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Translating research into prevention of high-risk behaviors in the presence of complex systems: definitions and systems frameworks.

ABSTRACT: To impact population health, it is critical to collaborate across disciplinary and practice-based silos and integrate resources, experiences, and knowledge to exert positive change. Complex systems shape both the prevention outcomes researchers, practitioners, and policymakers seek to impact and how research is translated and can either impede or support movement from basic scientific discovery to impactful and scaled-up prevention practice. Systems science methods can be used to facilitate designing translation support that is grounded in a richer understanding of the many interacting forces affecting prevention outcomes across contexts. In this paper, we illustrate how one systems science method, system dynamics, could be used to advance research, practice, and policy initiatives in each stage of translation from discovery to translation of innovation into global communities (T0-T5), with tobacco prevention as an example. System dynamics can be applied to each translational stage to integrate disciplinary knowledge and document testable hypotheses to inform translation research and practice.

SUBMITTER: Hassmiller Lich K

PROVIDER: S-EPMC4807191 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Translating research into prevention of high-risk behaviors in the presence of complex systems: definitions and systems frameworks.

Hassmiller Lich Kriste K Frerichs Leah L Fishbein Diana D Bobashev Georgiy G Pentz Mary Ann MA

Translational behavioral medicine 20160301 1

To impact population health, it is critical to collaborate across disciplinary and practice-based silos and integrate resources, experiences, and knowledge to exert positive change. Complex systems shape both the prevention outcomes researchers, practitioners, and policymakers seek to impact and how research is translated and can either impede or support movement from basic scientific discovery to impactful and scaled-up prevention practice. Systems science methods can be used to facilitate desi ...[more]

PMID: 27012250

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Project description:ObjectiveSignificant delays in translating health care-related research into public health programs and medical practice mean that people may not get the best care when they need it. Regarding cardiovascular disease, translation delays can mean lives may be unnecessarily lost each year. To facilitate the translation of knowledge to action, we created a Best Practices Guide for Cardiovascular Disease Prevention Programs.DesignUsing the Rapid Synthesis Translation Process and the Best Practices Framework as guiding frameworks, we collected and rated research evidence for hypertension control and cholesterol management strategies. After identifying best practices, we gathered information about programs that were implementing the practices and about resources useful for implementation. Research evidence and supplementary information were consolidated in an informational resource and published online. Web metrics were collected and analyzed to measure use and reach of the guide.ResultsThe Best Practices Guide was released in January 2018 and included background information and resources on 8 best practice strategies. It was published as an online resource, publicly accessible from the Centers for Disease Control and Prevention Web site in 2 different formats. Web metrics show that in the first year after publication, there were 25 589 Web page views and 2467 downloads. A query of partner use of the guide indicated that it was often shared in partners' own resources, newsletters, and online material.ConclusionIn following a systematic approach to creating the Best Practices Guide and documenting the steps taken in its development, we offer a replicable approach for translating research on health care practices into a resource to facilitate implementation. The success of this approach is attributed to 3 key factors: using a prescribed and documented approach to evidence translation, working closely with stakeholders throughout the process, and prioritizing the content design and accessibility of the final product.

Project description:Operational research (OR) is the discipline of using models, either quantitative or qualitative, to aid decision-making in complex implementation problems. The methods of OR have been used in healthcare since the 1950s in diverse areas such as emergency medicine and the interface between acute and community care; hospital performance; scheduling and management of patient home visits; scheduling of patient appointments; and many other complex implementation problems of an operational or logistical nature.To date, there has been limited debate about the role that operational research should take within implementation science. I detail three such roles for OR all grounded in upfront system thinking: structuring implementation problems, prospective evaluation of improvement interventions, and strategic reconfiguration. Case studies from mental health, emergency medicine, and stroke care are used to illustrate each role. I then describe the challenges for applied OR within implementation science at the organisational, interventional, and disciplinary levels. Two key challenges include the difficulty faced in achieving a position of mutual understanding between implementation scientists and research users and a stark lack of evaluation of OR interventions. To address these challenges, I propose a research agenda to evaluate applied OR through the lens of implementation science, the liberation of OR from the specialist research and consultancy environment, and co-design of models with service users. Operational research is a mature discipline that has developed a significant volume of methodology to improve health services. OR offers implementation scientists the opportunity to do more upfront system thinking before committing resources or taking risks. OR has three roles within implementation science: structuring an implementation problem, prospective evaluation of implementation problems, and a tool for strategic reconfiguration of health services. Challenges facing OR as implementation science include limited evidence and evaluation of impact, limited service user involvement, a lack of managerial awareness, effective communication between research users and OR modellers, and availability of healthcare data. To progress the science, a focus is needed in three key areas: evaluation of OR interventions, embedding the knowledge of OR in health services, and educating OR modellers about the aims and benefits of service user involvement.

Project description:BackgroundWhile frameworks exist for strengthening health care systems and public health systems, there are no practical frameworks to describe, assess and strengthen systems for chronic disease prevention (CDP) using complex systems approaches.MethodsA systematic and integrative review of peer reviewed literature was conducted to answer the following questions: How can systems for CDP be defined? What are key attributes of effective systems? How are complex systems approaches discussed? Search terms were identified and the Medline, SCOPUS, and Global Health databases were searched December 2017 and January 2018. Reference lists and selected journals were hand searched. A working definition for a system for CDP was developed to provide a guideline for inclusion. Key exclusion criteria were literature did not address the research questions or working definition; was published in a language other than English and before 2000; focused on specific chronic diseases and/or risk factors and not CDP broadly; concentrated on the health care sector and clinical services and/or health status and surveillance data; and described evaluations of setting specific actions such as policies, programs, interventions, approaches, projects, laws, or regulations. Selected literature (n = 141) was coded in terms of the extent to which the research questions and the working definition of systems for CDP were addressed. Data was then analysed and synthesized to determine key themes.ResultsA revised definition of systems for CDP and seven attributes of effective systems for CDP are reported (collaborative capacity, health equity paradigm, leadership and governance, resources, implementation of desired actions, information and complex systems paradigm). A framework was developed to provide a foundation for describing, assessing and strengthening systems for CDP.ConclusionsThe results of this literature review provide a strong foundation for a framework to help strengthen systems for CDP. The framework consolidates not only well-established attributes of effective CDP but also highlights theoretical and practical insights from complex systems perspectives.

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Translating research into prevention of high-risk behaviors in the presence of complex systems: definitions and systems frameworks.

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Translating research into prevention of high-risk behaviors in the presence of complex systems: definitions and systems frameworks.

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