Implementation Science
Networking Event
Social and Behavioral Science Core
UNC Center for AIDS Research
Bryan Weiner, PhD and Catherine Rohweder, DrPH: Slides 2- 10
Oscar Fleming, MSPH: Slides 11-21
Theresa Hoke, PhD, MPH: Slides 22-34
October 13, 2014
Integrating Implementation Science into
HIV Research:
Resources at the UNC Gillings
School of Global Public Health
and the TraCS Institute
Bryan Weiner, PhD and Catherine Rohweder, DrPH
UNC Gillings School of Global Public Health
Center for AIDS Research Fall Networking Event
10/13/14
Barriers to Evidence-Based
Practice and Policy
Adapted from:
Glasgow and Emmons. How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health. 2007; 28:413-33.
Brownson, Chriqui, and Stamat3akis. Understanding Evidence-based Public Health Policy. Am J Pub Health. 2009; 99(9):1576-1583.
3
What is Implementation Science?
IMPLEMENTATION SCIENCE is the study of methods to promote the use of
research findings in healthcare, community, and policy contexts. As a
multidisciplinary field, it examines how these findings are disseminated,
implemented, and sustained by targeted audiences.
Figure modified from National Cancer Institute Implementation Science Web Portal and Rubenstein et al. 2006.
4
The Consortium for Implementation Science
The CIS facilitates collaborations among UNC and
RTI scientists, practitioners and policy-makers with
the goal of advancing dissemination and
implementation science (D&I) through research,
education and policy.
The D&I Methods Unit, TraCS Institute
The Methods Unit seeks to advance the science of
translational research by supporting the development
and integration of innovative analytic frameworks,
methods, and metrics in community-engaged
research.
5
Goals and Services
The CIS / Methods Unit seek to:
• Increase researcher knowledge of and skills in D&I Science
• Facilitate the formation of investigator teams
• Develop and test new measures for use in D&I studies
CIS / Methods Unit faculty and staff provide
consultations and services including:
• Scientific support for grant/contract applications
• Training and technical assistance for researchers,
practitioners, and policy-makers
• Seminars and/or lectures on Implementation Science
6
Examples of CIS / Methods Unit Work
• Facilitated CDC IDIQ application lead by UNC Center for
Health Promotion/Disease Prevention
• Sponsored NC TraCS D&I Pilot Program
• Delivered 50+ consultations to UNC and RTI investigators
since July 2013
• Made 20 presentations to internal and external audiences
including a seminar series on Implementation Science 101
• Taught a Health Policy and Management capstone course
for UNC BSPH students
• Contributed letters of support for grant and training
applications
7
Dissemination and Implementation Portal
www.tracs.unc.edu/diportal
Purpose: Promote innovative D&I research
Target audience: Investigators
Approach:
 Integrate into the already existing TraCS and
CIS websites
 Highlight expertise of D&I investigators at UNC
 Use TraCS media lab for webinars/podcasts
 Create new content not available elsewhere
8
Content Categories
• Sample Grants and Grant Writing Resources
• Methods Presentations
• Sources of Evidence
• Tools
• Measures
• Journals
• Theories and Frameworks
• Conferences and Training
9
9
Thank you!
Please contact us at:
• CIS@ConsortiumforIS.org
or
• nctracs@unc.edu
10
Improving Outcomes
through Active
Implementation
Applied
Implementation
Science
Presentation for the CFAR Core G Networking
Event
October 13, 2014
Oscar Fleming
National Implementation Research Network
FPG Child Development Institute
University of North Carolina at Chapel Hill
Defining Implementation
Implementation is defined as a
specified set of activities
designed to put into practice an
activity or program of known
dimensions.
Why Focus on Implementation?
“Individuals cannot benefit from interventions
they do not experience.”
RESEARCH
IMPLEMENTATION
PRACTICE
Context
“Implementation science provides researchers [and
practitioners, program developers and policymakers]
with a framework to translate the evidence based
program interventions into practices and policies that
impact health outcomes.”
Kroelinger et al. Maternal Child Health Journal 2014
Formula For Success
• The “HOW” (e.g. strategies to build
competencies) & the “WHO” (e.g. Teams)
Effective
Interventions
Effective
Implementation
Methods
• The “WHAT” (e.g. evidence-based
home visitation programs)
Enabling
Contexts
Socially
Significant
Outcomes
Active Implementation Frameworks
Usable
Interventions
Improvement
Cycles
Teams
Stages
Drivers
Cascading Logic Model
All children, youth, and families will live and thrive in
healthy communities
…Served by a quality [competent] workforce that helps
assure their health and well-being…
…facilitated by engaged and skilled organizational and State
MCH/Title V leadership …
…Supported with strategic workforce development and
targeted technical support through MCH training programs…
…Guided and resourced through supportive policy and federal
guidance
Implementation Infrastructure
Outcomes: All children, youth, and families will live and thrive in healthy
communities
…Served by a quality [competent]
workforce that helps assure their
health and well-being…
…facilitated by engaged and skilled
organizational and State MCH/Title V
leadership …
…Supported with strategic workforce
development and targeted technical support
through MCH training programs…
…Guided and resourced through supportive policy
and federal guidance
For More Information
Oscar Fleming, MSPH
• 919-962-7193
• oscar.fleming@unc.edu
Frank Porter Graham Child Development Institute
University of North Carolina
Chapel Hill, NC
http://nirn.fpg.unc.edu/
www.scalingup.org
www.implementationconference.org
Implementation Science
Implementation
Research:
A Synthesis of
the Literature
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005).
Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South
Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation
Research Network (FMHI Publication #231).
HTTP://NIRN.FPG.UNC.EDU
©Copyright Dean Fixsen and Karen Blase
This content is licensed under Creative Commons license CC BY-NC-ND,
Attribution-NonCommercial-NoDerivs. You are free to share, copy, distribute
and transmit the work under the following conditions: Attribution — You
must attribute the work in the manner specified by the author or licensor
(but not in any way that suggests that they endorse you or your use of the
work); Noncommercial — You may not use this work for commercial
purposes; No Derivative Works — You may not alter or transform this
work. Any of the above conditions can be waived if you get permission
from the copyright holder.
http://creativecommons.org/licenses/by-nc-nd/3.0
Theresa Hoke, PhD, MPH
23
FHI 360: A Comprehensive Approach to Human Development
Civil Society +
Peacebuilding
Education
Economic
Development +
Livelihoods
Health
Gender
Nutrition
Environment
Research
Communication
+ Social
Marketing
Technology
Youth
FHI 360: A Comprehensive Approach to Human Development
Civil Society +
Peacebuilding
Education
Economic
Development +
Livelihoods
Health
Gender
Nutrition
Environment
Research
Communication
+ Social
Marketing
Technology
Youth
Implementation Science in Global Health
Maximizing Impact in an Imperfect World
Thursday, September 4, 2014
8:30 a.m. – 4:30 p.m.
Academy Hall, FHI 360
Washington, DC
This event is sponsored by FHI 360’s Global Health, Population and Nutrition Group.
What do we achieve through implementation
science?
• Identify implementation problems
• Develop and test practical solutions
• Determine how evidence-based interventions can achieve maximum
impact in real-world settings
• Facilitate full-scale implementation of evidence-based practices
Examples of FHI 360’s work in
implementation science
Facility RCT to test scaled-up mobile phone
intervention for HIV Care and Treatment
Aims:
1) Evaluate mHealth
intervention effects on
patient adherence and
health outcomes
2) Examine the delivery of
the mHealth intervention
for improving HIV care and
treatment
3) Assess the costeffectiveness of the
mHealth intervention
Panos Pictures
Testing implementation of evidencebased interventions for HIV risk
reduction in Ukraine
Tested EBIs
• mPowerment - gay,
bisexual and other MSM
• Project Start - individuals
to be released from a
correctional facility
• Street SMART – Most-atrisk adolescents
• Psycho-Medical
Intervention Model –
People who inject drugs
Jessica Scranton
Examining integration of reproductive health services into
HIV/AIDS services in South Africa, Uganda, and Kenya
Service Delivery
Health Workforce
Medical Products
Information
Leadership and
Governance
Financing
Testing integration of reproductive health services into
HIV/AIDS services in South Africa, Uganda, and Kenya
Service Delivery
Improve client flow
Health Workforce
Motivate providers
Medical Products
Reinforce commodity management
Information
Leadership and
Governance
Financing
Track performance
Translate policy guidance into
performance expectations
Deliver services in a way that’s
affordable to facilities and clients
FHI 360’s way forward in implementation science
Refine technical
capacity
Strengthen linkages
with programs
Form new
alliances