Challenges and Lessons Learned From the Translation of Evidence-Based Childhood Asthma Interventions

2011 ◽  
Vol 12 (6_suppl_1) ◽  
pp. 91S-99S ◽  
Author(s):  
Yvonne U. Ohadike ◽  
Floyd J. Malveaux ◽  
Julie Kennedy Lesch

The Merck Childhood Asthma Network (MCAN) used evidence-based interventions (EBIs) for children with asthma to design community-based programs in a wide variety of settings—with varying resource constraints and priorities—that were often determined by the program context. Although challenges were faced, lessons learned strongly suggest that adapting and implementing EBIs is feasible in a variety of settings using a multisite approach. Lessons learned during the MCAN initiative presented unique opportunities to refine best practices that proved to be important to translation of EBIs in community-based settings. The adopted best practices were based on experiential learning during different phases of the project cycle, including monitoring and evaluation, translational research, and implementing policies in local program environments. Throughout this discussion it is important to note the importance of program context in determining the effectiveness of the interventions, opportunities to scale them, their affordability, and the ability to sustain them. Lessons learned from this effort will be important not only to advance science-based approaches to manage childhood asthma but also to assist in closing the gap between intervention development (discovery) and program dissemination and implementation (delivery).

Author(s):  
Forrest Shull ◽  
Raimund Feldmann ◽  
Michelle Shaw ◽  
Michelle Lambert

For capturing and transferring knowledge between different projects and organizations, the concept of a Best Practice is commonly used. A similar but more general concept for knowledge capturing is often referred to as a Lesson Learned. Both best practices and lessons learned are frequently organized in the form of knowledge collections. Such collections exist in many forms and flavours: From simple notes on a white board, to paper file collections on a shelf, to electronic versions filed in a common folder or shared drive, to systematically archived and standardized versions in experience and databases, or even specific knowledge management systems. In the past few decades, many organizations have invested much time and effort in such specific knowledge collections (e.g., databases, experience repositories) for best practices and/ or lessons learned. The driving force behind all these activities is to disseminate knowledge about proven solutions to their workforce. Ultimately, the goal is to avoid mistakes and improve the overall workflow and processes to possibly save money and gain a competitive advantage.


2020 ◽  
pp. 152483992094768
Author(s):  
Terrinieka W. Powell ◽  
Meghan Jo ◽  
Anne D. Smith ◽  
Beth D. Marshall ◽  
Santha Thigpen ◽  
...  

Supplementing substance use prevention with sexual health education would allow educators to address the risk and protective factors that influence both health issues. This streamlined approach may minimize the inefficiencies of multisession, single-purpose interventions. Our team developed a supplemental sexual and reproductive health (SRH) unit to align with an existing evidence-based intervention, LifeSkills Training (LST). This goal of this article is to describe our process, final product, lessons learned, and future directions. Our partner-informed approach took place across three key phases: (1) formative insights, (2) unit development, and (3) pilot implementation. The final supplemental SRH unit is ten, 45-minute sessions offered to seventh- and eighth-grade students and includes a set of learning objectives that are aligned with individual sessions. The supplemental SRH unit also mirrors existing LST modules in length, flow, layout, facilitator instructions, focus on prevention, and utilization of a student workbook. Lessons learned include strategies to effectively incorporate a wide range of ongoing feedback from multiple sources and quickly respond to staff turnover. This partnership approach serves as a model for researchers and practitioners aiming to extend the reach of existing evidence-based programs.


2011 ◽  
Vol 26 (S1) ◽  
pp. s13-s13
Author(s):  
G.T. Hynes

The purpose of this presentation is to compare the lessons learned in acute nursing care in the post-disaster settings of Aceh Jaya, Indonesia (2004) and Port-au-Prince, Haiti (2010). The impact of such disasters disproportionally affects populations made vulnerable by poverty, marginalization, and structural violence. The recognition of these vulnerabilities heightens the role of the nurse as an advocate for the ill and injured. In addition, the lack of adequate human and material resources on all levels necessitates insisting on best practices for patient care despite the resource constraints. Consideration of best practices begins with rigorous personnel selection of nurses adequately trained in emergency/critical care, complex humanitarian emergencies, and disaster response. A proficient level of resource-specific triage knowledge is required to adequately provide the most effective care to patients. Not infrequently, disaster nursing care involves being tasked with a clinical skill or procedures that would be outside the scope of practice in the home country. While the expansion to such practices often is justified by need, an ethical framework demands consideration of the central tenet of “first do no harm”. A heavy burden of coordination among other caregivers, family, and the local staff is required by nurses in this environment. The substantial challenges include communication and continuity of care during the initial response phase among multiple partners with varied backgrounds and goals. Drawing from experiences in Haiti and Aceh, this presentation seeks to define the best practices in disaster nursing care and explore the ethical considerations that arise in such challenging environments.


2011 ◽  
Vol 12 (6_suppl_1) ◽  
pp. 63S-72S ◽  
Author(s):  
Marielena Lara ◽  
Tyra Bryant-Stephens ◽  
Maureen Damitz ◽  
Sally Findley ◽  
Jesús González Gavillán ◽  
...  

The Merck Childhood Asthma Network (MCAN) initiative selected five sites (New York City, Puerto Rico, Chicago, Los Angeles, and Philadelphia) to engage in translational research to adapt evidence-based interventions (EBIs) to improve childhood asthma outcomes. The authors summarize the sites’ experience by describing criteria defining the fidelity of translation, community contextual factors serving as barriers or enablers to fidelity, types of adaptation conducted, and strategies used to balance contextual factors and fidelity in developing a “best fit” for EBIs in the community. A conceptual model captures important structural and process-related factors and helps frame lessons learned. Site implementers and intervention developers reached consensus on qualitative rankings of the levels of fidelity of implementation for each of the EBI core components: low fidelity, adaptation (major vs. minor), or high fidelity. MCAN sites were successful in adapting core EBI components based on their understanding of structural and other contextual barriers and enhancers in their communities. Although the sites varied regarding both the EBI components they implemented and their respective levels of fidelity, all sites observed improvement in asthma outcomes. Our collective experiences of adapting and implementing asthma EBIs highlight many of the factors affecting translation of evidenced-based approaches to chronic disease management in real community settings.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
S Ratte

Abstract Road traffic crashes kill over 1.35 million people worldwide and injure up to 50 million people. They are the leading cause of death among the young. City governments, in conjunction with national governmental agencies, are critical to reducing road traffic deaths. Cities are well placed to demonstrate effective implementation of evidence-based interventions and catalyse national action. Proven road safety strategies include: → enforcing road safety laws on speeding, drink driving, motorcycle helmets and seat-belts → designing and building safer roads → managing speed effectively → implementing transportation systems to make urban mobility safer → promoting safe driving and building public support for road safety via communication campaigns → using data from high-quality monitoring and evaluation systems for policy and planning. This presentation will highlight the successes and challenges in some selected cities participating in the Bloomberg Philanthropies Initiative for Global Road Safety and share lessons learned in the implementation of a multi sector evidence-based comprehensive approach at city level.


2019 ◽  
Vol 7 ◽  
pp. 205031211984570 ◽  
Author(s):  
William C Livingood ◽  
Lori Bilello ◽  
Katryne Lukens-Bull

Objectives: To identify important characteristics of quality improvement applications for population health and healthcare settings and to explore the use of quality improvement as a model for implementing and disseminating evidence-based or best practices. Methods: A meta-synthesis was used to examine published quality improvement case studies. A total of 10 published studies that were conducted in Florida and Georgia were examined and synthesized using meta-synthesis (a qualitative research methodology) for meaningful insights and lessons learned using defined meta-synthesis inclusion criteria. The primary focus of the analysis and synthesis were the reported processes and findings that included responses to structured questioning in addition to emergent results from direct observation and semi-structured open-ended interviewing. Results: The key insights for the use of quality improvement in public health and healthcare settings included (1) the essential importance of data monitoring, analysis, and data-based decision making; (2) the need to focus on internal mutable factors within organizations; (3) the critical role of quality improvement team group dynamics; (4) the value of using a quality improvement collaborative or multi-clinic quality council/committee for sharing and comparing performance on key metrics; and (5) the need to identify a quality improvement approach and methods for clarification as a structured quality improvement intervention. Conclusion: In addition to the advantages of using quality improvement to enhance or improve healthcare and public health services, there is also potential for quality improvement to serve as a model for enhancing the adoption of evidence-based practices within the context of dissemination and implementation research.


Author(s):  
Shoba Ramanadhan ◽  
Kayoll Galbraith-Gyan ◽  
Anna Revette ◽  
Alisa Foti ◽  
Charlotte Rackard James ◽  
...  

Abstract Increasing the use of evidence-based programs (EBPs) in community settings is critical for improving health and reducing disparities. Community-based organizations (CBOs) and faith-based organizations (FBOs) have tremendous reach and trust within underserved communities, but their impact is constrained by limited staff capacity to use EBPs. This exploratory study sought to identify design and delivery considerations that could increase the impact of capacity-building interventions for CBOs and FBOs working with underserved communities. Data come from a community-based participatory research project addressing cancer disparities in Black, Latino, and Brazilian communities from Greater Boston and Greater Lawrence, Massachusetts. We conducted four focus group discussions with program coordinators in CBOs and FBOs (n = 27) and key informant interviews with CBO and FBO leaders (n = 15). Three researchers analyzed the data using a multi-stage coding process that included both prefigured and emergent codes. Key design considerations included embedding customized capacity-building interventions into community networks with local experts, supporting ongoing engagement with the intervention via a range of resources and communication channels, and addressing resource constraints. Regarding the contextual factors that should influence capacity-building intervention content, participants highlighted resource constraints, environments in which EBP use is not the norm, and challenges linking available programs with the multi-level barriers to good health faced by community members. Overall, the study highlights the need for integrated, long-term capacity-building efforts developed in partnership with, and ultimately sustained by, local organizations.


2021 ◽  
pp. 088740342110112
Author(s):  
Julie Brancale ◽  
Thomas G. Blomberg ◽  
Sonja Siennick ◽  
George B. Pesta ◽  
Nic Swagar ◽  
...  

Researcher–policymaker/practitioner partnerships (RPPs) have emerged as a successful tool for translating research into policy and practice. However, the available research has focused on RPPs with law enforcement and correctional agencies. Notably absent are studies that describe and evaluate RPPs between researchers and legislative bodies. Specifically, questions remain about the establishment, unique constraints, best practices for effective implementation, and sustainability of partnerships between researchers and policymakers. This study contributes to the literature by describing a unique RPP between a university and a state legislature. Through this retrospective case analysis, we describe the steps taken to initiate the partnership, its implementation, and outcomes. Importantly, in the context of the prior research, we describe the lessons learned, next steps, and implications for partnerships with policymakers.


2021 ◽  
Vol 9 ◽  
Author(s):  
Amy Rusch ◽  
Lindsay M. DeCamp ◽  
Celeste M. Liebrecht ◽  
Seo Youn Choi ◽  
Gregory W. Dalack ◽  
...  

Background: Despite increasing calls for further spread of evidence-based collaborative care interventions (EBIs) in community-based settings, practitioner-driven efforts are often stymied by a lack of experience in addressing barriers to community-based implementation, especially for those not familiar with implementation science. The Michigan Mental Health Integration Partnership (MIP) is a statewide initiative that funds projects that support implementation and uptake of EBIs in community-based settings. MIP also provides an in situ implementation laboratory for understanding barriers to the uptake of EBIs across a variety of settings. We report findings from a statewide qualitative study of practitioners involved in MIP projects to garner their perspectives of best practices in the implementation of EBIs.Methods: Twenty-eight semi-structured interviews of practitioners and researchers from six MIP Projects were conducted with individuals implementing various MIP EBI projects across Michigan, including stakeholders from project teams, implementation sites, and the State of Michigan, to identify common barriers, challenges, and implementation strategies deployed by the project teams, with the purpose of informing a set of implementation steps and milestones.Results: Stakeholders identified a number of barriers to and strategies for success, including the need for tailoring program deployment and implementation to specific site needs, development of web-based tools for facilitating program implementation, and the importance of upper-level administration buy-in. Findings informed our resultant community-based Implementation Roadmap, which identifies critical steps across three implementation phases—pre-implementation, implementation, and sustainability—for implementation practitioners to use in their EBI implementation efforts.Conclusion: Implementation practitioners interested in community-based EBI implementation often lack access to operationalized implementation “steps” or “best practices” that can facilitate successful uptake and evaluation. Our community-informed MIP Implementation Roadmap, offering generalized steps for reaching successful implementation, uses experiences from a diverse set of MIP teams to guide practitioners through the practices necessary for scaling up EBIs in community-based settings over pre-implementation, implementation and sustainability phases.


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