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
- 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.
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
D&I models (e.g., CFIR, Knowledge to Action, Diffusion Theory; PRECEDE
PROCEED; Dynamic Sustainability Framework) in the planning and
operationalization of programs
patients, families, and stakeholders
designs for typical and low resource settings
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
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
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.
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)
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
the first year
(likely one at time, but may overlap, as some of the series may anywhere from
1-9 months long
per year that trainees help to organize/present during their second year
lectures (60-90 minutes each)
and D&I team meeting
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)