NHLBI K-12 grants will advance implementation science
Every year, the outcomes of many millions of dollars in medical and health care research are, if not lost in translation, at least significantly delayed in getting into your doctor’s office.
Some experts propose that discoveries can take as long as 17 years, on average, to enter routine clinical practice. If they are among the lucky 14 percent that ever does. This means that proven knowledge about preventive, acute and long-term care may not affect the care and medical advice Americans receive.
“For sickle cell disease, hypertension, and other heart, lung, and blood diseases, we have compelling evidence-based strategies that can prevent these diseases or their complications,” said Dr. George Mensah, director of the National, Heart, Lung, and Blood Institute’s (NHLBI) Center for Translation Research and Implementation Science (CTRIS). “So why aren’t these strategies being widely used and what can we do to facilitate that use? Why do health disparities persist when we have compelling evidence that the disparities are preventable? These are the questions that CTRIS grantees will be asking, and, hopefully, also answering.”
It is through late-stage translation research, also known as T4 research, that investigators examine the effectiveness of interventions that influence the health of populations. Implementation research can address the lag of effective interventions in medical practice by identifying strategies that would speed up the sustainable adoption of discoveries and the weeding out of ineffective practices in real world settings.
The Vanderbilt Scholars in T4 Translational Research (V-sTTaR Program), a new career development program at Vanderbilt University Medical Center, seeks to address these issues by training “a cadre of talented researchers in how to overcome the hurdles associated with incorporating proven interventions into practice,” according to professor Sunil Kripalani, M.D., MSc, the project lead.
The V-STTaR Scholars will learn how to assess the barriers to adoption of proven interventions, adapt interventions to fit the local context, utilize effective strategies for implementing these interventions, carry out their work in a way that is mindful of future sustainability, and evaluate the impact on patient care, Kripalani said.
The Vanderbilt program is funded by one of the first implementation research grants recently awarded by CTRIS to ten institutions, in order to build and foster a sustainable, diverse and properly trained research workforce. The effort was chaired by Rear Admiral Helena Mishoe, a long-time leader in NHLBI and NIH training.
“The need for this grant initiative became apparent after an analysis of NHLBI’s research training portfolio,” said Mensah. “It showed a shortage of individuals in our pipeline with the requisite skill set to move science discoveries into practice.”
Through implementation science researchers address bottlenecks, test the effectiveness of interventions and rigorously assess the impact of programs to inform health care and public health.
“There is a huge amount of knowledge that is being developed through all of that investment at the NIH that can be used to help patients,” said State University of NY at Buffalo professor Ranjit Singh, MB BChir, MBA, one of the grant recipients. “But in order to get it to those patients, we have to do this health services research or late stage translational research to take the last steps to get over the finish line.”
All the projects are focused on researchers’ career development, but the settings and the approaches run the gamut from community health and global and impoverished settings, to ill patients in intensive care units. This, they expect, will result in a variety of methodologies and ideas to improve workforce training in institutions all across America.
In Vanderbilt, the grant will support a minimum of five faculty scholars for three years, allowing them to devote 75 percent of their time to training and research in this area, explained Kripalani, who believes this will help everyone to work together “to continually improve patient care and outcomes.”
Recipients of the Implementation K12 grants
University of Michigan
Principal Investigators: Theodore J. Iwashyna and Evelyn Ann Sales
University of Washington
Principal Investigators: David Au, Randall Curtis and Bryan Weiner
Washington University, St. Louis
Title: Washington University K12 Program in T4 IR (WU K12 T4)
Principal Investigator: Mario Castro
Principal Investigators: Sunil Kripalani and Christine Rouni
University of California, San Francisco
Title: UCSF Career Development Program in IR in HLBS
Principal Investigator: Kirsten Bibbins-Domingo
University of Colorado Denver
Title: Implementation to Achieve Clinical Transformation (IMPACT)
Principal Investigators: Russel Glasgow and Edward Paul Havranek
Title: Dissemination and Implementation Science in Cardiovascular Outcomes (DISCO)
Principal Investigator: Hayden Bosworth
Title: Yale Scholars in Implementation Science (YSIS)
Principal Investigator: Steven Bernstein
University of Massachusetts Medical School (UMMS)
Title: K12 Cardiopulmonary Implementation Science Program
Principal Investigators: Stephenie Lemon and Thomas Houston
State University of NY at Buffalo
Title: UB Clinical Scholar Program in Implementation Science to Achieve Triple Aims
Principal Investigators: Ranjit Singh and John Canty