Understanding the Supports of and Challenges to Community Engagement in the CTSAs

Background

The Clinical and Translational Science Award (CTSA) program has raised the profile and the available funding for engagement in biomedical research. Such increased funding and attention may address known barriers to engagement. However, little work has been done to describe experiences across multiple CTSAs, especially how the CTSA structure supports or challenges engagement.

Objective

We sought to understand the supports and challenges experienced by multiple CTSAs as they pursued community engagement. This knowledge may help guide future efforts to support and enhance community engagement in biomedical research.

Methods

We conducted semi‐structured, in‐depth interviews with CTSA community engagement core leaders and staff from the 2006 cohort of CTSAs (n = 12).

Results

A total of 17 interviews with respondents from nine institutions identified three support themes, including: funding, existing relationships with communities, and leadership and a partnership approach at the institution. Six challenge themes arose: need for capacity development, lack of positive relationships with communities, lack of leadership, funding constraints, time and staff constraints, and unsustainable models.

Conclusion

The CTSAs have brought much‐needed attention to community engagement in research, but more can be done to adequately support engagement. Challenges remain that need to be addressed to achieve the potential benefits of engagement.     

Appreciative Inquiry in Youthful Offender Psychiatric Nursing Research

PROBLEM: Combined with demonstrated impulsive behaviors and culturally bound expectations, youth who are detained in the juvenile justice system are challenged to find opportunities to articulate their stories and life experiences that contribute to a future life. METHODS: Appreciative inquiry (AI) as a research method is used to analyze interviews of youth residing in a juvenile detention center. FINDINGS: The narrative, or life pattern, that youth in detention express is explicated through the four processes of the 4‐D Cycle in AI. The processes are discovery, dreaming, designing, and delivery. CONCLUSIONS: AI as a research method is useful to conduct interviews with detained youth, to provide a data analysis method for qualitative interviews, and generate nursing interventions. Through articulation of their own stories, youth discover voice and envision empowerment.     

Enhancing Dissemination,Implementation, and Improvement Science in CTSAs through Regional Partnerships

Background and Importance

Challenges in healthcare policy and practice have stimulated interest in dissemination and implementation science. The Institute of Medicine Committee on the Clinical Translational Science Award (CTSA) program recommended expanding the CTSA program''s investment and activity in this domain. Guidance is needed to facilitate successful growth of DII science infrastructure, activity and impacts.

Objectives

Several CTSAs in Southern California collaborated to identify and respond to local challenges and opportunities to expand dissemination, implementation and improvement research by strengthening capacity and relationships between DII researchers and community, health system, and population health partners.

Main outcomes

Planning and outreach by the Southern California CTSAs increased awareness and interest in DII research and generated recommendations for growth. Recommendations include: increasing strong partnerships with healthcare and population health systems to guide policy research agendas and collaborative DII science; promoting multi‐sector partnerships that involve researchers and delivery systems throughout DII processes; bringing together multiple disciplines; and addressing national and international barriers as well as opportunities in DII science.

Implications

CTSAs through regional collaboration can increase their contributions to improved community health via skill‐building, partnership development and enhanced outreach to local healthcare and public health agencies and delivery systems.     

Clinical and Translational Scientist Career Success: Metrics for Evaluation

Despite the increased emphasis on formal training in clinical and translational research and the growth in the number and scope of training programs over the past decade, the impact of training on research productivity and career success has yet to be fully evaluated at the institutional level. In this article, the Education Evaluation Working Group of the Clinical and Translational Science Award Consortium introduces selected metrics and methods associated with the assessment of key factors that affect research career success. The goals in providing this information are to encourage more consistent data collection across training sites, to foster more rigorous and systematic exploration of factors associated with career success, and to help address previously identified difficulties in program evaluation. Clin Trans Sci 2012; Volume 5: 400–407     

Evaluating Various Areas of Process Improvement in an Effort to Improve Clinical Research: Discussions from the 2012 Clinical Translational Science Award (CTSA) Clinical Research Management Workshop

Emphasis has been placed on assessing the efficiency of clinical and translational research as part of the National Institutes of Health (NIH) goal to “improve human health.” Improvements identified and implemented by individual organizations cannot address the research infrastructure needs of all clinical and translational research conducted. NIH''s National Center for Advancing Translational Sciences (NCATS) has brought together 61 Clinical and Translational Science Award (CTSA) sites creating a virtual national laboratory that reflects the diversity and breadth of academic medical centers to collectively improve clinical and translational science. The annual Clinical Research Management workshop is organized by the CTSA consortium with participation from CTSA awardees, NIH, and others with an interest in clinical research management. The primary objective of the workshop is to disseminate information that improves clinical research management although the specific objectives of each workshop evolve within the consortium. The fifth annual workshop entitled “Learning by doing; applying evidence‐based tools to re‐engineer clinical research management” took place in June 2012. The primary objective of the 2012 workshop was to utilize data to evaluate, modify, and improve clinical research management. This report provides a brief summary of the workshop proceedings and the major themes discussed among the participants.     

Using the critical incident technique to measure long-term outcomes of interprofessional education

There is a critical need to develop methods that capture long-term trainee outcomes and link these outcomes to interprofessional education (IPE) to establish the value added from IPE. This article describes the use of the critical incident technique (CIT) to evaluate long-term trainee outcomes attributed to IPE. Critical incidents (CIs) are specific examples of behaviours that occurred within the recent past. Trainees of an IPE programme (n = 24) were interviewed using CIT. Across the trainees, 41 CIs were reported, of which 9 were collapsed due to similarity in theme. A final total of 32 CIs were mapped along the Kirkpatrick/Barr Model of Learner Outcomes. The mapping process revealed that all of the CIs reported described incidents at Levels 3, 4a, and 4b, indicating changes in trainees’ own professional behaviour and improvements in patient outcomes related to their IPE experience. Implications for evaluating IPE using the CIT method are discussed.     

Supporting organizational learning: a comparative approach to evaluation in action research

For well over a decade, the organizational context of nursing in the United Kingdom has been one of change and reform with a policy shift towards primary and community led health care. Such a major shift in policy provides nurses with an opportunity to re-think their approaches towards the individuals and communities they serve in order to promote self-care, recognize achievable health goals and provide family and community support. Although there is a growing appreciation of action research as an useful approach to this kind of development, it can be difficult to evaluate published studies because of the diverse nature of the literature. This paper will present and evaluate two case studies using a particular conceptual device (The Normative Information Model-based Systems Analysis and Design) in order to explore a possible alternative to the interpretative narrative or positivistic hypothesis-testing models used to report other kinds of nursing research and enlarge the debate about process evaluation.     

Action research in action: reflections on a project to introduce Clinical Practice Facilitators to an acute hospital setting

AIMS OF THE PAPER: The process and philosophical basis of action research are discussed in this article by reviewing the insights that were gained from a study designed to enhance the support available to junior nursing staff in an acute hospital setting. RATIONALE: It has been well documented that newly qualified nurses require help to develop professional competencies. With this in mind, the role of Clinical Practice Facilitator was established within a National Health Service (NHS) Trust to enhance clinical skill acquisition and the professional development of newly registered nurses and health care assistants. DESIGN: In order to facilitate the inception, development and subsequent evaluation of these new roles, an action research approach was adopted. Strategies used to encourage collaboration and flexibility during the project are also discussed. RESULTS: The primary aims of the project were achieved and the authors suggest that the choice of action research was significant to the successful outcome. However, a number of issues arose which deserve more attention including the importance of the interpersonal skills of the action researcher and the value of action research to facilitate change which is relevant at both an individual and organizational level.     

Using a women's health perspective to guide decisions made in quantitative research

Women's health, as an emerging area of nursing scholarship, is based on a set of philosophical assumptions. These assumptions are: (i) women's health can best be understood by examining women's lived experiences within a specific context; (ii) gender bias must be avoided; (iii) the focus should be on health rather than illness; and (iv) non-exploitative relationships should be established between the researcher and research participants. Assumptions from a women's health perspective can be used by researchers to guide decisions made in conducting research with women. In order to strengthen the correspondent validity (i.e., the fit between theory and methods), research decisions need to be consistent with the philosophical assumptions of the inquiry. Examples of quantitative research decisions influenced by a women's health perspective are illustrated using a study of binge eating in women.     

Interprofessional team building in the palliative home care setting: Use of a conceptual framework to inform a pilot evaluation

Home-based palliative care is increasingly dependent on interprofessional teams to deliver collaborative care that more adequately meets the needs of clients and families. The purpose of this pilot evaluation was to qualitatively explore the views of an interprofessional group of home care providers (occupational therapists, nurses, personal support work supervisors, community care coordinators, and a team coordinator) regarding a pilot project encouraging teamwork in interprofessional palliative home care services. We used qualitative methods, informed by an interprofessional conceptual framework, to analyse participants’ accounts and provide recommendations regarding strategies for interprofessional team building in palliative home health care. Findings suggest that encouraging practitioners to share past experiences and foster common goals for palliative care are important elements of team building in interprofessional palliative care. Also, establishing a team leader who emphasises sharing power among team members and addressing the need for mutual emotional support may help to maximise interprofessional teamwork in palliative home care. These findings may be used to develop and test more comprehensive efforts to promote stronger interprofessional teamwork in palliative home health care delivery.