Transcript Translating Research into Practice Developed through the APTR Initiative to Enhance Prevention and Population Health Education in collaboration with the Brody School.

Translating Research into Practice
Developed through the APTR Initiative to Enhance Prevention and Population
Health Education in collaboration with the Brody School of Medicine at East
Carolina University with funding from the Centers for Disease Control and
Prevention
APTR wishes to acknowledge the following individuals who
developed this module:

Anh Tran, PhD, MPH
Duke University School of Medicine, Department of Community and Family Medicine
Duke Center for Community Research

Victoria S. Kaprielian, MD, FAAFP
Duke University School of Medicine, Department of Community and Family Medicine

Jennifer Cook, MPH
Duke University School of Medicine, Department of Community and Family Medicine
This education module is made possible through the Centers for Disease Control and Prevention (CDC) and the
Association for Prevention Teaching and Research (APTR) Cooperative Agreement, No. 5U50CD300860. The module
represents the opinions of the author(s) and does not necessarily represent the views of the Centers for Disease
Control and Prevention or the Association for Prevention Teaching and Research.
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List reasons for lag time between scientific
discoveries and their application
Provide suggestions on how to facilitate translation
of research to practice
Discuss the value of working with practice based
research networks
List creative ways to disseminate research findings
with and to communities
Explain ways to build a pipeline of community
engaged researchers
Community
Medicine
Translation of Research
to Outcomes that
Matter!
Research
Public Health
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It takes, on average, a decade between a scientific
discovery and the application of that discovery as
standard of care.
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Example: Tamoxifen
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Many patients have co-morbid conditions, which require
complex solutions.
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Most studies conducted in academic centers
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Results found in academic research journals
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Practice patterns difficult to modify
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Lack of rewards to influence behavior
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Recommendations not always feasible
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Outcomes that matter:
 Access to safe, quality care
 Coordination between services
 Better prevention of disease
 Improved quality of life
 Safer, healthier communities
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Conduct larger population
health studies
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Organize education efforts
to share results
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Provide support to change
practice patterns
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Change reward systems and
metrics
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Practice Based Research Networks are important
partners in translational medicine
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Practice-based research networks can:
 help define the research agenda
 participate in research
 translate findings quickly into practice
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Family Medicine Networks
Internal Medicine Networks
Mixed Networks
Nursing Networks
Pediatric Networks
Nutritionist/Dietician Networks
Networks serving the uninsured or
underinsured.

PBRN projects must be a two-way street:
Researchers
Practicing Clinicians
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True success comes only with partnership.
HRSA Collaboratives:
http://www.hrsa.gov/healthit/collaboratives.html
 OCHIN: http://ochin.org
 Washington State Practice-Based Research Network:
http://www.kingcounty.gov/healthservices/health/p
artnerships/pbrn.aspx
 The Dental Practice-Based Research Network:
http://www.dentalpbrn.org
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 Funder: North Carolina Health and Wellness Trust Fund. Primary Grantee:
Duke Medicine. Time period: July 2008 – Dec. 2010.
 Purpose: Assess the feasibility and effectiveness of integrating registered
dietitians (RDs) into primary care practices to address weight problems in
overweight or obese children. Study of a model of care.
 Design: Half-time RDs placed in 8 practices to provide standard of care.
Abstracted data collected for clinical purposes , surveyed practices,
conducted RD interviews and practice focus groups.
 Findings: RD integration is feasible, but identified modifiable and non-
modifiable barriers to reimbursement. Indications of effectiveness for
individual patients and impact on practice overall.
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Translation:
 Five of eight practices hired the RD after the study ended.
 Billing guide for RD services hosted on American Dietetic Association website.
 Approach to financial assessment is being requested by clinicians.
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Study characteristics supporting translation:
 Addressed question of interest to those in practice.
 An effectiveness study of how the model worked in a real-world setting, not an
efficacy study of how it would work under controlled research conditions.
 Addressed implementation issues of work flow and cost.
 Provided practices with individualized implementation data and financial
assessments to support decision-making.
 Created billing guide to support RD integration.
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At the beginning of a study, it is crucial to plan for
dissemination back to patients and practitioners.
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Rarely, however, are researchers encouraged or
rewarded for this effort.
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Important to consider privacy concerns when
planning for dissemination.
Work with IRBs at the beginning stages of a
project to address dissemination issues such as:
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 Whether research participants can be directly contacted
without their consent.
 Ways to encourage more participants to receive
information.
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Dissemination strategies must go beyond traditional
medical journals.
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Journal articles do not always trickle down to the
community level.
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Work with community partners to creatively share
information in different ways.
Disseminate Research Findings:
In professional
journals,
conferences,
abstracts,
posters
Back to
referring
physicians
To the community
through emails,
newsletters, events
Back to
participants
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Universities can engage the community in the
research process through avenues such as:
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Regular emails
List-servs
Newsletters
“Open mic” nights
Radio/TV coverage
Social media marketing campaigns
Old Model:
New Model:
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Data is sole property of the
researcher
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Data is shared property
with the community
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Disseminate through
academic journals
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Disseminate regardless of
journal-worthy results
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Privacy and proprietary
concerns trump sharing
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Privacy is protected,
academic proprietary needs
addressed AND data is
freely shared.
Educate the community
about research
Inspire pre-college students
from underserved communities
to explore careers in research
Offer providers and social service
professionals in community
setting research methods training
Change the culture of medical
academia to appreciate
and reward community engagement
Make community engagement a required
competency at all levels of training
Old Model:
Research
Subjects from
Community
Research
Studies
Published
Literature
New Model:
Community
Partnerships
Research
Studies
Healthier Community
Expanded &
Coordinated
Access to Care
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Health problems exist within context of people’s
lives so solutions are context specific as well.
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Successful academic-community partnerships can
promote greater trust and more impacting research
that can influence clinical practice.
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Department of Public Health
Brody School of Medicine at East Carolina University
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Center for Public Health Continuing Education
University at Albany School of Public Health
Mike Barry, CAE
Lorrie Basnight, MD
Nancy Bennett, MD, MS
Ruth Gaare Bernheim, JD, MPH
Amber Berrian, MPH
James Cawley, MPH, PA-C
Jack Dillenberg, DDS, MPH
Kristine Gebbie, RN, DrPH
Asim Jani, MD, MPH, FACP
Denise Koo, MD, MPH
Suzanne Lazorick, MD, MPH
Rika Maeshiro, MD, MPH
Dan Mareck, MD
Steve McCurdy, MD, MPH
Susan M. Meyer, PhD
Sallie Rixey, MD, MEd
Nawraz Shawir, MBBS
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Sharon Hull, MD, MPH
President
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Allison L. Lewis
Executive Director
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O. Kent Nordvig, MEd
Project Representative