A Model for Translating Research into Practice in the United States - Mexico Border Region Howard J. Eng, MS, DrPH Director, Southwest Border Rural Health.

A Model for Translating Research into Practice in A Model for Translating Research into Practice in the United States - Mexico Border Regionthe United States - Mexico Border Region

Howard J. Eng, MS, DrPH Howard J. Eng, MS, DrPH

Director, Southwest Border Rural Health Research CenterDirector, Southwest Border Rural Health Research CenterRural Health OfficeRural Health Office

Mel and Enid Zuckerman College of Public HealthMel and Enid Zuckerman College of Public HealthThe University of ArizonaThe University of Arizona

United States - Mexico Border Center of Excellence ConsortiumUnited States - Mexico Border Center of Excellence Consortium

Arizona State ConferenceArizona State Conference

April 30, 2009April 30, 2009

Presentation OverviewPresentation Overview

Translational ResearchTranslational Research Overview of Translational ResearchOverview of Translational Research Examples of Translational Research ModelsExamples of Translational Research Models

U.S.-Mexico Border U.S.-Mexico Border

A Model for Translating Research into Practice in the A Model for Translating Research into Practice in the U.S. –Mexico Border RegionU.S. –Mexico Border Region

Translation Research Translation Research

© 2010 College of Medicine© 2010 College of Medicine

Translational Research Translational Research

Apply scientific discoveries to health professional Apply scientific discoveries to health professional practicepractice

Include basic, clinical, epidemiological, health Include basic, clinical, epidemiological, health services, intervention/evaluation, etc…services, intervention/evaluation, etc…

Implement into community health and medical Implement into community health and medical professional practiceprofessional practice

Reduce or delay the incidence, morbidity, and Reduce or delay the incidence, morbidity, and mortality of acute and chronic diseasesmortality of acute and chronic diseases

Can use different models to apply research results Can use different models to apply research results into health professional practicesinto health professional practices

Translational Research ModelsTranslational Research Models

UniversitiesUniversities Johns Hopkins’ Quality and Safety Research Group’s Johns Hopkins’ Quality and Safety Research Group’s

Translating Evidence into Practice ModelTranslating Evidence into Practice Model

Health Professional AssociationsHealth Professional Associations American Heart Association’s Improving Evidence-Based American Heart Association’s Improving Evidence-Based

Medicine ModelMedicine Model

Federal Health AgenciesFederal Health Agencies National Cancer Institute’s Translational Research ModelNational Cancer Institute’s Translational Research Model National Center for Chronic Disease Prevention and Health National Center for Chronic Disease Prevention and Health

Promotion’s Translational Research ModelPromotion’s Translational Research Model Agency for Healthcare Research and Quality Knowledge Agency for Healthcare Research and Quality Knowledge

Transfer FrameworkTransfer Framework

U.S.-Mexico BorderU.S.-Mexico Border


The United States – Mexico border extends for 1,952 miles The United States – Mexico border extends for 1,952 miles (3,141 kilometers), stretching from the Gulf of Mexico to the (3,141 kilometers), stretching from the Gulf of Mexico to the Pacific Ocean.Pacific Ocean.

The1983 La Paz Agreement defined the border area as the The1983 La Paz Agreement defined the border area as the land within 100 km (62.5 miles) on either side of the land within 100 km (62.5 miles) on either side of the international boundary. international boundary.

U.S.-Mexico BorderU.S.-Mexico BorderU.S.-Mexico BorderU.S.-Mexico Border

Source: PAHO/WHO Health in the Americas 2007

U.S.-Mexico Border States

Arizona-Sonora BorderArizona-Sonora Border

Cochise County Border = 87 miles Cochise County Border = 87 miles

Santa Cruz County Border = 60 milesSanta Cruz County Border = 60 miles

Pima County Border = 133 milesPima County Border = 133 miles

(Tohono O’odham Nation = 80 miles)(Tohono O’odham Nation = 80 miles)

Yuma County Border = 97 milesYuma County Border = 97 miles

Total Border = 377 milesTotal Border = 377 miles

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Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality Knowledge Transfer Framework Knowledge Transfer Framework


Agency for Healthcare Research and Quality Knowledge Transfer Framework Agency for Healthcare Research and Quality Knowledge Transfer Framework

Source: Nieva VF, et al. From Science to Service: A Framework for the Transfer of Patient Safety Research into Practice, Advances in Patient Safety, Vol 2. p.441-453


Knowledge Creators (Researchers)Knowledge Creators (Researchers)

UniversitiesUniversities Government AgenciesGovernment Agencies Research InstitutionsResearch Institutions Private CompaniesPrivate Companies Health Care ProvidersHealth Care Providers

Physician OfficesPhysician Offices Physician Group PracticesPhysician Group Practices Community Health CentersCommunity Health Centers ClinicsClinics HospitalsHospitals Long Term FacilitiesLong Term Facilities PharmaciesPharmacies Public Health DepartmentsPublic Health Departments


Research Types (Innovation) Research Types (Innovation)

New DrugsNew Drugs New Medical DevicesNew Medical Devices New Health TechnologiesNew Health Technologies New / Modified Diagnostic ProceduresNew / Modified Diagnostic Procedures New / Modified Treatment ProtocolsNew / Modified Treatment Protocols New / Modified Surgical ProceduresNew / Modified Surgical Procedures New / Modified Health ProgramsNew / Modified Health Programs Changes in the Delivery of CareChanges in the Delivery of Care New Health Care Delivery SystemsNew Health Care Delivery Systems


Distillation of Knowledge Distillation of Knowledge

Who does the distillation?Who does the distillation? ResearchersResearchers Expert PanelsExpert Panels Professional and Policy AssociationsProfessional and Policy Associations Federal Health Agencies Federal Health Agencies

How is it distillated?How is it distillated? Evidence Summaries / Syntheses PapersEvidence Summaries / Syntheses Papers Consensus Processes for Decision MakingConsensus Processes for Decision Making Criteria SelectionCriteria Selection

• Effectiveness comparisonsEffectiveness comparisons• Cost benefit analysisCost benefit analysis• Evidence need for the changeEvidence need for the change• Transportability to real life conditionsTransportability to real life conditions• Acceptance by practitioners and patientsAcceptance by practitioners and patients• Adoptability by the health care systemAdoptability by the health care system


Diffusion and Dissemination Diffusion and Dissemination

Creation of Dissemination PartnersCreation of Dissemination Partners Determination of the Targeted Health Determination of the Targeted Health

ProfessionsProfessions

Diffusion and Dissemination MethodsDiffusion and Dissemination Methods Academic and professional journalsAcademic and professional journals Professional newslettersProfessional newsletters Professional conferencesProfessional conferences Professional associationsProfessional associations WebsitesWebsites Fact sheetsFact sheets Workshops / Webcasts Workshops / Webcasts Professional continue education Professional continue education

presentationspresentations


Adoption and Implementation Adoption and Implementation

Review New Innovation(s)Review New Innovation(s) ProcessesProcesses TreatmentsTreatments ProgramsPrograms

Decision Levels (PRN)Decision Levels (PRN) Health Care System Health Care System Health FacilityHealth Facility PractitionerPractitioner

Implementation Implementation Notification of new innovation change(s)Notification of new innovation change(s) Adjusting to any cultural needs of border Adjusting to any cultural needs of border

patientspatients Training of the health care team Training of the health care team Pilot testing the new InnovationPilot testing the new Innovation Overcoming the barriers to changeOvercoming the barriers to change Evaluating the innovation implementation Evaluating the innovation implementation


Institutionalization Institutionalization

Successfully adoptedSuccessfully adopted Practitioner LevelPractitioner Level Facility LevelFacility Level Health Care System LevelHealth Care System Level

Approval by external organizationsApproval by external organizations Regulatory AgenciesRegulatory Agencies Credentialing AgenciesCredentialing Agencies


Source: Nieva VF, et al. From Science to Service: A Framework for the Transfer of Patient Safety Research into Practice, Advances in Patient Safety, Vol 2. p.441-453

Feedback to Decision Maker on Adoption*

*Note: Conference participants recommended adding a feedback loop to the Framework to provide the decision makers information on the adoption level.

Questions?Questions?Thank You!Thank You!


Contact InformationContact Information

Howard J. Eng, MS, DrPHHoward J. Eng, MS, DrPHDirectorDirectorSouthwest Border Rural Health Research CenterSouthwest Border Rural Health Research CenterRural Health OfficeRural Health OfficeMel and Enid Zuckerman College of Public HealthMel and Enid Zuckerman College of Public HealthP.O. Box 245177P.O. Box 2451771295 N. Martin Ave. 1295 N. Martin Ave. Tucson, Arizona 85724Tucson, Arizona [email protected] (520) 626-5840(520) 626-5840

A Model for Translating Research into Practice in the United States - Mexico Border Region Howard J. Eng, MS, DrPH Director, Southwest Border Rural Health.

Documents

healthcare research

translating research

research results

milestotal border

border area

safety research groups

health services

health programschanges