intended outcomes, or grounding in well-established theories of behavior and organization change. Moreover, there have been calls to clarify the mechanisms of change through which EIS influences related outcomes. Method In this article, we theorize about mechanisms of change within EIS. Our theorizing process aligns with the approach advocated by Kislov et al. We aim to consolidate prior EIS literature, combining related constructs from previous empirical and conceptual work while drawing on our extensive EIS experience to develop a higher-order, midrange theory of change. Results Our theory of change is empirically and practically informed, conceptually situated within an established grand theory of change, and guided by eight practice principles and social cognitive theory. The theory of change proposes 10 core practice components as mechanisms of change within EIS. When used according to underlying theory and principles, they are believed to contribute to favorable practice outcomes at individual, team, organizational, and system levels. The model offers flexibility by recognizing the need for sequential support processes and the demand to practice in dynamic and responsive ways. Case examples are presented to illustrate major themes and patterns of the model in action. Conclusions The proposed model is intended to support prospective EIS studies by conceptualizing discernable practice components with hypothesized relationships to proximal and distal practice outcomes. The model can be behaviorally operationalized to compliment and extend competency-based approaches to implementation support practitioner (ISP) training and coaching. Over time, the model should be refined based on new empirical findings and contributions from ISPs across the field.
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Affiliation(s)
- William A. Aldridge
- The Impact Center at Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rebecca H. Roppolo
- The Impact Center at Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Brian K. Bumbarger
- Griffith Criminology Institute, Griffith University, Mount Gravatt, Queensland, Australia
| | - Renée I. Boothroyd
- The Impact Center at Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Juckett LA, Bunger AC, McNett MM, Robinson ML, Tucker SJ. Leveraging academic initiatives to advance implementation practice: a scoping review of capacity building interventions. Implement Sci 2022; 17:49. [PMID: 35870930 PMCID: PMC9308361 DOI: 10.1186/s13012-022-01216-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Academic institutions building capacity for implementation scholarship are also well positioned to build capacity in real world health and human service settings. How practitioners and policy makers are included and trained in implementation capacity-building initiatives, and their impact on building implementation practice capacity is unclear. This scoping review identified and examined features of interventions that build implementation practice capacity across researchers and practitioners or practitioners-in-training.
Methods
Five bibliographic databases were searched. Eligible studies (a) described an implementation capacity building intervention with a connection to an academic institution, (b) targeted researchers and practitioners (including practitioners-in-training, students, or educators), and (c) reported intervention or participant outcomes. Articles that only described capacity building interventions without reporting outcomes were excluded. Consistent with Arksey and O’Malley’s framework, key study characteristics were extracted (target participants, core components, and outcomes) and analyzed using open coding and numerical analysis.
Results
Of 1349 studies identified, 64 met eligibility for full-text review, and 14 were included in the final analysis. Half of the studies described implementation capacity building interventions that targeted health or behavioral health researchers, practitioners, and practitioners-in-training together, and half targeted practitioners or practitioners-in-training only. The most common components included structured didactic activities offered in person or online, mentorship and expert consultation to support implementation, and practical application activities (e.g., field placements, case studies). Knowledge sharing activities and technical assistance were less common. All studies reported favorable outcomes related to knowledge attainment, increased ability to implement evidence, productivity, and satisfaction.
Conclusions
Building implementation capacity among practitioners is critical for integrating insights from implementation science into the field and preventing the “secondary” implementation research-to-practice gap. This scoping review identified several promising implementation practice capacity building interventions that tend to build practitioner capacity via expert led activities which may be relevant for academic institutions seeking to build implementation practice capacity. To avoid widening the implementation research-to-practice gap, implementation capacity building interventions are needed that target policy makers, expand beyond multiple practice settings, and leverage university/community partnerships or on-site academic medical centers. Future studies will also be needed to test the impact on service quality and public health outcomes.
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Metz A, Jensen T, Farley A, Boaz A, Bartley L, Villodas M. Building trusting relationships to support implementation: A proposed theoretical model. FRONTIERS IN HEALTH SERVICES 2022; 2:894599. [PMID: 36925800 PMCID: PMC10012819 DOI: 10.3389/frhs.2022.894599] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022]
Abstract
This paper presents a theory of change that articulates (a) proposed strategies for building trust among implementation stakeholders and (b) the theoretical linkages between trusting relationships and implementation outcomes. The theory of change describes how trusting relationships cultivate increases in motivation, capability, and opportunity for supporting implementation among implementation stakeholders, with implications for commitment and resilience for sustained implementation, and ultimately, positive implementation outcomes. Recommendations related to the measurement of key constructs in the theory of change are provided. The paper highlights how the development of a testable causal model on trusting relationships and implementation outcomes can provide a bridge between implementation research and implementation practice.
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Affiliation(s)
- Allison Metz
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Todd Jensen
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Amanda Farley
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Annette Boaz
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Leah Bartley
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Melissa Villodas
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Building Capacity for Implementation Science in Precision Health and Society: Development of a Course for Professional and Graduate Students in Pharmacy. J Pers Med 2022; 12:jpm12091499. [PMID: 36143284 PMCID: PMC9502747 DOI: 10.3390/jpm12091499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/21/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Training in the field of implementation science is critical for future pharmacists and pharmaceutical scientists to successfully implement precision health interventions in pharmacy practice. We developed an elective course for second- and third-year students at the UNC Eshelman School of Pharmacy to develop foundational knowledge in implementation science with a focus on precision health implementation. The eight-week course used a flipped classroom format featuring lecture videos, suggested readings, quizzes, guest lectures from experts, case studies, and a group project. We evaluated course quality through class participation, a pre- and post-test on course content, and a mixed-methods survey completed by the students. Overall engagement in in the course was high and students demonstrated significant improvement in understanding of implementation science and precision health. Strengths of the course as identified by students were the use of expert guest speakers, pre-class lectures, and case study exercises, while the ordering of content and improved connection between content and guest lectures were identified as areas for improvement. In conclusion, the elective course was well-received and meets a critical need in the field of pharmacy to build implementation science capacity. Future work is needed to expand and refine education for the implementation of precision health for pharmacy professionals.
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Astorino JA, Kerch S, Pratt-Chapman ML. Building implementation science capacity among practitioners of cancer control: development of a pilot training curriculum. Cancer Causes Control 2022; 33:1181-1191. [PMID: 35842850 PMCID: PMC9534372 DOI: 10.1007/s10552-022-01604-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/23/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Cancer control interventions are difficult to implement with fidelity, while tailoring to fit contexts. Engaged approaches are suggested to advance equity. On-the-ground practitioners are needed to serve as collaborators in the implementation process with research teams, but few trainings are designed with them in mind. METHODS The Cancer Control Implementation Science Base Camp (CCISBC) was created to improve capacity among cancer control practitioners when implementing evidence-based cancer screening programs in specific contexts. Development of the curriculum included the following: (1) performing a literature review assessing extant curricula, (2) comparing competencies of these curricula, (3) user-centered design, (4) producing learning materials, (5) recruiting two teams to test a pilot, (6) running the pilot, and (7) evaluating results. RESULTS Nine competencies overlapped between four of the curricula scanned in this study, all of which served as the basis for learning objectives. Principles that emerged from design sessions included staying clear about terminology, supporting the brokerage of knowledge, reframing theories, models, and frameworks as tools, and including equity in everything. Pilot testing showed that the average learner increased 74.5% in knowledge and 75% in confidence regarding implementing evidence-based cancer screening. Evidence suggests that the training increased the skill of implementing evidence-based interventions (EBIs) with a health equity lens. CONCLUSION In order to scale practice-based evidence, practitioners will need to be engaged. This engagement is optimized when practitioners are trained to collaborate on implementation research. The CCISBC is a feasible program to develop capacity among practitioners in comprehensive cancer control in order to optimize EBIs tailored to context.
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Affiliation(s)
- Joseph A Astorino
- The George Washington University Cancer Center, School of Medicine and Health Sciences, George Washington University, Washington, D.C, United States of America.
| | - Sarah Kerch
- The George Washington University Cancer Center, School of Medicine and Health Sciences, George Washington University, Washington, D.C, United States of America
| | - Mandi L Pratt-Chapman
- The George Washington University Cancer Center, School of Medicine and Health Sciences, George Washington University, Washington, D.C, United States of America
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17
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Metz A, Jensen T, Farley A, Boaz A. Is implementation research out of step with implementation practice? Pathways to effective implementation support over the last decade. IMPLEMENTATION RESEARCH AND PRACTICE 2022; 3:26334895221105585. [PMID: 37091077 PMCID: PMC9978647 DOI: 10.1177/26334895221105585] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: There is growing interest in the lived experience of professionals who provide implementation support (i.e., implementation support practitioners). However, there remains limited knowledge about their experiences and how those experiences can contribute to the knowledge base on what constitutes successful and sustainable implementation support models. This study aimed to examine pathways of implementation support practice, as described by experienced professionals actively supporting systems' uptake and sustainment of evidence to benefit children and families. Methods: Seventeen individuals with extensive experience providing implementation support in various settings participated in semi-structured interviews. Data were analyzed using qualitative content analysis and episode profile analysis approaches. Iterative diagramming was used to visualize the various pathways of implementation support practitioners' role reflection and transformation evidenced by the interview data. Results: Findings highlighted rich pathways of implementation support practitioners' role reflection and transformation. Participants described their roots in providing implementation support as it relates to implementing and expanding the use of evidence-based programs and practices in child and family services. Almost all participants reflected on the early stages of their careers providing implementation support and described a trajectory starting with the use of "push models," which evolved into "pull models" and eventually "co-creation or exchange models" of implementation support involving both technical and relational skills. Conclusions: Developing an implementation support workforce will require a deeper understanding of this lived experience to prevent repeated use of strategies observed to be unsuccessful by those most proximal to the work. The pathways for implementation practice in this study highlight impressive leaps forward in the field of implementation over the last 15 years and speaks to the importance of the professionals leading change efforts in this growth. Plain Language Summary Over the past few years, professionals in the field of implementation science have identified a growing gap between implementation research and implementation practice. While this issue has been highlighted informally, the field is lacking a shared understanding and clear way forward to reconcile this gap. In this paper, the authors describe how professionals providing implementation support have shifted their implementation practice over time through systematic observations of what works (and what does not work) for supporting and sustaining evidence use in service systems to improve population outcomes. The authors share the impressive leaps forward made in the field of implementation practice - from didactic training to responsive and tailored implementation strategies to co-created and relationship-based implementation solutions. The paper concludes with a call to action to the field for the creation of a virtuous learning cycle between professionals conducting implementation research and professionals providing implementation support to change practice as a way to produce a more robust and relevant science of implementation.
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Affiliation(s)
- Allison Metz
- School of Social Work, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Todd Jensen
- School of Social Work, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Amanda Farley
- School of Social Work, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Annette Boaz
- Department of Health Services Research and Policy, London School of Hygiene and Tropical
Medicine, London, UK
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18
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Turner MW, Bogdewic S, Agha E, Blanchard C, Sturke R, Pettifor A, Salisbury K, Marques AH, Excellent ML, Rajagopal N, Ramaswamy R. Learning needs assessment for multi-stakeholder implementation science training in LMIC settings: findings and recommendations. Implement Sci Commun 2021; 2:134. [PMID: 34863314 PMCID: PMC8642989 DOI: 10.1186/s43058-021-00238-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/05/2021] [Indexed: 11/23/2022] Open
Abstract
Background Despite significant progress in the field of implementation science (IS), current training programs are inadequate to meet the global need, especially in low-and middle-income countries (LMICs). Even when training opportunities exist, there is a “knowledge-practice gap,” where implementation research findings are not useful to practitioners in a field designed to bridge that gap. This is a critical challenge in LMICs where complex public health issues must be addressed. This paper describes results from a formal assessment of learning needs, priority topics, and delivery methods for LMIC stakeholders. Methods We first reviewed a sample of articles published recently in Implementation Science to identify IS stakeholders and assigned labels and definitions for groups with similar roles. We then employed a multi-step sampling approach and a random sampling strategy to recruit participants (n = 39) for a semi-structured interview that lasted 30–60 min. Stakeholders with inputs critical to developing training curricula were prioritized and selected for interviews. We created memos from audio-recorded interviews and used a deductively created codebook to conduct thematic analysis. We calculated kappa coefficients for each memo and used validation techniques to establish rigor including incorporating feedback from reviewers and member checking. Results Participants included program managers, researchers, and physicians working in over 20 countries, primarily LMICs. The majority had over 10 years of implementation experience but fewer than 5 years of IS experience. Three main themes emerged from the data, pertaining to past experience with IS, future IS training needs, and contextual issues. Most respondents (even with formal training) described their IS knowledge as basic or minimal. Preferences for future training were heterogeneous, but findings suggest that curricula must encompass a broader set of competencies than just IS, include mentorship/apprenticeship, and center the LMIC context. Conclusion While this work is the first systematic assessment of IS learning needs among LMIC stakeholders, findings reflect existing research in that current training opportunities may not meet the demand, trainings are too narrowly focused to meet the heterogeneous needs of stakeholders, and there is a need for a broader set of competencies that moves beyond only IS. Our research also demonstrates the timely and unique needs of developing appropriately scoped, accessible training and mentorship support within LMIC settings. Therefore, we propose the novel approach of intelligent swarming as a solution to help build IS capacity in LMICs through the lens of sustainability and equity. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00238-2.
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Affiliation(s)
| | | | - Erum Agha
- University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Audrey Pettifor
- University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Marie Lina Excellent
- University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.,Institut pour la Santé, la Population et le Développement, Petion-Ville, Haiti
| | | | - Rohit Ramaswamy
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
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Walker AE, Wattick RA, Olfert MD. The Application of Systems Science in Nutrition-Related Behaviors and Outcomes Implementation Research: A Scoping Review. Curr Dev Nutr 2021; 5:nzab105. [PMID: 34522835 PMCID: PMC8435056 DOI: 10.1093/cdn/nzab105] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/22/2021] [Accepted: 07/29/2021] [Indexed: 11/14/2022] Open
Abstract
Use of systems science can improve the dissemination and implementation (D&I) process. However, little is known about use of systems science in nutrition D&I research. The purpose of this article is to synthesize the ways in which systems science methodology is applied in nutrition D&I research. Scoping review methodology involved searching 6 academic databases for full-text, peer-reviewed, English articles published between 1970 and 2020 that employed systems science within nutrition D&I research. Data extraction included intervention type, population, study aim, methods, theoretical approach, outcomes, and results. Descriptive statistics and qualitative thematic analysis followed. Thirty-four retained articles qualitatively identified benefits (successful planning and organization of complex interventions) and challenges (limited resources, trainings, and lack of knowledge) to utilizing systems science in nutrition D&I research. Future research should work toward building knowledge capacity among nutrition practitioners by increasing available trainings and resources to enhance the utilization of systems science in nutrition D&I research.
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Affiliation(s)
- Ayron E Walker
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources and Design, West Virginia University, Morgantown, WV, USA
| | - Rachel A Wattick
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources and Design, West Virginia University, Morgantown, WV, USA
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources and Design, West Virginia University, Morgantown, WV, USA
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20
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Vroom EB, Albizu‑Jacob A, Massey OT. Evaluating an Implementation Science Training Program: Impact on Professional Research and Practice. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2021; 1:147-159. [PMID: 34778809 PMCID: PMC8589303 DOI: 10.1007/s43477-021-00017-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/26/2021] [Indexed: 11/25/2022]
Abstract
Real-world application and implementation of evidence-based practice continue to be a challenge across multiple sectors, including behavioral health settings. Providing the opportunity for future researchers and practitioners to gain capacity and knowledge through structured experiential learning in implementation science is critical to closing the research to practice gap. The Institute for Translational Research Education in Adolescent Drug Abuse (ITRE) is a graduate certificate program that offers specific coursework, a large-scale service-learning project based in the community, and mentorship related to implementation science research and practice. The purpose of this evaluation was to examine, from the perspective of ITRE scholars, the perceived impact on the development of professional research and practice skills once graduated from the ITRE program. Fifty-eight semi-structured interviews across five cohorts were selected randomly for in-depth thematic analysis (n = 58). Results suggest that the ITRE provides a unique approach grounded in implementation science for building robust and transferable skills for future researchers and practitioners working in a variety of behavioral healthcare settings.
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Affiliation(s)
- Enya B. Vroom
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Alexandra Albizu‑Jacob
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Oliver T. Massey
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
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21
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Implementing Implementation Research: Teaching Implementation Research to HIV Researchers. Curr HIV/AIDS Rep 2021; 18:186-197. [PMID: 33709323 DOI: 10.1007/s11904-021-00551-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW Given the growth in HIV-related implementation research, there is a need to expand the workforce and rigor through implementation science (IS) training and mentorship. Our objective is to review IS training opportunities for HIV-focused researchers and describe the approach and lessons learned from a recent HIV-related implementation research training initiative. RECENT FINDINGS IS training opportunities range from degree programs to short- and longer-term professional development institutes and community-focused institutional trainings. Until recently, there have not been extensive dedicated opportunities for implementation research training for HIV-focused investigators. To meet this gap, an inter-Center for AIDS Research IS Fellowship for early-stage investigators was launched in 2019, building on lessons learned from dissemination and implementation training programs. Key components of the HIV-focused IS fellowship include didactic training, mentorship, grant-writing, and development of HIV-IS collaborative networks. Fellows to-date were two-thirds junior faculty and one-third post-doctoral fellows, the majority (69%) with prior public health training. Perceived value of the program was high, with a median rating of 9 [IQR 8-9] on a 10-point scale. Overall, 22/27 (81%) Fellows from the first cohort submitted IS-related grants within 12 months of Fellowship completion, and by 1 year 13 grants had been funded among 10 investigators, 37% overall among Fellows. Mentors identified framing of IS questions as the top-ranked training priority for HIV-investigators. Increasing knowledge of the utility of IS may support more grants focused on optimal implementation of HIV treatment and prevention strategies. Experiences from mentors and trainees engaged in an IS-focused fellowship for HIV investigators demonstrate the demand and value of a dedicated training program and reinforce the importance of mentorship.
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22
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Aja GN, Francisco J, Matunga M, Trye A, Lyngdoh B, Zambelli C, Aja VT. "We Need a Song of Hope": Responding to the COVID-19 Informational and Psychospiritual Needs of Residents of a Gated Community in the Philippines. JOURNAL OF RELIGION AND HEALTH 2021; 60:1543-1555. [PMID: 33782845 PMCID: PMC8006874 DOI: 10.1007/s10943-021-01237-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
The brutal disruptions caused by the novel coronavirus (COVID-19) pandemic require dynamic ways of responding, not only to the informational needs of communities, but also engaging and creating interventions they consider relevant to their psychospiritual needs. Using the design thinking steps, we identified, developed and tested the type and nature of a unique song which residents of a gated community needed in their journey through COVID-19 lockdowns and government restrictions. The design thinking model provided clear steps for engaging residents to develop an anti-COVID-19 song of hope to cope with the physical, sociopolitical, psychological and spiritual trauma caused by the pandemic.
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Affiliation(s)
- Godwin Nwadibia Aja
- Graduate School Public Health Department, Adventist International Institute of Advanced Studies, Silang, Cavite, Philippines.
| | - Jose Francisco
- Graduate School Public Health Department, Adventist International Institute of Advanced Studies, Silang, Cavite, Philippines
| | - Muriel Matunga
- Graduate School Public Health Department, Adventist International Institute of Advanced Studies, Silang, Cavite, Philippines
| | - Adma Trye
- Graduate School Public Health Department, Adventist International Institute of Advanced Studies, Silang, Cavite, Philippines
| | - Baiada Lyngdoh
- Graduate School Public Health Department, Adventist International Institute of Advanced Studies, Silang, Cavite, Philippines
| | - Cynthia Zambelli
- Graduate School Public Health Department, Adventist International Institute of Advanced Studies, Silang, Cavite, Philippines
| | - Victoria Tayo Aja
- Applied Theology Department, Theological Seminary, Adventist International Institute of Advanced Studies, Silang, Cavite, Philippines
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Gummeson H, Raj Goel S, Elmusharaf K. Public health practicum: a scoping review of current practice in graduate public health education. BMJ Open 2021; 11:e047512. [PMID: 33958343 PMCID: PMC8103934 DOI: 10.1136/bmjopen-2020-047512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The objectives of this study are to (1) identify Graduate Public Health (GPH) programmes with an integrated practicum, (2) determine current practice for practicum design and (3) use the information to make recommendations to inform the design of Public Health Graduate programme practicums. DESIGN Scoping review. DATA SOURCES Academic Ranking World Universities 2019 was used to identify top 10 institutions in each geographical hub offering GPH programmes. Each GPH programme website was searched for practicum information. ELIGIBILITY CRITERIA GPH programmes offering a practice-based component as a requirement in their curriculum. DATA EXTRACTION AND SYNTHESIS One reviewer screened GPH websites for eligibility and extracted data. Verification of data for accuracy and completeness was done on 10% of the sample by the second author. Data were compiled into an Excel file and were analysed to describe the duration, timing, credit, contact hours, preceptor requirements, prerequisites, objectives, deliverables and methods of evaluation of the practice-based component. RESULTS Out of the 108 GPH programmes screened, a total of 35 programmes were included. There was a significant variation in required practicum duration ranging from 4 to 16 weeks. Only 31% specifically outlined prerequisites to be completed before the initiation of the practicum. More than half (57%) had a published list of core competencies. A majority of practicum did not provide criteria for appropriate preceptors (63%) and their responsibilities (66%). All programmes listed assessment criteria however the majority (57%) did not specify if the practicum was graded or a for-credit component. CONCLUSIONS The integration of practical components into curricula is inconsistent. This research resulted in 14 recommendations intended to guide GPH practicum design. We propose that this study be used as a tool to spark a global dialogue about best practices in GPH education through the identification of common practices and opportunities for improvement.
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Affiliation(s)
- Hannah Gummeson
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Sonika Raj Goel
- School of Medicine, University of Limerick, Limerick, Ireland
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Hamid S, Mureed S, Kayani A, Javed K, Khan A, Awais S, Khan N, Tus-Salam F, Fixsen DL. Learning Active Implementation Frameworks: the role of implementation teams in a case study from Pakistan. Glob Health Action 2021; 13:1805164. [PMID: 32838706 PMCID: PMC7480595 DOI: 10.1080/16549716.2020.1805164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In Pakistan, although coverage of Maternal, Newborn, and Child Health (MNCH) services has increased, the attributable disease burden remains high, indicating quality of these services remains suboptimal. To address this quality gap, challenges associated with the implementation of MNCH services will need to be addressed and effective use of the various MNCH guidelines will need to be supported, evaluated, and continuously improved. Even though the application of the field of implementation science and practice in the low- and middle-income settings has been limited, it is our belief, based on the experience described in this article that these competencies could enhance health professionals' ability to, not only successfully integrate MNCH guidelines into health systems, but to also support their effective and sustainable use. To address this capacity gap in Pakistan, the Health Services Academy, as a member of the World Health Organization's Human Reproduction Program (HRP) Alliance for Research Capacity Strengthening (RCS), has engaged, over the course of 16 months, in the 'Implementation for the Professional Learner Program' in 2019. This innovative implementation science and practice capacity-building program is developed and conducted by The World Health Organization (WHO) Collaborating Centre for Research Evidence for Sexual and Reproductive Health at the University of North Carolina at Chapel Hill (UNC). The initial cohort of this Program also included Palestine's West Bank, and Egypt. The objectives of this Program were to cultivate implementation science and practice competencies, and to support the development of national, community-based or institution-based implementation teams. The expected outcomes of this program included, further enhancement of the capacity of local health professionals in implementation science, systemic change and the effective use of innovations in practice at sub-national/regional levels.
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Affiliation(s)
- Saima Hamid
- Fatima Jinnah Women University, Faculty of Social Sciences , Rawalpindi, Pakistan.,Maternal and Child Health Department, Health Services Academy , Islamabad, Pakistan
| | - Sheh Mureed
- Maternal and Child Health Department, Health Services Academy , Islamabad, Pakistan
| | - Aasia Kayani
- Obstetrics and Gyna Ecology Department Holy Family Hospital , Rawalpindi, Pakistan
| | - Kiran Javed
- Obstetrics and Gyna Ecology Department Holy Family Hospital , Rawalpindi, Pakistan
| | - Adnan Khan
- Maternal and Child Health Department, Health Services Academy , Islamabad, Pakistan
| | - Sayema Awais
- Maternal and Child Health Department, Health Services Academy , Islamabad, Pakistan
| | - Neelam Khan
- Maternal and Child Health Department, Health Services Academy , Islamabad, Pakistan
| | - Fakiha Tus-Salam
- Maternal and Child Health Department, Health Services Academy , Islamabad, Pakistan
| | - Dean L Fixsen
- Active Implementation Research Network , Chapel Hill, North Carolina, United States
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Davis R, D’Lima D. Building capacity in dissemination and implementation science: a systematic review of the academic literature on teaching and training initiatives. Implement Sci 2020; 15:97. [PMID: 33126909 PMCID: PMC7597006 DOI: 10.1186/s13012-020-01051-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/08/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The field of dissemination and implementation (D&I) science has grown significantly over recent years. Alongside this, an increased demand for training in D&I from researchers and implementers has been seen. Research describing and evaluating D&I training opportunities, referred to here as 'capacity building initiatives' (CBIs), can help provide an understanding of different methods of training as well as training successes and challenges. However, to gain a more detailed understanding of the evidence-base and how D&I CBIs are being reported in publications, a field-wide examination of the academic literature is required. METHODS Systematic review to identify the type and range of D&I CBIs discussed and/or appraised in the academic literature. EMBASE, Medline and PsycINFO were searched between January 2006 and November 2019. Articles were included if they reported on a D&I CBI that was developed by the authors (of each of the included articles) or the author's host institution. Two reviewers independently screened the articles and extracted data using a standardised form. RESULTS Thirty-one articles (from a total of 4181) were included. From these, 41 distinct D&I CBIs were identified which focussed on different contexts and professions, from 8 countries across the world. CBIs ranged from short courses to training institutes to being part of academic programmes. Nearly half were delivered face-face with the remainder delivered remotely or using a blended format. CBIs often stipulated specific eligibility criteria, strict application processes and/or were oversubscribed. Variabilities in the way in which the D&I CBIs were reported and/or evaluated were evident. CONCLUSIONS Increasing the number of training opportunities, as well as broadening their reach (to a wider range of learners), would help address the recognised deficit in D&I training. Standardisation in the reporting of D&I CBIs would enable the D&I community to better understand the findings across different contexts and scientific professions so that training gaps can be identified and overcome. More detailed examination of publications on D&I CBIs as well as the wider literature on capacity building would be of significant merit to the field.
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Affiliation(s)
- Rachel Davis
- Centre for Implementation Science, Health Service and Population Research Department, King’s College London, London, UK
| | - Danielle D’Lima
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Davis R, Mittman B, Boyton M, Keohane A, Goulding L, Sandall J, Thornicroft G, Sevdalis N. Developing implementation research capacity: longitudinal evaluation of the King's College London Implementation Science Masterclass, 2014-2019. Implement Sci Commun 2020; 1:74. [PMID: 32944717 PMCID: PMC7488442 DOI: 10.1186/s43058-020-00066-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 08/18/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Despite an increasing number of training opportunities in implementation science becoming available, the demand for training amongst researchers and practitioners is unmet. To address this training shortfall, we developed the King's College London 'Implementation Science Masterclass' (ISM), an innovative 2-day programme (and currently the largest of its kind in Europe), developed and delivered by an international faculty of implementation experts. METHODS This paper describes the ISM and provides delegates' quantitative and qualitative evaluations (gathered through a survey at the end of the ISM) and faculty reflections over the period it has been running (2014-2019). RESULTS Across the 6-year evaluation, a total of 501 delegates have attended the ISM, with numbers increasing yearly from 40 (in 2014) to 147 (in 2019). Delegates represent a diversity of backgrounds and 29 countries from across the world. The overall response rate for the delegate survey was 64.5% (323/501). Annually, the ISM has been rated 'highly' in terms of delegates' overall impression (92%), clear and relevant learning objectives (90% and 94%, respectively), the course duration (85%), pace (86%) and academic level 87%), and the support provided on the day (92%). Seventy-one percent of delegates reported the ISM would have an impact on how they approached their future work. Qualitative feedback revealed key strengths include the opportunities to meet with an international and diverse pool of experts and individuals working in the field, the interactive nature of the workshops and training sessions, and the breadth of topics and contexts covered. CONCLUSIONS Yearly, the UK ISM has grown, both in size and in its international reach. Rated consistently favourably by delegates, the ISM helps to tackle current training demands from all those interested in learning and building their skills in implementation science. Evaluation of the ISM will continue to be an annual iterative process, reflective of changes in the evidence base and delegates changing needs as the field evolves.
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Affiliation(s)
- Rachel Davis
- Centre for Implementation Science, Health Service and Population Research Department, King’s College London, London, UK
| | - Brian Mittman
- Department of Research and Evaluation, Kaiser Permanente, Pasadena, USA
| | - Madelene Boyton
- Centre for Implementation Science, Health Service and Population Research Department, King’s College London, London, UK
| | - Aoife Keohane
- Centre for Implementation Science, Health Service and Population Research Department, King’s College London, London, UK
| | - Lucy Goulding
- Centre for Implementation Science, Health Service and Population Research Department, King’s College London, London, UK
| | - Jane Sandall
- Department of Women and Children’s Health, School of Life Course Science, King’s College London, London, UK
| | - Graham Thornicroft
- Centre for Implementation Science, Health Service and Population Research Department, King’s College London, London, UK
- Centre for Global Mental Health, Health Service and Population Research Department, King’s College London, London, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, King’s College London, London, UK
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Abookire S, Plover C, Frasso R, Ku B. Health Design Thinking: An Innovative Approach in Public Health to Defining Problems and Finding Solutions. Front Public Health 2020; 8:459. [PMID: 32984247 PMCID: PMC7484480 DOI: 10.3389/fpubh.2020.00459] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/22/2020] [Indexed: 11/13/2022] Open
Abstract
Current trends in the United States health care landscape call for innovative and adaptive approaches to improve outcomes and reduce inefficiencies. Design Thinking is an innovative approach to problem-solving that leverages insights from the end-users of new products, services, and experiences in order to develop best-fit solutions that are rapidly prototyped and iteratively refined. When compared to traditional problem-solving methods in health care and other public health adjacent fields, Design Thinking leads to more successful and sustainable interventions. Design Thinking has facilitated improvements in patient, provider, and community satisfaction, and in public health, has increased efficiency and collaboration in intervention development. Given the promising nature of Design Thinking as an effective problem-solving method, it follows that Design Thinking training would prove a beneficial addition to public health education. The integration of Design Thinking in public health education may equip public health leaders with essential skills necessary to understand and more effectively approach historically intractable challenges. This article describes the development and evaluation of a hands-on Design Thinking workshop, piloted with Master of Public Health (MPH) students in April, 2019 at Thomas Jefferson University. Preceding and following the workshop, evaluation forms were used to assess participants' knowledge about Design Thinking concepts and attitudes towards the workshop experience. Metrics were aligned with established learning objectives related to process, impact, and outcomes of the workshop. We hypothesized that the workshop intervention would increase participants understanding of Design Thinking concepts and applications in public health. Evaluations demonstrated that after attending the workshop, participants were able to understand and apply Design Thinking concepts in a public health context. Following the evaluation of pilot data, the workshop was refined and embedded in the MPH curriculum at Thomas Jefferson University in Philadelphia, PA.
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Affiliation(s)
- Sylvie Abookire
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
| | - Colin Plover
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
| | - Rosemary Frasso
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
| | - Bon Ku
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
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Albers B, Metz A, Burke K. Implementation support practitioners - a proposal for consolidating a diverse evidence base. BMC Health Serv Res 2020; 20:368. [PMID: 32357877 PMCID: PMC7193379 DOI: 10.1186/s12913-020-05145-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 03/24/2020] [Indexed: 02/08/2023] Open
Abstract
Background Workforce development for implementation practice has been identified as a grand challenge in health services. This is due to the embryonic nature of the existing research in this area, few available training programs and a general shortage of frontline service staff trained and prepared for practicing implementation in the field. The interest in the role of “implementation support” as a way to effectively build the implementation capacities of the human service sector has therefore increased. However, while frequently used, little is known about the skills and competencies required to effectively provide such support. Main body To progress the debate and the research agenda on implementation support competencies, we propose the role of the “implementation support practitioner” as a concept unifying the multiple streams of research focused on e.g. consultation, facilitation, or knowledge brokering. Implementation support practitioners are professionals supporting others in implementing evidence-informed practices, policies and programs, and in sustaining and scaling evidence for population impact. They are not involved in direct service delivery or management and work closely with the leadership and staff needed to effectively deliver direct clinical, therapeutic or educational services to individuals, families and communities. They may be specialists or generalists and be located within and/or outside the delivery system they serve. To effectively support the implementation practice of others, implementation support practitioners require an ability to activate implementation-relevant knowledge, skills and attitudes, and to operationalize and apply these in the context of their support activities. In doing so, they aim to trigger both relational and behavioral outcomes. This thinking is reflected in an overarching logic outlined in this article. Conclusion The development of implementation support practitioners as a profession necessitates improved conceptual thinking about their role and work and how they enable the uptake and integration of evidence in real world settings. This article introduces a preliminary logic conceptualizing the role of implementation support practitioners informing research in progress aimed at increasing our knowledge about implementation support and the competencies needed to provide this support.
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Affiliation(s)
- Bianca Albers
- European Implementation Collaborative, Søborg, Denmark. .,University of Melbourne, Melbourne, Australia.
| | - Allison Metz
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Katie Burke
- Centre for Effective Services, Dublin, Ireland
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