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Evidence Integration Triangle

Evidence Integration Triangle. Implementation Science Team Division of Cancer Control and Population Sciences National Cancer Institute. August 2011. Rationale – Square Peg, Round Hole. Majority of research tested programs do not translate into real world settings

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Evidence Integration Triangle

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  1. Evidence Integration Triangle Implementation Science Team Division of Cancer Control and Population Sciences National Cancer Institute August 2011

  2. Rationale – Square Peg, Round Hole • Majority of research tested programs do not translate into real world settings • Those that do, often take an inordinately long period of time to so so 2 Glasgow 2011

  3. Research to Practice Pipeline Green, LW et al. 2009. Annual Rev. Public Health. 30: 151-174 Balas EA, Boren SA. 2000. Managing clinical knowledge for health care improvement. In: Yearbook of Medical Informatics.

  4. Evidence Integration Triangle Intervention Program/Policy(Prevention or Treatment) (e.g. design; key components; principles; external validity) Evidence Stakeholders 4 Glasgow 2011

  5. Evidence Integration Triangle Intervention Program/Policy(Prevention or Treatment) (e.g. design; key components; principles; external validity) Evidence Stakeholders Practical Progress Measures (e.g. actionable & longitudinal measures) 5 Glasgow 2011

  6. Evidence Integration Triangle Intervention Program/Policy(Prevention or Treatment) (e.g., design; key components; principles; external validity) Evidence Stakeholders Practical Progress Measures (e.g., practical, actionable & longitudinal measures) Implementation Process (e.g., stakeholder engagement team-based science; CBPR; patient centered care) 6 Glasgow 2011

  7. Evidence Integration Triangle Intervention Program/Policy – The “What” “If we want more evidence-based practice, we need more practice-based evidence.” Identify key components or theoretical principles Need for detailed implementation guides, lessons learned manuals Need to focus and report on both internal and external validity (need to add relevance to rigor) Current focus mostly on treatment, more is needed on prevention, and even more on policy Green LW & Glasgow R. Eval Health Profess. 2006, 29: 126-53. Rothwell, PM. Lancet. 2006, 365:82-93. 7 Glasgow 2011

  8. Evidence Integration Triangle Practical Measures of Progress – the “So What” Measures need to be: Brief and practical Collected longitudinally to assess progress Reliable and valid Sensitive to change Have national norms, easily understood and ACTIONABLE Culturally appropriate across groups Reflect multiple stakeholder perspectives Society of Behavioral Medicine Health Policy Statement on Public Health Need for Patient Reported Measures. http://www.sbm.org/policy/patient-reported_measures.pdf 8 Glasgow 2011

  9. Evidence Integration Triangle Implementation Process – The “How” Partnership and Community Based Participatory Research (CBPR) approaches1 Patient-centered Care Approach Team science in action2,3 Iterative, self-correcting 1 Guidelines and Categories for Classifying Participatory Research Projects in Health: http://lgreen.net/guidelines.html 2Gray, D. O. (2008). In C. L. S. Coryn& M. Scriven (Eds.), Reforming the evaluation of research. New Directions for Evaluation, 118, 73–87. 3Mâsse, LC, et al. Am J Prev Med. 2008; 35 (2S): S151-S160. 9 Glasgow 2011

  10. Evidence Integration Triangle CURRENT IDEAL Intervention Program/Policy(Prevention or Treatment) (e.g., design; key components; principles; external validity) Evidence Stakeholders Practical Progress Measures (e.g., actionable & longitudinal measures) Implementation Process (e.g., stakeholder engagement; team-based science; CBPR; patient centered care) 10 Glasgow 2011

  11. Evidence Integration Triangle Intervention Program/Policy(Prevention or Treatment) (e.g., design; key components; principles; external validity) Feedback Feedback Evidence Stakeholders Practical Progress Measures (e.g., actionable & longitudinal measures) Implementation Process (e.g., stakeholder engagement; team-based science; CBPR; patient centered care) Feedback 11 Glasgow 2011

  12. Conclusions • The evidence-based movement was a good start, but only gets us so far • To make greater progress, two other elements also need attention: • Practical MEASURES to track PROGRESS, and • Implementation PROCESSES that use partnership principles • The 3 legs of the ‘EIT” are each necessary but not sufficient by themselves 12

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