supporting evidence-based practice : center of excellence for training and research translation sip...
TRANSCRIPT
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Supporting Evidence-based Practice : Center of Excellence for Training and Research Translation
SIP 10-04 Cooperative Agreement Number U48-DP000059Centers for Disease Control and Prevention
Division for Heart Disease and Stroke PreventionDivision of Nutrition, Physical Activity and Obesity
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Center TRT – Promoting Evidence-based Practice
Brief Overview and HistoryTraining practitioners
◦Obesity Prevention Course◦Web-based Training
Translation and Dissemination ProductsTranslation and Dissemination MethodsQuestions and Discussion
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Center TRT LeadershipPrincipal Investigator:
◦Alice Ammerman, RD DrPH
Co-Investigators:◦Jennifer Leeman, DrPH, MDIV◦Tom Keyserling, MD, MPH
Project Director:◦Janice Sommers, MPH
CDC Technical Advisors from DNPAO◦Claire Heiser, MS, RD◦Diane Thompson, MPH, RD
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Center TRT Staff
Nancy AycockAvia MainorKelly NorbySusanne SchmalJanice SommersMay May Leung (not pictured)
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National Advisory Board
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Their Advice…..Use a broad definition of evidence and
include evidence from practice in the translation model
The potential public health impact of an intervention is a result of more than effectiveness
Include a feedback loop that provides an opportunity for practice to inform research
Invest time and energy in obtaining input from primary audience (intended users)
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2005-06 Website: designed, tested, launched
2004 Infrastructure takes root: Staff, Coordinating Committee,National Board
2005 Formative work: surveys and focused discussion with state staff, literature reviews, web searches, lots of meetings
2005-09 Training Courses: Nutrition and Public Health, Obesity Prevention, WW Short Courses
2005-06 Methods Developed: criteria, review tools, processes for review, methods for literature reviews
2008-09 Disseminate Evidence: web-based training, contributing factors, strategies, interventions
Growing the Center-TRT
2007-09 Interventions reviewed and templates developed
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Center TRT TRAINING
Primary Audience is State-level Program staff
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Develop training competencies Conduct training needs assessments Develop a training plan Provide training for state-level
WISEWOMAN and Obesity Prevention Program staff
Evaluate impact of trainings on practice
Training
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Training
Obesity Prevention in Public Health2005: Program Coordinators (29)2006: Nutrition Coordinators (44)2007: Physical Activity Coordinators (35)2008: Open to new state staff (31)
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Obesity Prevention in Public Health Course: 2009
DATES: August 23 – 28 at the Rizzo Center in Chapel Hill, NC
NEW Curriculum focused on leadership development for NPAO State Coordinators
APPLICATIONS are being accepted; we have a number of scholarships available for unfunded states
www.center-trt.org
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Cover the basics to allow more advanced material during in-person trainings
Extends the reach of Center TRT Easily accessed at any time (great staff
orientation) Interactive and self-paced Low cost to participant (time only; no
travel, no registration fee)
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Nutrition, Physical Activity, and Chronic Disease Series
Nutrition and Health Physical Activity and Health Nutrition, Physical Activity and Cardiovascular Health (April 2009) Obesity Prevention in Children (Summer 2009)
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Physical Activity Module
Required ReadingsLesson 1: Terms and Definitions Lesson 2: Recommendations & RationaleLesson 3: Barriers Lesson 4: Science to PracticeSupplemental Materials
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RE-AIM Online! Reach, Effectiveness, Adoption,
Implementation and Maintenance
Required Readings
Lesson 1: Introduction to RE-AIM
Lesson 2: RE-AIM for Behavior Change
Lesson 3: RE-AIM for Policy/Environmental Change
Lesson 4: Putting it All Together
Available Summer 2009
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Nutrition and Health Demonstration
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Intervention-Specific Implementation Trainings
NAPSACC
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Online LifestyleAssessments
www.center-trt.org
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Web-based TrainingThe 2008 Numbers
• 595 users registered for the modules
• 305 completed the post tests▫ 82 – NAPSACC (4/08) ▫ 97 – Physical Activity and Health
(6/08)▫ 126 – Nutrition and Health (6/08)
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Phase 1: Evidence Identification and
Review
Phase 2: Intervention Abstraction
Phase 3: Dissemination
Phase 4: Research – Practice Integration
Center TRT Translation and Dissemination Framework
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Phase 3: DisseminationIntervention Resources
• Evidence to support development of interventions• Contributing Factors (target areas)• Intervention Strategies (approaches)
• Interventions that can be adapted• Research-tested • Practice-based • Emerging
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www.center-trt.orgwww.center-trt.org
www.center-trt.org
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Center-TRT.org UsersThe 2008 Numbers
• Users in every state and the District of Columbia. Visitors from North Carolina were among the most frequent users.
• People from 79 different countries with users in the US, Canada, United Kingdom and Australia, the most frequent visitors
• 5,725 NEW users, defined as first-time-ever visitors and an additional 6,000 unique but not new visitors
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Center-TRT.org Center-TRT.org DownloadsDownloadsThe 2008 NumbersThe 2008 Numbers
7,926 documents were downloaded from the website.
New Leaf, Choices for Healthy Living and the Nutrition and Physical Activity Self-Assessment for Childcare (NAPSACC) are UNC developed and tested interventions and were the most frequently downloaded interventions from the site!
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Center TRT Translation Methods
A Model for Balancing Evidence of Effectiveness with Other Practice-
relevant Evidence
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Phase 1: Evidence Identification and Review
Evidence
Contributing Factors
Intervention Strategies
Research-Tested Interventions
Practice-Based Interventions
Source
Systematic Reviews
Systematic Reviews and Other Consensus Documents
Research Studies
Evaluation in real-life conditions
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Criteria for Review of Interventions
Potential public health impactDissemination readinessEvidence in support of its
effectiveness
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Review Criteria: Potential Public Health ImpactREACH and representation
EFFECTIVENESS, especially in groups disproportionately affected
Evidence of and Potential for ADOPTION, IMPLEMENTATION, and MAINTENANCE in public health practice.
Glasgow et al., 2003
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Review Criteria: Dissemination ReadinessIntervention/policy described sufficiently
to allow replication
Materials/supporting documents are available for download and of useable quality
A knowledgeable contact person is available
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Review Criteria: Evidence for its Effectiveness
Research-Tested Interventions
Assess strength of reported methods for
Sampling
Design
Measurement
Analysis
Interpretation of Results
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Review Criteria: Evidence for its EffectivenessPractice-Based Interventions
Use of an evidence-based intervention strategy
Formative work with stakeholder groups & intended audience
Logic and theory
Methods for evaluating processes and outcomes
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Review Criteria: Evidence for its Effectiveness
Practice-Based Interventions illustrate how practitioners working within the constraints of a real world setting implemented an evidence-based strategy in practice.
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Review ProcessApplication from Developer
Stop
NO
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Review ProcessReview ProcessExpert PanelExpert Panel
NO
Stop
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In the pipeline…In the pipeline…
Food Access
Food Pricing Policy
Play Space
Afterschool policy
Worksite Wellness Incentives
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Questions, Counterpoints, Discussion….