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✪ Creating research-ready partnerships: the initial development of seven implementation laboratories to advance cancer control

Authors:

Gina R. Kruse, Erica Hale, Justin E. Bekelman, Jennifer E. DeVoe, Rachel Gold, Peggy A. Hannon, Thomas K. Houston, Aimee S. James, Ashley Johnson, Lisa M. Klesges & Andrea L. Nederveld

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: February 2023

Read the full text in the open access journal BMC Health Services Research

Abstract:

Background

In 2019–2020, with National Cancer Institute funding, seven implementation laboratory (I-Lab) partnerships between scientists and stakeholders in ‘real-world’ settings working to implement evidence-based interventions were developed within the Implementation Science Centers in Cancer Control (ISC3) consortium. This paper describes and compares approaches to the initial development of seven I-Labs in order to gain an understanding of the development of research partnerships representing various implementation science designs.

Methods

In April-June 2021, members of the ISC3 Implementation Laboratories workgroup interviewed research teams involved in I-Lab development in each center. This cross-sectional study used semi-structured interviews and case-study-based methods to collect and analyze data about I-Lab designs and activities. Interview notes were analyzed to identify a set of comparable domains across sites. These domains served as the framework for seven case descriptions summarizing design decisions and partnership elements across sites.

Results

Domains identified from interviews as comparable across sites included engagement of community and clinical I-Lab members in research activities, data sources, engagement methods, dissemination strategies, and health equity. The I-Labs use a variety of research partnership designs to support engagement including participatory research, community-engaged research, and learning health systems of embedded research. Regarding data, I-Labs in which members use common electronic health records (EHRs) leverage these both as a data source and a digital implementation strategy. I-Labs without a shared EHR among partners also leverage other sources for research or surveillance, most commonly qualitative data, surveys, and public health data systems. All seven I-Labs use advisory boards or partnership meetings to engage with members; six use stakeholder interviews and regular communications. Most (70%) tools or methods used to engage I-Lab members such as advisory groups, coalitions, or regular communications, were pre-existing. Think tanks, which two I-Labs developed, represented novel engagement approaches. To disseminate research results, all centers developed web-based products, and most (n = 6) use publications, learning collaboratives, and community forums. Important variations emerged in approaches to health equity, ranging from partnering with members serving historically marginalized populations to the development of novel methods.

Conclusions

The development of the ISC3 implementation laboratories, which represented a variety of research partnership designs, offers the opportunity to advance understanding of how researchers developed and built partnerships to effectively engage stakeholders throughout the cancer control research lifecycle. In future years, we will be able to share lessons learned for the development and sustainment of implementation laboratories.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

Realist evaluation in times of decolonising global health

Authors:

Dimitri Renmans, Nandini Sarkar, Sara Van Belle, Clara Affun-Adegbulu, Bruno Marchal, & Ferdinand C. Mukumbang

University of Washington affiliated authors are displayed in bold.

Subscription Required for Full Text Access

Published: June 2022

Read the full text in the subscription access journal, The International Journal of Health Planning and Management

✪ Using a continuum of hybrid effectiveness-implementation studies to put research-tested colorectal screening interventions into practice

Authors:

Beverly B. Green, Gloria D. Coronado, Malaika Schwartz, Jen Coury, & Laura-Mae Baldwin

University of Washington affiliated authors are displayed in bold.

Published: May 2019

Read the full text in the open access journal Implementation Science

Abstract:

Background

Few previous studies have applied the hybrid effectiveness-implementation design framework to illustrate the way in which an intervention was progressively implemented and evaluated across multiple studies in diverse settings.

Methods

We describe the design components and methodologies of three studies that sought to improve rates of colorectal cancer (CRC) screening using mailed outreach, and apply domains put forth by Curran et al.: research aims, research questions, comparison conditions, sample, evaluation methods, measures, and potential challenges.

The Hybrid 1 study (emphasis on effectiveness) was a patient-level randomized trial of a mailed fecal test and stepped phone-outreach intervention program delivered in an integrated healthcare system (21 clinics, 4673 patients). The primary outcome was effectiveness (CRC screening uptake). Implementation outcomes included cost-effectiveness and acceptability.

The Hybrid 2 study (shared emphasis on effectiveness and implementation) was a pragmatic cluster-randomized trial of mailed fecal immunochemical test (FIT) outreach implemented at safety net clinics (26 clinics, 41,000 patients). The intervention used electronic health record tools (adapted from Hybrid 1) and clinic personnel to deliver the intervention. Outcomes included effectiveness (FIT completion) and implementation (FIT kits delivered, clinic barriers and facilitators, cost-effectiveness).

Hybrid 3 study (emphasis on implementation) is a demonstration project being conducted by two Medicaid/Medicare insurance plans (2 states, 12,000 patients) comparing two strategies for implementing mailed FIT programs that addressed Hybrid 2 implementation barriers. Outcomes include implementation (activities delivered, barriers) and effectiveness (FIT completion).

Results

The effectiveness-implementation typology successfully identified a number of distinguishing features between the three studies. Two additional features, program design and program delivery, varied across our studies, and we propose adding them to the current typology. Program design and program delivery reflect the process by which and by whom a program is designed and delivered (e.g., research staff vs. clinic/health plan staff).

Conclusions

We describe three studies that demonstrate the hybrid effectiveness to implementation continuum and make recommendations for expanding the hybrid typology to include new descriptive features. Additional comparisons of Hybrid 1, 2, and 3 studies may help confirm whether our hybrid typology refinements are generalizable markers of the pipeline from research to practice.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

Intentional research design in implementation science: Implications for the use of nomothetic and idiographic assessment

Authors:

Aaron R. Lyon, Elizabeth Connors, Amanda Jensen-Doss, Sara J. Landes, Cara C. Lewis, Bryce D. McLeod, Christopher Rutt, Cameo Stanick, Bryan J. Weiner

University of Washington affiliated authors are displayed in bold.

Subscription Required for Full Text Access

Published: September 2017

Read the full text in the subscription access journal Translational Behavioral Medicine