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Implementation Science at UW

Tag: 2018

Increasing Implementation of Evidence-Based Interventions at Low-Wage Worksites

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Funding has been awarded to principal investigator Margaret (Peggy) Hannon by the NIH National Cancer Institute for "Increasing Implementation of Evidence-Based Interventions at Low-Wage Worksites".

 

Abstract:

Cancer and other chronic diseases are the leading causes of death in the United States for working-age adults. There are several behavioral risk factors that increase disease risk, including missed cancer screenings, physical inactivity, poor eating habits, and tobacco use. Evidence-based interventions (EBIs) exist that improve each of these risk behaviors, and many of these EBIs can be implemented in worksites where the majority of U.S. adults spend most of their waking hours. There are significant disparities in access to worksite EBIs; large worksites (more than 1000 employees) are much more likely to offer EBIs to their employees than small worksites with less than 250 employees.

The American Cancer Society (ACS) and the University of Washington Health Promotion Research Center (HPRC) developed HealthLinks, a package of EBIs appropriate and feasible for small worksites. We are currently completing a randomized controlled trial of HealthLinks with more than 70 small worksites; results show that worksites in the HealthLinks arms implemented significantly more EBIs at follow-up than worksites in the delayed control arm. Now that we know HealthLinks is effective, we need a way to scale it up beyond the location of the trial. Local health departments (LHDs) cover almost every community in the United States and most LHDs' missions include preventing chronic disease. In a separate project, we pilot-tested training staff in six LHDs in Washington State to deliver HealthLinks to worksites in their communities. We found that LHD staff completed the training and recruited worksites to participate in HealthLinks; these worksites implemented EBIs.

The primary goals of this competing renewal are (a) to scale up HealthLinks by training staff in LHDs across the United States to deliver HealthLinks to small employers in their communities, and (b) to further implementation science by conducting a hybrid type III trial comparing the effectiveness and costs of two different implementation strategies. We will achieve these goals through three specific aims, guided by the HPRC Dissemination and Implementation Framework. We will conduct qualitative audience research with state and local health department directors and local health department staff to refine our training and support approaches (Aim 1); we will conduct a hybrid type III trial comparing standard and enhanced technical assistance combined with online training for HealthLinks (Aim 2); and we will measure the costs of each strategy, both to the local health departments and to the research team (Aim 3). The proposed activities will increase the reach of HealthLinks across the United States to small employers with limited capacity for and access to EBIs.

These activities will also advance implementation science by measuring the impact and costs of implementation strategies offering different levels of ongoing support. The findings from this project may inform implementation strategies for other workplace health promotion programs focused on EBIs and small worksites, as well as a variety of implementation efforts that include partnerships with LHDs.

Sponsor Award Number: 2R01CA160217-06A1

Improving the HIV Care Cascade in Kenya through Implementation Science Training

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Funding has been awarded to principal investigator Dr. Carey Farquhar by the NIH's Fogarty International Center, National Institute on Drug Abuse, and National Institute of Mental Health for "Improving the HIV Care Cascade in Kenya through Implementation Science Training".

 

Abstract:

This application seeks to renew the D43 HIV Research Training grant entitled, “Improving the HIV Care Cascade in Kenya through Implementation Science Training,” by building on longstanding UW collaborations with Kenyan institutions and our first 4 years of successful training. From September 2013 to the present, the program has focused on increasing capacity at Kenyatta National Hospital (KNH), the largest teaching and referral hospital in Kenya, and the Ministry of Health (MOH), in implementation science research targeting HIV testing, linkage to care, antiretroviral initiation and viral suppression, a continuum known as the HIV care cascade.

During this period, 10 KNH Care Cascade (KNHCC) trainees have earned MPH or PhD degrees and laid a solid foundation for KNH and its partners at MOH and University of Nairobi (UON) to take a bold step towards creation of an Implementation Science and Dissemination Research Center of Excellence. This renewal application will provide critical support for the training, teaching and research activities needed to realize this vision. The program will continue to be led by Dr. Carey Farquhar, Director of the UW International AIDS Research and Training Program (IARTP) since 2003, and Dr. John Kinuthia, Head of the Department of Research and Programs at KNH.

Two complementary training tracks will be offered: 1) MPH/PhD sandwich program in implementation science which will take place in Seattle, USA (year 1) and in Nairobi, Kenya (years 2-4) and 2) a 1-year certificate program which will include 1 month of mentoring and relevant coursework at the UW followed by completion of additional in-person courses and workshops at KNH and UON, UW e-learning courses, and completion of a mentored research project. Candidates for the training will have permanent positions at KNH or MOH, and may be from medicine, nursing, pharmacy or public health. We will also offer shorter in-country trainings lasting from 3 days to 1 week that reach a larger number of KNH and MOH professional staff. The short-term trainings will build broader institutional capacity, promote awareness of key research concepts and practices, and identify the best candidates for future degree and certificate training.

A Steering Committee comprised of leading researchers, educators and policy makers from all 4 institutions (UW, KNH, UON, MOH) will work closely with the KNHCC Program Director and Co-director and receive regular input from an external Training Advisory Group (TAG) to ensure success of each trainee and the overall program. This success will translate into improving the HIV care cascade in Kenya and the region by producing high-quality and locally relevant research, influencing national guidelines and policies, and training the next generation of African researchers in implementation science.

Sponsor Award Number: 2D43TW009580-06