Center for Translation Research and Implementation Science

CTRIS, in collaboration with other NHLBI units and NIH Institutes, is leading the effort to integrate community-engaged research with implementation science. In so doing, CTRIS is testing the idea that when communities are meaningfully engaged early and throughout all phases of research, strategies for disseminating and implementing research findings are more effective, more likely to be sustained, and ready to expand and be adopted by others.

CTRIS supports testing community engagement in Dissemination and Implementation (D&I) research across a spectrum of approaches, such as community-based participatory research, participatory action research, practice-based research networks, and asset-based community development. CTRIS promotes community-engaged research that leverages the best available theories, models, and frameworks for D&I and community engagement, like the National Academy of Medicine’s ‘Assessing meaningful engagement conceptual model.’ CTRIS also validates pragmatic measures to promote generalizable knowledge.

In addition, CTRIS hosts scientific workshops to inform this research:

• Advancing the science of community-engaged health disparities research
• Centering Communities in Dissemination Research to Promote Health Equity

CTRIS also supports NHLBI in its partnership with NIMHD to lead the Community Engagement Alliance (CEAL), an NIH-wide research network of academic and community partners to conduct community-engaged research working to eradicate disparities.

Training and career development opportunities are particularly important to growing the dissemination and implementation (D&I) community of researchers studying heart, lung, blood, and sleep disorders. Researchers need to learn D&I research terminology, outcomes, measures, theories, models, frameworks, and reporting guidelines. In addition, the nature of D&I research demands skill in engaging multiple interested entities, including patients and their communities, providers, care teams, administrators, leaders, policymakers, and payors. For example, bringing D&I methods together with numerous partners demands creativity in selecting study designs that fit different priorities and constraints.

CTRIS and NHLBI participate in many parent NOFOs designed to bolster training and career development, including F31s, F32s, T32s, R25s, K01s, and K23s. CTRIS and NHLBI also partner with the Fogarty International Center on training and career development awards, including the D43 and K43. CTRIS is committed to growing a diverse D&I workforce, and several opportunities are available to applicants. Interested applicants are encouraged to seek technical assistance from CTRIS staff when exploring these investigator-initiated training and fellowship programs.

Increasingly, there is recognition that many evidence-based interventions fail to reach populations in need because of social and structural determinants of health that require multilevel strategies. However, multilevel strategy design and testing is complex for multiple reasons.

• More pragmatic methods that integrate the extant literature and theorizing are needed because it can be difficult to identify and prioritize interrelated barriers and facilitators with communities.
• More evidence is needed to match feasible strategies to the changing barriers, facilitators, and various constraints in specific contexts. There are still many unanswered empirical questions:
  • When should social determinants be changed instead of adapting the evidence-based intervention? When should both be tailored to the context?
  • What is the best approach for designing the most cost-effective multilevel strategy to achieve outcomes such as the degree of reach of an intervention within a target population?

CTRIS is highly involved in NIH-wide efforts to promote multilevel and intervention-based health disparities research, such as the Transformative Research to Address Health Disparities and Advance Health Equity funding opportunity and the post-pandemic refocusing of the CEAL teams and initiatives toward intervention-based research that seeks to address disparities in social and structural determinants of health.