HELLO, EVERYONE AND WELCOME
TO THE DISSEMINATION AND
IMPLEMENTATION SCIENCE AND
COMMUNICATION DISORDERS A
VIRTUAL WORKSHOP.
I'M HOLLY STORKEL THE PROGRAM
FOR LANGUAGE AT NIDCD AND ONE OF
THE CO-CHAIR FOR THE WORKSHOP.
I APPRECIATE EVERYONE ATTENDING
TODAY AND LOOK FORWARD TO YOUR
CONTRIBUTIONS TO THIS DISCUSSION
THROUGHOUT NEXT FEW DAYS.
I WANT TO COVER LOGISTICS.
WE HAVE A NUMBER OF FOLKS ON
ZOOM.
IF YOU'RE WITH US VIA THE ZOOM
LINK A COUPLE THINGS TO KNOW.
FIRST OF ALL, CAPTIONS ARE
ENABLED AND YOU CAN TAKE
ADVANTAGE OF THAT BY ACCESSING
THAT FEATURE ON YOUR CONTROL
PANEL.
IF YOU HAVE ANY DIFFICULTIES,
PLEASE PUT A NOTE IN THE CHAT
AND SOMEONE WILL HELP YOU.
WE ALSO HAVE AN ASL INTERPRETER
PRESENT AND YOU SHOULD ABLE TO
SEE THEM ON YOUR SCREEN NOW.
LET US KNOW VIA CHAT IF YOU
CAN'T.
PLEASE MUTE YOUR MICROPHONES AT
ALL TIMES UNLESS YOUR YOU'RE
SPEAKING AND DURING PRESENTATION
WE ASK YOU TURN OFF YOUR CAMERAS
TO SAVE BANDWIDTH AND MAKE IT
EASIER TO IDENTIFY THE SPEAKERS
IN A GIVEN PANEL.
WE DO HAVE DESIGNATED
PARTICIPATION TIMES THROUGHOUT
THE DAY.
DURING A PARTICIPATION TIME
THERE WON'T BE ANY ATIME SO AT
THAT TIME YOU CAN TURN ON YOUR
CAMERAS IF YOU'RE COMFORTABLE
DOING SO AND IF THE BANDWIDTH
WORKS FOR YOU.
IF YOU HAVE SOMETHING YOU'D LIKE
TO SHARE, RAISE YOUR HAND USING
THE RAISED HAND FEATURE AND
AGAIN USE THE CHAT IF YOU'RE NOT
SURE WHERE TO FIND THAT AND
WE'LL GIVE YOU HELP.
WAIT TO BE CALLED ON AND GO
AHEAD AND UNMUTE YOURSELF AND
MAKE YOUR CONTRIBUTION.
WHEN YOU'RE DONE, GO AHEAD AND
REMUTE AND LOWER YOUR HAND.
AS I INDICATED THE CHAT IS
AVAILABLE BUT WE'RE ONLY GOING
TO BE USING THAT FOR TECH ISSUES
EASIER FOR US TO FIND WHO NEEDS
HELP.
AND WE ARE ALSO LIVE STREAMING
THIS WORKSHOP VIA VIDEOCAST SO
FOLKS ON THE VIDEOCAST CAN SEE
AND HEAR US BUT CANNOT SEE THE
CHAT SO WE DON'T WANT TO LEAVE
ANYONE OUT WITH ANY RESOURCES OR
QUESTIONS OR THINGS THAT ARE
IMPORTANT FOR EVERYONE TO KNOW
ABOUT AND YOUR TECH ISSUES ARE
NOT IMPORTANT FOR EVERYONE TO
KNOW ABOUT SO YOU CAN KEEP THOSE
IN THE CHAT.
FOR MORE SUBSTANTIVE
CONTRIBUTIONS WAIT UNTIL A TIME
WHEN WE CAN HAVE PARTICIPATION.
ON THE LIVE STREAM WE HAVE
CAPTIONS AND THE LIVE STREAM
AUDIENCE SHOULD BE ABLE TO SEE
THE ASL INTERPRETER.
WE HAVE SOMEONE MONITORING THE
FEED AND KNOW THE TECHNICAL
ISSUES ON OUR END ARE GOING
WELL.
SO IF YOU'RE HAVING TECHNICAL
ISSUES AND ON THE VIDEOCAST YOU
PROBABLY NEED TO PROBLEM SOLVE
THIS YOURSELF BECAUSE IT'S
PROBABLY ON YOUR END OF THINGS.
THE LINK WILL SEND TO YOU HELP
HOW TO TROUBLE SHOOT ON YOUR OWN
OR CONTACT THE HELP DESK IF YOU
CAN'T FIGURE IT OUT.
AND OUR TEAM IS MONITORING
QUESTIONS AND WE'LL RAISE ISSUES
OR CONTRIBUTIONS AS THE
APPROPRIATE TIME DURING OUR
PARTICIPATION PERIOD.
SO NEXT I'D LIKE TO THANK OUR
PLANNING COMMITTEE BEGINNING
WITH OUR CO-CHAIRS.
KATHY BINGER FROM THE UNIVERSITY
OF NEW MEXICO AND TINA STUDTS
FROM THE COLORADO SCHOOL OF
MEDICINE.
THEY'VE BEEN INVALUABLE
COLLABORATORS IN THINKING
THROUGH THE TOPICS AND SPEAKERS
AND ISSUES WE WANT TO BRING UP
OVER NEXT COUPLE OF DAYS.
IT WOULD BE AN UNDERSTATEMENT TO
SAY WE COULDN'T HAVE DONE IT
WITHOUT THEM SO WE APPRECIATE
THEIR CONTRIBUTION TO THE
WORKSHOP.
OTHER MEMBERS OF OUR TEAM, KELLY
KING AND SUSAN SULLIVAN ARE
PROGRAM OFFICERS LIKE ME AT
NIDCD AND THEY'VE BEEN HELPING
WITH THE CONTENT TO MAKE SURE WE
COVER THE BROAD MISSION AREAS
WITHIN NIDCD AND ALSO HELPING US
WITH LOGISTICS AND SUPPORT
JOINEDLY LISA COX WHO WILL ALSO
PROVIDE ADDITIONAL HANDS FOR
SUPPORT.
AND LASTLY A BIG THANK YOU TO
TANJI JOHNSON OUR PROGRAM
ASSISTANT AT NIDCD.
SHE HAS HANDLED THE ORGANIZATION
OF ALL THE MEETING LOGISTICS,
MAKING SURE THAT WE HAVE ZOOM
AND LIVE STREAM AND TECH SUPPORT
AND ASL INTERPRETERS.
I WANT TO EXTEND MY GRATITUDE TO
THE FULL TEAM.
IT'S TAKEN ALL OF US TO MAKE IS
THIS HAPPEN.
NOW WITH THOSE LOGISTICS OUT OF
THE WAY, LET'S MOVE ON TO SOME
OF THE CONTENT.
I STOLE A SLIDE FROM TINA
STUDTS.
SHE WAS NICE ENOUGH TO SHARE
SOME OF HER TRIED AND TRUE
PRESENTATION SLIDES AS I WAS
PREPARING REMARKS I'LL BE MAKING
AND THIS ONE STOOD OUT TO ME.
AT THE INTERVENTION WORKS AND
NOBODY CAN USE IT, DOES IT STILL
MAKE AN IMPACT.
THAT TO ME GOT TO THE HEART OF
WHAT WE WANT TO THINK ABOUT AND
DO TODAY.
WE'RE TRYING TO THINK HOW WE
MAKE CHANGE SO WE CAN WALK INTO
EVERYDAY CLINICAL SETTINGS AND
SEE PEOPLE GETTING
EVIDENCE-BASED CARE.
TO GIVE US A BIG PICTURE OF
WHAT'S GOING ON IN THE SPACE
NIDCD, WE HAVE WITH US
DR. DEBORAH -- DEBARA TUCCI AND
WE'RE LED BY A DIRECTOR WHO HAS
RICH EXPERIENCE AS A CLINICIAN
SCIENTIST AND REALLY
INFORMATIONS THIS KIND OF ISSUE
AND THE IMPORTANCE THIS ISSUE IS
TO OUR FIELD.
SHE'LL MAKE REMARKS ABOUT
CLINICAL RESEARCH AT NIDCD
ESPECIALLY DISSEMINATION AND
IMPLEMENTATION.
>> THANK YOU, HOLLY.
GOOD MORNING, EVERYONE.
WELCOME TO THIS WORKSHOP.
I'M DEB TUCCI THE DIRECTOR OF
THE NIDCD AND I'M SO PLEASED TO
WELCOME YOU HERE TODAY TO
DISCUSS HOW DISSEMINATION AND
IMPLEMENTATION RESEARCH CAN
BRIDGE THE GAP BETWEEN RESEARCH,
PRACTICE AND POLICY SO WE CAN
BRING SCIENTIFIC DISCOVERIES
INTO OUR COMMUNITIES.
SO WE'VE SEEN OVER THE PAST
DECADES -- OVER THE PAST FEW
DECADES WE'VE SEEN EVEN WHEN WE
HAVE RESEARCH FINDINGS THAT
INFORM EVIDENCE-BASED CARE IT
TAKES YEARS, TYPICALLY OVER A
DECADE, FOR THOSE INTERVENTIONS
TO BE WIDELY ADOPTED AND
IMPLEMI
IMPLEMENTED SO THEY IMPACT
INDIVIDUALS.
BASED THIS REALIZATION RESEARCH,
DISSEMINATION AND IMPLEMENTATION
IS CRITICALLY IMPORTANT TO CLOSE
THE LOOP AND TRANSLATE RESEARCH
INTO PRACTICE.
SO ONE OF THE FIRST THINGS THAT
WE DID AFTER I CAME TO NIDCD A
LITTLE OVER FOUR YEARS AGO IS TO
START TO THINK ABOUT A BRAND NEW
STRATEGIC PLAN.
WE ENGAGED WITH SCIENTIFIC
EXPERTS AND OTHER STAKEHOLDERS,
DID A REAL DEEP DIVE USING A
GRASSROOTS APPROACH AND WORKED
THROUGH A PROCESS TO DEVELOP
SCIENTIFIC PRIORITIES THAT WE
WOULD HOLD FOR THE NEXT FIVE
YEARS.
AND THIS GRAPHIC ILLUSTRATES THE
PROCESS THAT WE FOLLOWED TO
DEVELOP THAT PLAN.
WE BEGAN WITH IDEAS FROM OUR
SCIENTIFIC COMMUNITY AS WELL AS
OTHER STAKEHOLDERS.
THOSE IDEAS WERE DEBATED AND
REFINED AND THEN ORGANIZED INTO
GOALS UNDER OVER ARCHING THEMES
AND FINALLY METRICS WERE
DEVELOPED TO HELP US TO EVALUATE
OUR PROGRESS OVER THE COMING
YEARS.
AND IT WAS CLEAR FROM THIS
PROCESS THAT DISSEMINATION AND
IMPLEMENTATION RESEARCH SHOULD
BE A SCIENTIFIC PRIORITY AS
SHOWN ON THE NEXT SLIDE.
AND SO THIS SLIDE SHOWS
SPECIFICALLY THEME FOUR WHICH
ADDRESS THE IMPORTANCE OF
TRANSLATING SCIENTIFIC ADVANCES
TO DELIVERING BETTER HEALTH TO
THE COMMUNITY.
SPECIFICALLY GOAL 2 WHICH IS TO
DEVELOP DISSEMINATE AND
IMPLEMENT EVIDENCE-BASED
PRACTICES TO IMPROVE
HEALTH-RELATED OUTCOMES.
I LOOK FORWARD TO HEARING THE
DISCUSSIONS OVER THE NEXT TWO
DAYS TO HEAR ABOUT HOW RESEARCH
MIGHT CLOSE THE GAP BETWEEN
BASIC BEHAVIORAL DISCOVERY AND
THE INTERVENTIONS THAT IMPROVE
HEALTH CARE DELIVERY, COMMUNITY
HEALTH AND PUBLIC HEALTH SO THAT
ALL POPULATIONS CAN BENEFIT FROM
THE NATION'S INVESTMENTS IN
SCIENTIFIC DISCOVERIES.
SO FINALLY, I WOULD LIKE TO ECHO
HOLLY AND EXPRESS MY
APPRECIATION FOR ALL THE HARD
WORK THAT WENT INTO THE
DEVELOPMENT AND EXECUTION OF
THIS WORKSHOP.
SPECIFICALLY FROM THE PLANNING
COMMITTEE CO-CHAIRS, KATHY
BINGER AND HOLLY STORKEL AND
FROM THE PLANNING COMMITTEE
MEMBERS INCLUDING KELLY LING,
SUSAN SULLIVAN AND TANJI JOHNSON
AND GRATEFUL WE'RE MOVING
FORWARD WITH THE WORKSHOP I
THINK WILL MAKE GREAT
CONTRIBUTION TO NIDCD'S WORK AND
THE WORK OF THIS FIELD GOING
FORWARD.
AGAIN, THANK YOU FOR ATTENDING
AND THANK YOU ALL FOR YOUR
CONTRIBUTIONS TO THIS WORKSHOP
AND HOLLY BACK OVER TO YOU.
>> THANKS SO MUCH, DR. TUCCI.
NEXT I WANT TO TALK ABOUT THE
GOALS OF THE WORKSHOP AND WHAT
WE'LL BE DOING OVER NEXT COUPLE
DAYS.
WE HAVE THREE MAIN GOALS.
OUR FIRST GOAL IS TO UNDERSTAND
KIND OF WHERE WE'RE AT WITH
DISSEMINATION AND IMPLEMENTATION
IN OUR MISSION AREAS.
WE'LL SPEND THE FIRST PART OF
TODAY THINKING ABOUT THAT.
THEN WE WANT TO SPEND MORE OF
THE BULK OF OUR TIME IDENTIFYING
THE RESEARCH NEEDS AND
OPPORTUNITIES.
WE WANT TO THINK ABOUT THE
EXPERIENCE OF YOU ALL AS
INDIVIDUAL RESEARCHERS WANTING
TO CONDUCT THE D&I RESEARCH OR
MOVE YOUR RESEARCH INTO
DISSEMINATION AND IMPLEMENTATION
AND WE ALSO WANT TO THINK
COLLECTIVELY HOW WE CAN WORK
TOGETHER AS GROUPS OF
INDIVIDUALS TO DEVELOP CAPACITY
TO CONDUCT AND SUSTAIN THE D&I
RESEARCH AND THE NIDCD MISSION
AREAS.
IN TERMS OF OUR AGENDA, IT'S
AVAILABLE AT THE LINK TO THE
WORKSHOP AND POSSIBLY THAT QR
CODE WORKS.
WE'LL FIND OUT.
YOU CAN SEE OUR SLATE OF TOPICS
AND SPEAKERS AND TIMING OF
BREAKS AND SO ON.
FOR THE FIRST CHUNK OF TODAY
WE'LL REALLY TALK AT YOU AND
THIS IS TO SET THE STAGE, SET
THE FOUNDATION AND MAKE SURE
WE'RE ALL USING SAME LANGUAGE
AND PLAY BOOK AS WE'RE THINKING
ABOUT D&I AND WHERE WE ARE AS A
FIELD AND THE SECOND HALF OF THE
DAY WE'LL GET MORE INTERACTIVE
AND MORE PARTICIPATORY AND HAVE
MORE PANELS AND MORE TIME FOR
DISCUSSION AS WE START TO THINK
ABOUT WHAT INVESTIGATORS NEED TO
BE ABLE TO CONDUCT D&I RESEARCH.
I'LL ONLY SAY A LITTLE BIT ABOUT
WHAT WILL HAPPEN TOMORROW BUT
TOMORROW WE WILL WIDEN OUR LENS
AND THINK BEYOND INDIVIDUALS.
WE'LL THINK MORE ABOUT
COLLECTIVE ACTION TO BUILD AND
FURTHER DISSEMINATION AND
IMPLEMENTATION RESEARCH.
THEN WE'LL CLOSE BY COMING BACK
TO THE INDIVIDUAL AND HAVING
PEOPLE THINK ABOUT WHAT MIGHT BE
SOME WAYS THAT YOU COULD GET
STARTED AS AN INDIVIDUAL
RESEARCHER IN CONDUCTING D&I
RESEARCH.
AND THAT CONCLUDES MY OPENING
REMARKS.
TEAM, KELLY, TANJI ANY
LOGISTICAL ISSUES AND I SEE
ACTION IN THE CHAT.
ANYTHING WE NEED TO LET ANYONE
KNOW ABOUT?
>> WE'RE GOOD.
>> OKAY.
THEN WE'LL LAUNCH IN THE FIRST
OF OUR PLANNED PRESENTATIONS
TODAY WHICH IS BY ME.
I'M FOCUSSING HERE ON HOW WE
DEFINE DISSEMINATION AND
IMPLEMENTATION TO MAKE SURE THAT
WE'RE ALL WORKING FROM THE SAME
PLAYBOOK AND I WANT TO
ACKNOWLEDGE TINA AND BORSIKA WHO
PROVIDED SLIDES AND KATHY WHO
LOOKED AT THE CONTENT ABOUT WHAT
WE WANT TO COVER TO SET THE
DISCUSSION WE WANT TO HAVE.
FIRST I'M GOING TO BEGIN BY
GIVING YOU A DEFINITION.
AND THIS COMES FROM ONE OF OUR
FUNDING OPPORTUNITIES THAT'S
FOCUSSED ON DISSEMINATION AND
IMPLEMENTATION.
I'M JUST GOING TO READ IT TO
YOU.
DISSEMINATION RESEARCH IS
DEFINED AS SCIENTIFIC STUDY OF
THE TARGETED DISTRIBUTION OF
INFORMATION AND INTERVENTION
MATERIALS TO A SPECIFIC PUBLIC
HEALTH CLINICAL PRACTICE OR
POLICY AUDIENCE.
THE INTENT IS TO UNDERSTAND HOW
BEST TO COMMUNICATE AND
INTEGRATE KNOWLEDGE IN THE
ASSOCIATED EVIDENCE-BASED
INTERVENTIONS.
IN CONTRAST, IMPLEMENTATION
RESEARCH IS DEFINED AS THE
SCIENTIFIC STUDY OF THE USE OF
STRATEGIES TO ADOPT AND
INTEGRATE EVIDENCE-BASED HEALTH
INTERVENTIONS INTO CLINICAL AND
COMMUNITY SETTINGS TO IMPROVE
INDIVIDUAL OUTCOME AND BENEFIT
POPULATION HEALTH.
NOW, IF YOU UNDERSTOOD THOSE
DEFINITIONS PERFECTLY FINE, THE
REST OF THIS TALK WILL PROBABLY
BE A REVIEW AND YOU CAN GO GET A
CUP OF COFFEE AND PAY MINOR
ATTENTION TO IT.
THAT SOUNDED LIKE A LOT OF WORDS
WITHOUT A LOT OF MEANING, THEN
THE REST OF THIS TALK IS REALLY
FOR YOU.
I'M GOING TO BREAK THESE THINGS
DOWN AND TRY TO MAKE THEM MORE
UNDERSTANDABLE.
I'M GOING TO USE A FRAMEWORK BY
CURRAN 2020 AND IF YOU GOOGLE
YOU'LL FIND THE ARTICLE.
I'LL START WITH THE PART YOU'RE
PROBABLY PRETTY FAMILIAR WITH.
MOST THE FOLKS DRAWN TO THIS
TOPIC ARE TYPICALLY FOLKS
ALREADY DOING CLINICAL RESEARCH
AND SO YOU'RE PROBABLY DOING
RESEARCH ON INTERVENTION OR
INNOVATION AND IT'S THE THING
THAT IMPROVES HEALTH
COMMUNICATION OR HEALTH
COMMUNICATION FOR US BECAUSE
WE'RE INTERESTED IN
COMMUNICATION DISORDERS OR
QUALITY OF LIFE.
I'LL OFTEN SAY INNOVATION RATHER
THAN INTERVENTION BECAUSE WE
WANT TO THINK BROADLY ABOUT THE
KINDS OF THINGS THAT CAN IMPROVE
COMMUNICATION SO WHEN I SAY THAT
SOME MAY IMMEDIATELY THINK OF
PROGRAMS WHICH ARE DEFINED AS
BEHAVIORAL TREATMENT PROGRAMS IN
A LOT OF OUR SPEECH AND LANGUAGE
INTERVENTIONS FALL INTO THAT
CATEGORY.
OTHERS MIGHT THINK IMMEDIATELY
ABOUT PRODUCTS SO HEARING AIDS,
COCHLEAR IMPLANTS, AUGMENTATIVE
AND COMMUNICATION DEVICES.
YOU MAY THINK ABOUT AND MORE ON
THE FRINGE THINGS LIKE
PROCEDURES LIKE UNIVERSAL
HEARING SCREENING OR YOU MAY
THINK ABOUT POLICIES LIKE THE
POLICY CHANGES THAT MAY MAKE IT
A REALITY.
THERE'S A WHOLE RANGE OF ACTIONS
THAT WE CAN TAKE THAT IMPROVE
HEALTH COMMUNICATION OR QUALITY
OF LIFE AND WE WANT TO BE
THINKING ABOUT THAT BROAD RANGE.
SO NOW WHAT YOU'RE FAMILIAR WITH
WHEN YOU'RE DOING RESEARCH IN
THE AREA IS YOU START WITH
DEVELOPING THE THING AND THAT'S
WHAT WE REFER TO AS OUR EARLY
PHASE CLINICAL TRIAL.
I'LL GIVE AN EXAMPLE FROM THE
RESEARCH I USED TO DO.
ONE OF THE THINGS I WAS
INTERESTED IN WAS DEVELOPING
BOOK READING PROGRAMS THAT HELP
CHILDREN LEARN NEW WORDS BY
HAVING A PERSON READING THE BOOK
ENGAGE IN CERTAIN TEACHING
TECHNIQUES THAT WOULD HELP A
CHILD LEARN THE WORDS IN THE
BOOK.
SO EN OUR EARLY PHASED WORK WE
HAD TO FIGURE OUT HOW MANY TIMES
DO WE NEED TO READ THE BOOK TO
HELP A CHILD LEARN THE WORDS.
WHAT SPECIFIC TEACHING
STRATEGIES DO WE NEED TO USE AND
HOW OFTEN DO WE NEED TO REACH
THOSE STRATEGY.
THAT'S THE EARLY PHASE WORK.
ONCE YOU HAVE A PROMISING
INTERVENTION YOU WANT TO TEST
WHETHER THAT THING WORKS AND
TYPICALLY THE FIRST TEST OF THAT
STRONG TEST IS EFFICACY TRIAL
WHERE YOU PROVIDE THAT
INNOVATION UNDER HIGHLY
CONTROLLED CONDITIONS.
SO WITH THE BOOK READING
INTERVENTION WE MIGHT COMPARE A
GROUP OF KIDS TO OUR WORKING
WITH GRADUATE RESEARCH ASSISTANT
WHO ARE BEING READ THE SAME
BOOKS AS THE TREATMENT GROUP BUT
NOT GETTING ANY OF THE HELPFUL
TEACHING TECHNIQUES AND THEN WE
MAY HAVE ANOTHER GROUP OF KIDS
WHO ARE GETTING INTERVENTIONS
FROM GRADUATE RESEARCH
ASSISTANTS WHERE THEY'RE USING
ALL THE HELPFUL TEACHING
TECHNIQUES AND THEN WHAT WE
LOOKED AT FOR THE OUTCOMES IS
HOW MUCH THE INDIVIDUAL IMPROVES
OR HOW MUCH THEY PREVENTED OR
REDUCED ISSUES, PROBLEMS.
SO FOR MY EXAMPLE, WE MIGHT BE
LOOKING AT HOW MANY WORDS THE
CHILDREN ARE LEARNING UNDER EACH
OF THOSE CONDITIONS AND IF WE
SEE A BIG ENOUGH DIFFERENCE
BETWEEN THE TWO, WE WOULD THEN
SAY THAT THE HELPFUL BOOK
READING INNOVATION IS
EVIDENCE-BASED.
THERE'S EFFICACY TOWARD IT.
WE ALSO MIGHT HAVE EFFECTIVENESS
TRIALS UNDER THIS LINE OF
RESEARCH AND THAT'S WHERE WE
WOULD BE TESTING WHETHER THE
INNOVATION WORKS OF UNDER LESS
CONTROLLED REAL WORLD
CONDITIONS.
SO AT THIS POINT ONCE WE'VE DONE
OUR EFFICACY RESEARCH, ASSUMING
IT COMES OUT THE WAY WE'RE
EXPECTING, WE WOULD NOW DECLARE
WE HAVE AN EVIDENCE-BASED
INNOVATION.
IN THIS CASE WE SAY THE HELPFUL
BOOK READING GETS THE GOLD STAR.
SO NOW WE MIGHT THINK, WELL, OUR
JOB IS ALL DONE AS RESEARCHERS.
WE HAVE PROVEN THE THING WORKS
AND WE CAN SIT BACK.
BUT AS I SAID AT THE BEGINNING,
OUR IMPACT ON PEOPLE'S LIVES AND
PEOPLE AND PLACES NEED TO DO THE
THING.
AND IT TURNS OUT AS DR. TUCCI
INDICATED THEY TEND NOT TO DO
THIS.
SO YOU MIGHT HAVE HEARD SOME OF
THESE STATISTICS THAT IT TAKES 1
YEARS FOR EFFECTIVE INNOVATION
TO MOVE FROM RESEARCH STUDIES
INTO CLINICAL PRACTICE OR PEOPLE
ONLY RECEIVE ABOUT 50% OF
RECOMMENDED HEALTH CARE
PROCEDURES AND MAYBE WHEN I SAY
THE THINGS YOU'RE THINKING,
WELL, THAT WASN'T EXACTLY FROM
OUR FIELD OR EXACTLY FROM THE
AREA I WORK IN BUT I THINK IN
MOST CASES IF YOU COMPARE A
SYSTEMATIC REVIEW AND
SYSTEMICALLY IDENTIFIES THE
EVIDENCE-BASED INTERVENTION FROM
A PARTICULAR AREA AND THEN LOOK
AT SURVEY OR INTERVIEW RESEARCH
THAT ASKS WHAT PROFESSIONALS
ROUTINE DO IT'S COMMON YOU SEE A
MISMATCH BETWEEN THE TWO THINGS
AND THAT'S WHAT'S REFERRED TO AS
THE NO-DO GAP OR THE RESEARCH
PRACTICE GAP.
WE KNOW CERTAIN THINGS ARE
EFFICACIOUS THROUGHOUT OUR
RESEARCH BUT DON'T SEE PEOPLE
AND PLACES DOING THOSE THINGS IN
THEIR CLINICAL PRACTICE.
SO THAT BRINGS US TO REALLY THE
HEART OF WHAT WE WANT TO LOOK AT
TODAY WHICH IS HOW DO WE HELP
PEOPLE AND PLACES DO THE THINGS?
HOW DO WE HELP THEM DO THESE
EVIDENCE-BASED INNOVATIONS?
SO I'LL START WITH OUR CURRENT
STRATEGY.
WHICH IS WE HOPE THE PEOPLE AND
PLACES DO THE THING.
AND TECHNICALLY THIS IS REFERRED
TO AS THE PASSIVE UNTARGETED,
UNPLANNED AND UNCONTROLLED
APPROACHES FOR SPREADING
KNOWLEDGE ABOUT EVIDENCE.
AND AS I'VE JUST SHOWN YOU, THIS
NOT A VERY EFFECTIVE STRATEGY.
THIS IS NOT REALLY HOW WE MOVE
THINGS INTO CLINICAL PRACTICE SO
WE WANT TO CONSIDER OTHER
OPTIONS.
SO OUR SECOND OPTION IS TO
ACTIVELY TELL PEOPLE IN PLACES
TO DO THE THINGS AND THIS IS
REALLY WHAT DISSEMINATION IS ALL
ABOUT.
DISSEMINATION ARE, IS ACTIVE
APPROACHES FOR SPREADING
EVIDENCE TO A TARGETED EVIDENCE
VIA PREDETERMINED CHANNELS USING
PLANNED STRATEGIES.
WHEN SOMEONE IS DOING
DISSEMINATION RESEARCH THEY'RE
TRYING TO UNPACK THE ELEMENTS IN
THE DEFINITION.
THEY'RE TRYING TO UNDERSTAND THE
AUDIENCE.
WHAT DOES THE AUDIENCE WANT TO
KNOW?
WHAT CHANNELS DO THEY USE?
WHAT INFORMATION DO THEY GET
FROM DIFFERENT CHANNELS?
WHAT KIND OF TYPES OR MESSAGES
DO THEY LIKE TO RECEIVE THROUGH
THOSE CHANNELS?
WHAT SORT OF INFORMATION DO THEY
NEED TO BE ABLE TO ADOPT A
PARTICULAR PRACTICE?
SO THIS IS A MUCH MORE TAILORED
APPROACH.
IT'S REALLY ABOUT MEETING THE
PRACTITIONERS WHERE THEY ARE AND
GIVING THEM THE INFORMATION THEY
REALLY WANT IN THE WAY THEY WANT
TO RECEIVE IT.
IT'S MUCH MORE TARGETED.
I WANTED TO ACKNOWLEDGE IN
DISSEMINATION AND IMPLEMENTATION
RESEARCH WE DON'T SEE AS MUCH
ATTENTION TO DISSEMINATION AND
SHOULD WRITE IT HIT AS A LITTLE
"D" AND BIG "I" BECAUSE THERE
ISN'T AS MUCH ACTION IN THE
DISSEMINATION AREA.
WE WANTED TO MAKE YOU AWARE OF
WHAT DISSEMINATION RESEARCH IS
AND WE WON'T BE TALKING A LOT
ABOUT IT THROUGHOUT THE WORKSHOP
BECAUSE THERE'S LESS INFORMATION
ABOUT IT.
LESS STRATEGIES.
THE THIRD OPTION IS WE CAN DO
STUFF TO HELP PEOPLE AND PLACES
DO THE EVIDENCE-BASED
INTERVENTION.
AND DO STUFF THAT'S VERY BROAD
WHICH IS WHY I'M SHOWING A LOT
OF TOOLS.
THERE'S A VARIETY OF THINGS WE
CAN DO TO HELP PEOPLE AND PLACES
DO THE THING AND THIS IS
IMPLEMENTATION AND ACTIVE AND
PLANNED EFFORT TO INTEGRATE
EVIDENCE INTO PRACTICE.
SO LET'S BREAK THIS DOWN A
LITTLE BIT MORE.
SO I'M GOING GO BACK TO MY
HELPFUL BOOK READING STRATEGY
AND TALK THROUGH THIS SLIDE
HERE.
SO WE KNOW THAT HELPFUL BOOK
READING IS A GOOD WAY TO TEACH
WORDS TO CHILDREN.
SO NOW WE WANT TO GET TEACHERS
IN SCHOOLS TO DO THE HELPFUL
BOOK READING PRACTICE.
SO WE NEED TO CONSIDER WHAT WE
CAN DO TO HELP THEM.
SO ONE THING YOU MIGHT THINK OF
RIGHT OFF THE BAT IS WE SHOULD
TEACH THEM HOW TO DO THE
STRATEGY.
THAT MAKES A LOT OF SENSE.
THAT'S WHAT WE DO AND WE HAVE
GRADUATE RESEARCH ASSISTANTS DO
THE PROGRAM SO WE SHOULD
PROBABLY TEACH THEM.
THAT'S ONE STRATEGY.
WE ALSO MIGHT WANT TO MONITOR
THEM DOING THE HELPFUL BOOK
READING PROGRAM AND GIVE THEM
FEEDBACK ON HOW WELL THEY'RE
DOING THIS SO THAT'S ANOTHER
IMPLEMENTATION STRATEGY.
WE MIGHT ALSO THINK ABOUT GIVING
THEM BONUSES IF THEY DO THE
PROGRAM TO A CERTAIN LEAVE --
CERTAIN LEVEL OF QUALITY THEY
GET A BUMP IN THEIR PAYCHECK IS
IS ANOTHER IMPLEMENTATION
STRATEGY.
THAT FALLS UNDER HELPING THE
PEOPLE AND PLACES DO THE BOOK
READING.
NOW WE WANT TO TAKE THIS TO
RESEARCH SIDE OF THINGS.
WE WANT TO FIGURE OUT FROM THE
STRATEGIES HOW BEST TO HELP
PEOPLE AND PLACES DO THE THINGS.
SO WE COULD NOW LOOK AT THOSE
STRATEGIES INDIVIDUALLY.
WE CAN HAVE A GROUP OF PEOPLE
WHO GET THE TRAINING BUT NOT THE
OTHER THINGS.
A GROUP OF PEOPLE WHO GET THE
TRAINING AND THE MONITORING AND
THE FEEDBACK AND THEN A GROUP OF
TEACHERS WHO ARE GETTING THE
TRAINING AND MONITORING AND
FEEDBACK AND THE BONUSES.
NOW, ACROSS THE GROUPS WE COULD
LOOK AT HOW MUCH AND HOW WELL
THEY'RE DOING THE THING.
WE WOULD MEASURE THE TEACHERS
AND HOW WELL THEY ARE DOING THE
HELPFUL BOOK READING STRATEGY SO
WE CAN LOOK AT THINGS LIKE HOW
OFTEN THEY'RE READING THE BOOK
AND HOW MUCH TEACHING TECHNIQUES
THEY'RE USING AND SO ON AND WE
WOULD USE THAT THEN TO DECIDE
WHICH OF THOSE GROUPS DID BETTER
IN DOING THE THINGS AND WE COULD
THEN RECOMMEND THAT PACKAGE
WHATEVER IT IS AS BEING KIND OF
THE BEST WAY TO IMPLEMENT THE
BOOK READING PROGRAM AND WE
COULD TRY TO ROLL THAT OUT TO A
VARIETY OF DIFFERENT SITES.
OKAY.
SO HOPEFULLY THAT HELPS YOU SEE
WE HAVE TWO LINES OF RESEARCH
THAT NEED TO LAP -- HAPPEN.
A LINE OF RESEARCH ABOUT THE
EVIDENCE-BASED INTERVENTION AND
SHOW IT HELP PEOPLE IMPROVE
THEIR COMMUNICATION AND
DISSEMINATION ON HOW TO DO THE
EVIDENCE-BASED INTERVENTION.
WE HAVE DIFFERENT THINGS WE WANT
TO LOOK AT AND DIFFERENT KINDS
OF RESEARCH STUDIES WE NEED TO
INCORPORATE.
NOW I'M GOING TO GO INTO MORE
DETAIL ABOUT THE IMPLEMENTATION
SCIENCE PART.
I TOLD YOU WE HAD IMPLEMENTATION
STRATEGIES.
THAT WHAT WE'RE DOING WITH
TEACHERS IN MY EXAMPLE AND TOLD
YOU WE HAVE OUTCOME MEASURES.
AND MODELS AND FRAMEWORK.
IT TURNS OUT WE CAN USE
IMPLEMENTATION STUDIES FROM A
VARIETY OF FIELD TO GET A SENSE
GENERALLY OF WHAT HELPS PEOPLE
IMPLEMENT DIFFERENT KINDS OF
INNOVATION AND THIS GIVES THE
BODY OF LITERATURE TO DRAW FROM
SO WE'RE NOT STARTING IN A
VACUUM WHEN WE'RE DOING OUR
IMPLEMENTATION RESEARCH.
I'M GOING TO TALK THROUGH ONE
FRAMEWORK THAT LAYS OUT ALL THE
DIFFERENT PIECES AND I PICKED
THIS PARTICULAR ARTICLE BECAUSE
IT DOES HAVE ALL THREE OF THOSE
COMPONENTS THAT I JUST SHOWED
FOR IMPLEMENTATION IN ONE PAPER.
IT'S MORE COMMON TO SEE
DIFFERENT PAPERS ON DIFFERENT
TOPICS AND ONE PAPER ON
STRATEGIES AND ANOTHER ON
OUTCOMES AND NOT HAVE IT ALL
BROUGHT TOGETHER.
THIS IS A NICE PAPER TO START
WITH TO GET THAT COMPREHENSIVE
LOOK AND UNDERSTANDING.
SO THE FIRST THING I WANT TO
POINT OUT ARE THE CIRCLES ON THE
SLIDE.
MOST OF THE MODELS AND FRAMEWORK
IN IMPLEMENTATION SCIENCE
RECOGNIZE IT'S HAPPENING IN REAL
WORLD SETTINGS AN THEY'RE
COMPLICATE AND MULTI-LEVEL AND
THE MULTILEVELS MATTER FOR WHAT
IS GOING TO BE IMPLEMENTED WELL
AND WHAT ISN'T.
ONE OF THE BUBBLES IS ABOUT THE
INNOVATION AND THERE'LL BE
IMPLICATIONS WHETHER AN
INNOVATION WILL BE ADOPTED.
THIS MODEL IS MEANT FOR SCHOOLS.
IT TALKS ABOUT THE STUDENT OR
FAMILY WHICH WOULD BE YOUR
TARGET PERSON YOU'RE TRYING TO
HELP AND CHARACTERISTICS OF
TEACHERS AND WHETHER THEY'LL
IMPLEMENT A PARTICULAR
INNOVATION.
WE HAVE WORK STUDY REFERRED TO
AS THE INNER SETTING WHICH MEANS
THE IMMEDIATE WORK ENVIRONMENT.
THAT'S GOING TO EXERT PRESSURES
ON WHETHER SOMETHING IS
IMPLEMENTED WELL OR NOT AND THEN
WE ALSO HAVE ANOTHER SETTING
WHICH IS OTHER ISSUES OUTSIDE OF
THE IMMEDIATE SETTING THAT MIGHT
IMPACT WHAT'S HAPPENING.
WITHIN THE MULTI LAYERS THEY'LL
IMPEDE OR HELP THE PROGRAM AND
YOU WANT TO GET YOUR HEAD AROUND
THROUGH THE RESEARCH PROCESS
WHAT THE FACTORS ARE THAT ARE
GOING TO MATTER.
FOR EXAMPLE FOR THE INNOVATION,
THE COST, THE COMPLEXITY OF IT.
HOW MUCH BETTER IT IS THAN THE
OTHER THINGS THAT ARE OUT THERE.
THOSE ARE THINGS THAT COULD
POTENTIALLY MATTER FOR WHETHER
SOMEONE IS GOING TO ADOPT THIS
NEW PRACTICE.
WHEN WE THINK ABOUT THE EDUCATOR
OR THE PROFESSIONAL, THEY'RE
KNOWLEDGE AND BELIEFS ABOUT THE
INTERVENTION OR THEIR OWN
CAPABILITY MIGHT MATTER FOR
WHETHER THEY'RE GOING TO WANT TO
ADOPT THIS INNOVATION AND
LIKEWISE THE CLIMATE AND THEIR
WORK ENVIRONMENT IS IT TOTAL
CHAOS OR IS THERE OPENNESS TO
CHANGE AND STRONG LEADERSHIP TO
FACILITATE CHANGE?
THESE ARE ALL THINGS YOU WANT TO
FIND OUT EARLY IN YOUR
IMPLEMENTATION RESEARCH PROCESS
SO YOU CAN UNDERSTAND THE
CONTEXT THE INNOVATION WOULD BE
ADOPTED IN.
SO IN MY BOOK READING PROGRAM,
FOR EXAMPLE, THINGS THAT MIGHT
MATTER ARE ONE, THE COMPLEXITY
OF THE PROGRAM ITSELF AND THE
COST OF THE PROGRAM AND THE
SPECIAL SET OF BOOKS OR CAN YOU
JUST USE WHATEVER BOOKS ARE IN
THE SCHOOL LIBRARY AND THAT
MIGHT MATTER.
BOOK READING IS NOT NECESSARILY
UNIVERSAL OF POP CULTURE.
THERE COULD BE SOME VARIATION
THERE THAT WOULD BE IMPORTANT TO
KNOW ABOUT.
AND WHEN WE THINK ABOUT
FACILITATOR.
FOR EXAMPLE VOCABULARY LEARNING
MAY WANT SOMEBODY WANT TO ADOPT
INNOVATION.
IN THE OUTER SETTING I USED TO
THINK BOOK READING WAS INNOCUOUS
AND NOW THERE'S TALK ABOUT
BANNING BOOKS EVEN FOR YOUNG
CHILDREN.
MAYBE THAT NOW COULD PLAY INTO
BEING A POTENTIAL AREA.
AND IT'S NOT THAT WE'RE GOING TO
MAKE ASSUMPTIONS ABOUT THIS.
WE'RE GOING COLLECT DATA TO
UNDERSTAND THE DIFFERENT FACTORS
AND HOW THEY IMPACT.
AND THEN WHAT WE DO ONCE WE
UNDERSTAND KIND OF THAT CONTEXT,
THAT'S WHEN WE START DESIGNING
OUR IMPLEMENTATION STRATEGIES
AND THE STRATEGIES CAN BE
DEPLOYED ACROSS ANY OF THESE
LEVELS AND OFTEN ACROSS MULTIPLE
LEVELS AND THE STRATEGIES HELP
YOU LEVERAGE THOSE FACILITATORS
AND TRY TO OVERCOME SOME OF THE
BARRIERS.
AND THEN WE'RE ALSO GOING TO
EVALUATE THE OUTCOMES SO
EVALUATION IS WHAT WE'RE TALKING
ABOUT.
THE NEXT SLIDES I'M NOT GOING
READ BECAUSE I HOPE HAVE YOU A
GOOD FEELING FOR WHAT
IMPLEMENTATION STRATEGIES ARE
AND THERE'S A WORK SHEET THAT
HAS A LONG LIST OF I DON'T KNOW
HOW MANY IMPLEMENTATION S
STRATEGIES BUT THERE'S A LOT OF
THEM AND DIVERSE.
YOU HAVE A LOT OF OPTIONS TO
TAILOR YOUR IMPLEMENTATION
STRATEGIES TO WHAT YOU'RE
UNDERSTANDING ABOUT THE CONTEXT
YOU'RE WORKING IN.
AND THIS ONE LOOKS AT HOW WELL
THE TEACHERS ARE EM EMPLOYING
THE INNOVATION AND THERE'S A
VARIETY OF OTHERS TO LOOK AT.
IN THE BOOK READING IN ADDITION
TO LOOKING AT HOW WELL THEY'RE
DOING WE MIGHT WANT TO SEE WHAT
THEY THINK ABOUT IT.
SO WE MIGHT LOOK AT
ACCESSIBILITY OR APPROPRIATENESS
TO GET A BETTER SENSE OF THEIR
PERCEPTION.
THAT IN A NUTSHELL HOPEFULLY
GIVES YOU AN IDEA OF WHAT THE
COMPONENTS OF IMPLEMENTATION
LOOK LIKE.
NOW I WANT TO MOVE INTO THINKING
ABOUT HOW WE PUT THESE TWO LINES
OF RESEARCH TOGETHER.
WE HAVE THE EVIDENCE BASED
INNOVATION AND RESEARCH AND
EFFICACY AND EFFECTIVENESS AND
THEN WE GOT THIS HELPING OTHERS
DO THE THING, DO THE INNOVATION
OR IMPLEMENTATION RESEARCH SO
HOW DO WE BRING THESE TOGETHER
AND INTEGRATE THEM?
IS THIS ONE IDEA HOW TO DO THIS.
THIS ARTICLE TALKS ABOUT THE
PRACTICE OF INTEREST.
SO THE INNOVATION AND THEY'RE
REFERRING TO IT IN GENERIC TERMS
AS THE PRACTICE YOU'LL ASK
YOURSELF QUESTIONS ABOUT WHAT DO
WE KNOW ABOUT THE PRACTICE.
SO THE FIRST QUESTION TO
YOURSELF IS HAS EFFICACY BEEN
DEMONSTRATED FOR THE
IMPLEMENTATION.
IF NO, YOU SHOULD DO EFFICACY
AND THAT TAKES YOU THROUGH THE
RED LINE.
IF YES YOU ASK YOURSELF ANOTHER
QUESTION, HAS EFFECTIVENESS BEEN
PART OF INNOVATION?
IF NO THEN YOU DO EFFECTIVENESS
RESEARCH.
THAT'S WHEN WE'RE LOOKING AT THE
INNOVATION.
THEN IF YOU'RE ANSWER IS MAYBE,
NO OR PARTIAL TO THE
EFFECTIVENESS, YOU CAN DO THE
HYBRID TRIALS THAT ABUT YOU --
ALLOW YOU TO LOOK AT
EFFECTIVENESS TOGETHER IN THE
SAME SETTING AND IF YOU HAVE
STRONG EFFECTIVENESS DATA THEN
YOU CAN MOVE INTO AN
IMPLEMENTATION TRIAL.
HERE WE'RE ONLY LOOKING AT THE
REAL WORLD SIDE OF THINGS AND
EFFECTIVENESS AND ORIENTATION IN
THE EFFECTIVENESS TRIAL YOU'RE
DOING IT AS YOUR PRIMARY THING
AND NOT REALLY PAYING ATTENTION
TO THE IMPLEMENTATION SIDE.
THEN WE MOVE TO THE HYBRID
TRIALS AND YOU CAN SEE WE'RE
DOING EFFECTIVENESS AND
IMPLEMENTATION RESEARCH TOGETHER
IN PARALLEL.
WHAT'S VARIED ACROSS THE TYPES
IS WHICH ONE OF THOSE IS
IDENTIFIED WHETHER WE HAVE MORE
EMPHASIS ON THE EFFECTIVENESS AS
IN THE TYPE ONE OR WHETHER WE
HAVE EQUALNESS ON IMPLEMENTATION
OR MORE ON THE IMPLEMENTATION AS
HYBRID TYPE 3 AND THEN ON
IMPLEMENTATION TRIAL WE'RE NOT
REALLY LOOKING AT EFFECTIVENESS
BUT FOCUSSED ON THE
IMPLEMENTATION SIDE OF THINGS.
NOW, ONE OF THE THINGS THAT MANY
OF US ARE FRUSTRATED BY WITH
THESE TYPES OF FRAMEWORKS IS
THAT IT FEELS VERY STEP WISE,
VERY LINEAR.
POTENTIALLY VERY LOW -- SLOW.
I TRIED TO REFLECT ON WHY IS
THAT AND WHAT IS MISSING FROM
THE FRAMEWORK?
WHAT I CAME UP WITH IS WE NEED A
DESTINATION.
YOU DON'T TAKE THE SUBWAY TO
TAKE THE SUBWAY.
IT'S UNDERGROUND.
YOU DON'T JUST RIDE THE RAILS TO
RIDE THE RAILS.
YOU WANT TO GO SOMEWHERE.
SO WHEN WE'RE STARTING OUR
RESEARCH EVEN AT THE BEGINNING
WHEN WE'RE DEVELOPING AN
INNOVATION, WE NEED TO BE
THINKING ABOUT THAT END POINT.
WHO ARE WE SERVING IN THE WORLD.
WHAT CONTEXT?
WHO IS GOING TO BE USING THIS
INNOVATION AND WE WANT TO AT
LEAST SKETCH THAT OUT FROM THE
BEGINNING AND CONTINUE TO
FULFILL IN DETAIL AS WE GO
THROUGH OUR PROCESS AND BECOME
MORE KNOWLEDGEABLE HOW THIS
COULD BE USED.
AND SO THEN WHAT I THINK THIS
ALLOWS US TO DO IS CREATE A MORE
EFFICIENT TRACK FROM THE
BEGINNING TO THE END POINT AND
THIS IS THE D&I BULLET TRAIN
FROM THE BEGINNING OF OUR COMING
UP WITH THE IDEA FOR AN
INNOVATION TO ACTUALLY HAVING IT
IN PRACTICE.
KNOW, WE'RE STILL GOING TO GO
THROUGH THESE DIFFERENT STAGES
BUT I HOPE WE'LL ABLE TO GO
THROUGH THEM A LITTLE MORE
EFFICIENTLY BECAUSE WE'LL BE
ABLE TO BLUR THE LINES WITH WHAT
WE'RE DOING.
FOR EXAMPLE, I TOLD YOU THAT
CHARACTERISTICS OF THE
INNOVATION CAN MAKE DIFFERENCE
FOR WHETHER IT'S GOING TO BE
ADOPTED IN THE REAL WORLD.
SO DOES IT MAKE SENSE TO MAKE AN
INNOVATION, TEST THE EFFICACY
AND THEN PUT IT IN THE REAL
WORLD AND FIND OUT THEY TOTALLY
HATE IT AND NEVER USE IT?
IF THAT'S SOMETHING YOU FOUND
OUT WE'D HAVE TO REDESIGN THE
WHOLE THING AND WOULD HAVE TO GO
BACK THROUGH OUR INITIAL
PROCESS.
THAT'S NOT VERY EFFICIENT.
IT WOULD MAKE MORE SENSE TO
THINK ABOUT THE REAL WORLD
PEOPLE WHO ARE GOING TO USE THE
INNOVATION FROM THE VERY
BEGINNING AND ENGAGE IN SOME
KIND OF CO-DESIGN PROCESS SO
THAT WHAT COMES OUT OF OUR
EFFICACY RESEARCH IS SOMETHING
THAT IS MORE IMMEDIATELY
IMPLEMENTABLE OR SOMETHING THE
PEOPLE WHO ARE GOING TO ADOPT IT
WILL USE.
AND WHAT I'M GETTING AT IS HOW
WE THINK ABOUT THE BALANCE OF
INTERNAL VALIDITY VERSUS
EXTERNAL VALIDITY MOVING THROUGH
THE PROCESS.
THAT IS THE GRAPHIC ON THE RIGHT
SIDE.
INTERNAL VALIDITY IS THE RIG
PERP WE WANT HIGH -- RIGOR.
WE WANT HIGH RIGOR TO MAKE
STRONG STATEMENTS ABOUT OUR
INNOVATION CAUSING THE CHANGE IN
THE PERSON'S BEHAVIOR USUALLY
THE PERSON'S COMMUNICATION IS
WHAT WE'RE INTERESTED IN.
EXTERNAL VALIDITY IS THE REAL
WORLD GENERALIZABILITY IS WHAT
WE WANT WHEN WE'RE IN THE
IMPLEMENTATION PHASE WHERE WE
WANT TO MAKE SURE THERE'S A HIGH
DEGREE OF EXTERNAL VALIDITY.
WE CAN'T GO EXTERNAL AND MAKE A
SHIFT AND IT WON'T BE A SMOOTH
HANDOFF.
WE WANT TO THINK HOW WE BALANCE
THE INTERNAL AND EXTERNAL
VALIDITY THROUGH OUR WHOLE
RESEARCH PROCESS SO WE HAVE A
TRANSITION FROM ONE TO THE
OTHER.
ON THE LEFT SIDE OF THE SCREEN
IS A PARTICULAR FRAMEWORK THAT
HELPS YOU THINK THROUGH THIS.
WHAT THE FOLKS ARE ON THE WHEEL
ARE ALL THE ELEMENTS OF YOUR
RESEARCH DESIGN WHERE YOU MAKE
CHOICES THAT EITHER INCREASE
YOUR INTERNAL VALIDITY OR YOUR
EXTERNAL VALIDITY AND GIVES YOU
A WAY TO THINK THROUGH WHAT IS
THE QUESTION YOU'RE TRYING TO
ASK AND WHAT IS REALLY THE RIGHT
BALANCE OF INTERNAL AND EXTERNAL
VALIDITY.
THERE'S NOT GOING TO BE A
ONE-SIZE FITS ALL ANSWER TO THIS
PUZZLE BUT I THINK WE REALLY
NEED TO GRAPPLE WITH THIS MUCH
MORE AS WE GO THROUGH OUR
RESEARCH DESIGN PROCESS.
THIS A FRAMEWORK OF THE ELEMENTS
AND WE HOPE THIS WILL HELP YOU
THINK THROUGH YOUR OWN RESEARCH
PROJECTS AND PUT ALL THE
ELEMENTS ON ONE SLIDE TO SEE
THEM TOGETHER.
YOU CAN SEE WE WANT YOU TO
DEFINE WHAT YOUR EVIDENCE-BASED
INNOVATION IS AND WANT YOU TO
THINK ABOUT THE DYNAMIC
MULTI-LEVEL CONTEXT TO BRING IN
WHAT THE DESTINATION IS AND THEN
OUTLINE YOUR IMPLEMENTATION
STRATEGY TO HELP PEOPLE AND
PLACES DO YOUR INNOVATION.
OUTLINE YOUR IMPLEMENTATION
OUTCOME.
HOW WOULD YOU KNOW THE PEOPLE
AND PLACES ARE DOING THE
INNOVATION AND YOU MIGHT ALSO BE
LOOKING AT EFFECTIVENESS
OUTCOMES WHICH ARE WHAT'S GOING
ON WITH YOUR TARGETED INDIVIDUAL
AND THE PERSON WITH THE
COMMUNICATION DISORDER AND HOW
THEY'RE OUTCOMES ARE IMPROVING.
I'LL GOOD BACK TO MY EXAMPLE
WHICH I THINK YOU CAN PROBABLY
FILL IN THE BUBBLE BUT TO SHOW
WE HAVE THIS HELPFUL BOOK
READING PROGRAM THE
EVIDENCE-BASED INTERVENTION AND
THIS HYPOTHETICAL EXAMPLE.
WHO WILL USING IT?
WE THINK WE'LL HAVE TEACHERS DO
IT IN CLASSROOMS WITH CHILDREN
WITH NORMAL LANGUAGE DEVELOPMENT
AND TALK ABOUT THE BROADER
ENVIRONMENT AND MAYBE THE BOOK
BANNING PROCESS MAY BE SOMETHING
THAT MAKES SENSE OF THIS
INNOVATION TO APPLY AND WE WANT
TO THEN AND MONITORING AND
PROVIDING FEEDBACK ON THE FLY.
INCENTIVES LIKE BONUSES.
AND BECAUSE I PUT INTO CONTEXT
THE BOOK BANNING ISSUE WE MAY
WANT TO IDENTIFY THE BOOKS PART
OF A PROGRAM TO PICK BOOKS THAT
WOULD BE ACCEPTABLE TO THE
COMMUNITY.
SO THOSE WOULD BE ALL THE
STRATEGIES THAT WE COULD
POTENTIALLY USE.
THEN WE WOULD MEASURE OUR
OUTCOMES.
HOW WELL ARE THE TEACHERS USING
THE HELPFUL BOOK READING
PROGRAM.
WHAT DO THEY THINK ABOUT THE
ACCEPTABILITY AND FEASIBILITY OF
THE PROGRAM AND SO ON.
FOR AN EFFECTIVENESS OUTCOME WE
COULD LOOK AT THE CHILDREN AND
HOW MANY WORDS THEY'RE LEARNING
AND AGAIN THIS WOULD BE IN THE
CONTEXT OF A RESEARCH STUDY SO
IF WE'RE ON THE IMPLEMENTATION
SIDE WE WOULD BE COMPARING SOME
OF THE STRATEGY PACKAGES AND
LOOKING AT HOW THAT VARIES THE
ACCEPTABILITY AND FEASIBILITY.
I HOPE THAT WAS A HELPFUL CRASH
COURSE IN IMPLEMENTATION SCIENCE
AND DISSEMINATION.
WHAT WE'RE GOING TO DO NEXT IS
WE HAVE INVITED THREE NIDCD
FUNDED INVESTIGATORS WHO HAVE
DISSEMINATION AND IMPLEMENTATION
RESEARCH PROJECTS AND THEY'RE
GOING TO KIND OF RAPID FIRE
PRESENT THEIR PROJECTS USING
THAT FRAMEWORK THAT I JUST
SHOWED YOU.
SO OUR FIRST IS JESSICA CARON
FROM PENN STATE UNIVERSITY AND
HER PROJECT IS IMPROVING
LITERACY OUTCOMES IN CHILDREN
WHO USING AUGMENTATIVE AND
ALTERNATIVE COMMUNICATION.
ARE YOU ABLE TO UNMUTE AND TALK
THIS THROUGH?
>> THANKS, HOLLY.
I'M EXCITED TO BE HERE TO
PROVIDE AN EXAMPLE OF OUR
RESEARCH.
SO THE FRAMEWORK JUST SHARED WE
AIM TO IMPROVE OUTCOMES FOR
CHILDREN WHO USE AUGMENTATIVE
AND ALTERNATIVE COMMUNICATION
AND INDIVIDUALS WHO USE THIS ARE
EXTREMELY POOR RESULTING IN A
PROBABLE OF LIFE LONG ISSUE AND
PROHIBITS INCLUSION OF USE
PHONICS CURRICULUMS IN SCHOOLS
RIGHT NOW AND SERVICE PROVIDERS
ARE THEN REQUIRED TO MAKE
ADAPTATIONS TO CURRENT
CURRICULUMS WITH LIMITED
KNOWLEDGE AND TIME.
THE ACCESSIBLE LITERACY LEARNING
APP IS THE INTERVENTION THAT HAS
POTENTIAL TO IMPROVE EARLY
LITERACY SKILLS AND DAILY
INSTRUCTION THAT ARE EVIDENCE
BASED CAN CHANGE THE POOR
OUTCOMES AND LIMITED RESEARCH
EXISTS RELATED TO LITERACY
INTERVENTIONS THAT INCLUDE
PHONICS-BASED TASKS INDIVIDUALLY
FOR THESE INDIVIDUALS THAT USE
PIS.
THE FIRST IS TO ASSESS THE
EFFECTIVENESS FOR INDIVIDUALS
WITH DISABILITY WHO'S USE EAC
AND THE SECOND AIM IS LOOKING AT
THE ACCEPTABLITY AND FEASIBILITY
OF THE LESSONS USING THE
TECHNOLOGY AND WE'RE LOOKING AT
THIS TO FIGURE OUT WHAT'S BEEN
HELPFUL OR HINDERING TO ADOPTION
OF THE TECHNOLOGY IN THE
SCHOOLS.
SO AGAIN THE EVIDENCE-BASED
INTERVENTION IS GOING TO BE THE
ACCESSIBILITY LESSON CURRICULUM
WITH STIMULI FOR INDIVIDUAL
WHO'S USING AAC AND WHEN WE LOOK
AT THE CONTEXT THERE'S A NUMBER
OF FACTORS THAT PLAY.
THE EVIDENCE-BASED INTERVENTION
IS ACTUALLY PRESENTED ON AN iPAD
SO THERE NEEDS TO BE ACCESS TO
iPADS AND PHYSICALLY BEING ABLE
TO ACCESS THE iPADS.
IT'S BEING USED AT SCHOOLS.
WE HAVE PUBLIC AND PRIVATE
SCHOOLS AND THERE'S DIFFERENT
CONTEXT DIFFERENCES DEPENDING ON
THOSE THINGS.
AND THERE'S CHILDREN WITH
DISABILITIES AND WE INCLUDE
INDIVIDUALS WITH A RANGE OF
DISABILITIES, AUTISM, CEREBRAL
PALSY, DOWNS SYNDROME.
AND IN ADDITION THOSE PROVIDING
INSTRUCTION WE DIDN'T LIMIT TO
TEACHERS, THEY'RE SLPs,
OCCUPATIONAL THERAPISTS AND
PARENT EDUCATORS COMING WITH
DIFFERENT LENSES AND
EXPERIENCES.
AND THEN THE BROADER ENVIRONMENT
WE'RE DEALING WITH ATTITUDINAL
BARRIERS WHERE A NUMBER OF
PEOPLE STILL BELIEVE THESE
INDIVIDUALS CAN'T LEARN TO READ
OR THEY BELIEVE THEY CAN ONLY
LEARN TO READ IN A CERTAIN WAY
LIKE MORE OF A SITE WORD
APPROACH INSTEAD OF ACCESS TO
PHONICS AND BIGGER PICTURE
HISTORY THERE'S NO PREVIOUS
STUDIES OF ALL BEING USED BY
SERVICE PROVIDERS IN SCHOOLS.
IN TERMS OF IMPLEMENTATION
STRATEGIES OR THINGS WE HAVE IN
PLACE TO TRY TO GET THE SERVICE
PROVIDERS TO USE THIS CURRICULUM
DAILY, WE PROVIDE TRAINING ON
THE APP AND THEN WE PROVIDE AN
OVERVIEW TRAINING OF HOW DO YOU
IMPLEMENT THE APP LIKE WHAT IS
PART OF THE LESSON.
SO AN EXAMPLE IS OUR LESSON
INCLUDES MODELLED GUIDANCE AND
UP DEPENDENT PRACTICE AND HOW TO
DO THAT.
WE PROVIDE TECHNICAL SUPPORT.
WE SET THE APP UP FOR THE USER
AND IF ANYTHING GOES WRONG
THEY'RE SUPPOSED TO FIRST
CONTACT US AND LUCKILY WE
HAVEN'T HAD A LOT OF ISSUES
AROUND THAT AND WE HAVE AUDITING
WHERE DAILY THEY'RE TO FULL OUT
A BINDER OF WHAT THEY'RE TO
IMPLEMENT PER LESSON AND THEY'RE
SUPPOSED TO IMPLEMENT 35 TO 50
TRIALS AND WHAT DID YOU GET TO.
THERE'S FIDELITY CHECKS AND SOME
ARE SELF-CHECKS AND SOME ARE
FIDELITY CHECKS WHERE WE OBSERVE
EITHER VIA VIDEO OR LIVE HOW
THEY'RE IMPLEMENTING THE LESSON.
AND WE ALSO HAVE FOR EACH SCHOOL
WE HAVE BIWEEKLY OFFICE HOURS WE
ENGAGE WITH THE KEY IMPLEMENTERS
OR DRIVERS AT EACH SCHOOL WHERE
WE'RE TRYING TO KEEP IN TOUCH OF
WHAT'S GOING ON OR ISSUES AND
GENERALLY THE INCENTIVES TO
PARTICIPATE WOULD BE THEY GET TO
KEEP THE APP AND GET ACCESS TO
THE MATERIALS WE'VE CREATED AND
GET AMAZON GIFT CARDS FOR
PARTICIPATING.
IN MATERIALS OF THE
IMPLEMENTATION OUTCOMES OR
THINGS WE'RE INTERESTED IN TERMS
OF USE IS WE'RE MEASURING
ACCEPTABILITY, FEASIBILITY,
ADOPTION AND FIDELITY AND WE'RE
MEASURING THE FIRST THREE
THROUGH A QUESTIONNAIRE THAT WE
CREATED AND WE'VE DEVELOPED IT
BASED ON SOME PREVIOUS RESEARCH.
AND THEY IMPLEMENT THAT
QUESTIONNAIRE AT MULTIPLE TIME
POINTS AT LATEST FOUR TIME
POINTS THROUGHOUT THE STUDY AND
ALSO WE DID A FOCUS GROUP AT
EACH SCHOOL TO GET A BETTER
UNDERSTANDING OF KIND OF
BARRIERS OF CURRENT PRACTICE AND
THEN WE'VE BEEN DOING PRE-POST
INTERVIEWS WITH EACH IMPLEMENTER
TO GET A BETTER SENSE OF WHAT
THEY LIKED ABOUT IT AND WHAT WAS
FEASIBLE AND WHAT WAS HARD AND
THE THINGS.
I'M HOPING OVER THE COURSE OF
THE PROJECT OVER THREE YEARS
WE'LL BE ABLE TO GET SOME
SUSTAINMENT DATA.
WE DIDN'T BUILD THAT INTO THE
GRANT BUT WE'RE REALLY
INTERESTED IN SINCE WE HAVE
THREE YEARS TO LOOK AT OUR
SCHOOLS CONTINUING AFTER WE
COLLECTED THE DATA THAT WE'VE
NEEDED.
SO FINALLY, THIS GRANT DID ALSO
HAVE EFFECTIVENESS OUTCOMES
WHICH IS OUR -- THE AIM 1
MEASURE WHERE WE'RE LOOKING AT
IMPROVEMENT IN EARLY LITERACY
SKILLS OF THE INDIVIDUALS THAT
PARTICIPATE WITH THE
ALL-CURRICULUM AND WITH THAT
WE'RE LOOKING AT THEIR
IMPROVEMENT ACROSS SIX DIFFERENT
EARLY LITERACY SKILLS COVERED IN
THE INSTRUCTION THEY RECEIVED.
SO WE'RE GLAD WE WENT WITH MORE
OF A HYBRID DESIGN AND THE
IMPLEMENTATION OUTCOME DATA HAS
BEEN REALLY INTERESTING AND
WE'RE DEFINITELY USING THAT AS
WE TRY TO SCALE UP FOR OUR NEXT
GRANT.
THANKS.
>> THANKS, VERY MUCH.
NEXT WE HAVE MATTHEW BUSH FROM
THE UNIVERSITY OF KENTUCKY
MEDICAL CENTER AND HIS TALK IS
TITLED COMMUNITIES HELPING THE
HEARING OF INFANTS BY REACHING
PARENTS THE CHHIRP NAVIGATOR
TRIAL.
IF YOU CAN GO AHEAD AND UNMUTE
AND TAKE IT AWAY THAT'D BE
GREAT.
>> THANKS, HOLLY.
GREETINGS, EVERYONE.
I'M EXCITED TO PARTICIPATE IN
THE WORKSHOP.
IT REPRESENTS EXCITING VISION
FOR THE FUTURE HOW WE ADVANCE
HEARING HEALTH CARE AND HEALTH
CARE THAT IMPACTS THOSE PATIENTS
AND RESEARCH PARTICIPANTS THAT
WE CARE ABOUT AS PART OF THE
NIDCD.
I'M GOING TO TALK TO YOU ABOUT
AN RO1 FUNDED STUDY ENTITLED
COMMUNITIES HELPING THE HEARING
OF INFANTS BY REACHING PARENTS
THE CHHIRP NAVIGATOR TRIAL.
SO, OUR STUDY IS AN R01 STUDY
WE'RE IN THE FIFTH YEAR AND
RESEARCH IN RURAL POPULATIONS
PRIMARILY BUT OVER ALL WITH THE
HEART AND SOUL TOWARDS TRYING TO
ADDRESS HISTORICALLY
MARGINALIZED POPULATIONS.
AND INFANTS THAT HAVE DIFFICULTY
ACCESSING AND UTILIZING IN A
TIMELY MANNER THE EARLY HEARING
DETECTION INTERVENTION SYSTEM.
WE KNOW HEARING LOSS IS A COMMON
SENSORY CONGENITAL DISORDER AND
IT'S TREATABLE AND THE TRUTH IS
THAT INFANT HEARING HEALTH CARE
IS NOT SIMPLE.
THERE'S SEVERAL DIAGNOSTIC TEST
ARE NECESSARY AND FAMILIES MAY
HAVE DIFFICULTY ESPECIALLY THOSE
FROM RURAL COMMUNITIES MAY HAVE
DIFFICULTY IN NAVIGATING THROUGH
THE HEARING HEALTH CARE SYSTEM.
BASED ON PRELIMINARY WORK THAT
WE'VE DONE PREVIOUSLY, WE HAVE
DEMONSTRATED EFFICACY OF A
PATIENT NAVIGATION INTERVENTION
IN WHICH A PARENT OF A CHILD WHO
HAS GONE THROUGH THE SYSTEM HAS
BEEN RECRUIT AND TRAINED AS AN
INTERVENTIONIST TO PROVIDE
PATIENT NAVIGATION SUPPORT IT
DRAWS FROM THE CANCER FIELD AND
ONCOLOGY WORLD TO HELP NAVIGATE
CANCER SURVIVORS HELPING OTHER
CANCER PATIENTS NAVIGATE THROUGH
COMPLEX CHEMOTHERAPY OR
RADIATION THERAPY AND PROVIDE
EDUCATION AND OTHER PSYCHOSOCIAL
SUPPORT AS WELL AS OTHER
LOGISTIC SUPPORT AND CONNECTIONS
BETWEEN THE PATIENT AND THE
HEALTH CARE SYSTEM.
SO BASED ON SOME WORK WE'VE DONE
AS WE'VE DEVELOPED THE
NAVIGATION SYSTEM FOR THE SYSTEM
THAT FAIL THE NEW BORB SCREEN WE
DEMONSTRATE THE ITTISM PROEFDZ
THE ADHERENCE OF INFANTS ONCE
THEY ARE REFERRED FROM THE
NEWBORN NURSERY TO RETURN BACK
TO THE AUDIOLOGY CLINIC FOR
OTONOMIC TESTING THROUGH A SLEEP
DEPRIVED ADR AND SHOWING IT'S
DECREASED THE TIMING AND THIS
MOVE BEYOND THE EFFICACY DRISTU
AND I LIKE THE BULLET TRAIN AS
THOSE OF US WHO THINK OF
PRAGMATIC INTERVENTIONS HOW DO
WE MOBILIZE THAT MOVING FORWARD
TO EXPEDITE THE IMPLEMENTATION.
THIS BUILDS ON THE EFFICACY WORK
AND THE FIRST AIM IS USING A
STEP-WEDGE, RANDOMIZED TRIAL
DESIGN WE'RE GOING BEYOND A
SINGLE SITE OR SMALL ONE OR
TWO-SITE STUDY AND EXTENDING
THAT TO THE ENTIRE SYSTEM WITHIN
THE STATE OF KENTUCKY FOR
PUBLICLY FUNDED HEARING HEALTH
CLINICS TO TEST THE
EFFECTIVENESS OF THIS NAVIGATION
INTERVENTION FOR INFANTS
REFERRED ON NEWBORN HEARING
SCREENING TO DECREASE THE
NON-ADHERENCE OF INFANT
DIAGNOSTIC TESTING WITHIN THREE
MONTHS AFTER BIRTH.
THE SECOND AIM IS THEN TO
SIMULTANEOUSLY EXPLORE
ASSOCIATIONS AMONG
IMPLEMENTATION FACTORS OF COURSE
DERIVE FROM THE FURTHER
CONSOLIDATED FRAMEWORK OF
IMPLEMENTATION RESEARCH JUST
DISCUSSED AND ASSESS THESE
IMPLEMENTATION OUTCOMES.
THOUGH IT'S NOT A SEPARATE
IMPLEMENTATION MEASURE OUTCOME
IT'S CERTAINLY WITHIN THE
IMPLEMENTATION FIELD TO EVALUATE
COST BUT WE DEVOTED A SEPARATE
AIM TO HELP US EVALUATE COST
ASSOCIATED WITH THIS INCREMENTAL
CHANGE IN EFFECTIVENESS FOR THE
NAVIGATION COMPARED TO THE
STANDARD OF CARE.
>> ONE MINUTE LEFT, MATT.
>> THANK YOU.
SO YOU CAN SEE BASED ON OUR
DIAGRAM BASED ON THE STATEMENT
FRAMEWORK THAT THE
EVIDENCE-BASED INTERVENTION IS
NAVIGATION IN TIMELY EHDI
APPOINTMENT AND THE INTERVENTION
IS THE NAVIGATOR AS WELL AS THE
PARENTS, INNER SETTING OF THE
INDIVIDUAL CLINIC AND CLINIC
SYSTEM AND THE OUTER SYSTEM IS
WHERE IT'S LOCATE.
THE DIFFERENT STRATEGIES AND THE
ADAPTATION OF OUR INTERVENTION
TO A BROADER SCALE AND TRAINING
OF NAVIGATORS THROUGH DIFFERENT
METHODS.
CAN SEE OUR IMPLEMENTATION
OUTCOME IS SIMILAR TO
ACCEPTABILITY, ADOPTIVENESS AND
FEASIBILITY AND EFFECTIVENESS
OUTCOMES OF THE INTERVENTION TO
DECREASE NON-ADHERENCE TO
NEWBORN HEARING SCREENING AS
WELL AS THE TIME IT TAKES FROM
BIRTH TO RECEIVE THE DIAGNOSTIC
TESTING.
VERY GOOD.
THANK YOU VERY MUCH FOR THE
OPPORTUNITY TO SHARE OUR WORK.
>> THANK YOU, MATT.
OUR THIRD AND FINAL EXAMPLE IS
FROM KEVIN KERBER FROM OHIO
STATE UNIVERSITY THE DIZZINESS
TREATMENT THROUGH IMPLEMENTATION
AND CLINICAL STRATEGY TACTICS.
>> GOOD AFTERNOON.
CAN YOU HEAR IS THE
>> YES.
>> THANK YOU VERY MUCH TO HOLLY
FOR THE INVITATION.
I'M THRILLED TO GIVE A BRIEF
SUMMARY CALLED DIZZINESS
TREATMENT THROUGH IMPLEMENTATION
AND CLINICAL STRATEGY TACTICS.
THIS STUDY IS PRIMARILY FOCUSSED
ON ONE CAUSE OF DIZZINESS
VERTIGO OR BBPV WHICH ASK OUR
LOWEST HANGING FRUIT AND WE HAVE
EVIDENCE TO SUPPORT A VERY
EFFECTIVE METHOD TO IDENTIFY AND
TREAT BENIGN VERTIGO BUT WE SEE
MANY TIMES OVER THAT THIS IS
UNDER USED BROADLY BUT FOR THIS
PROJECT IT'S SPECIFICALLY
FOCUSSED ON THE EMERGENCY
DEPARTMENT THAT TESTS FOR BENIGN
VERTIGO AND AT THE SAME TIME
EVER UNNECESSARY TESTS LIKE HEAD
CTs ARE TYPICALLY OVERUSED AND
ONE THING WE USUALLY SAY IS IF
YOU HAVE BENIGN VERTIGO AND
YOU'RE LIKELY TO GET RADIATE AND
POISONED THAN ROLLED OVER AND
CURED.
TO EXPRESS THE EXTREMES OF THIS.
OUR FIRST PROJECT WAS WITH US
FOCUSED ON PROVEDERS AND FOUND
WITH EDUCATIONAL MATERIALS AND
DEVELOPMENT OF LOCAL CHAMPIONS
WE WERE ABLE TO INCREASE THE
DOCUMENTATION OF THE TEST AND
TREATMENT FOR BENIGN POSITIONAL
VERTIGO AND HAD AN ASSOCIATION
WITH DECREASED HEAD CT AND
IMPROVED PROVIDER EXPERIENCES
AND TREND TO DECREASE
POTENTIALLY MISSED STROKES IN
THIS CIRCUMSTANCE.
AND THE SECOND STUDY IS DESIGN
TO EVALUATE A SCALING UP AND
ENHANCEMENT OF THE INTERVENTION
TO FURTHER INCREASE USE
PARTICULARLY IN NON-ACADEMIC
SETTINGS TO IMPROVE SCALABILITY
AND TO EVALUATE CLINICAL
OUTCOME.
SO OUR AIMS IS AN IMPLEMENTATION
AIM TO DETERMINE THE IMPACT OF
THE ENHANCED INTERVENTION ON THE
TEST AND POSITION IN DIZZINESS
AND THE SECOND IS THE
EFFECTIVENESS OUTCOME TO
EVALUATE CLINICAL OUTCOMES WHICH
WE DID NOT DO IN THE FIRST STUDY
ASSOCIATED WITH THE
IMPLEMENTATION STRATEGY.
WE'RE ENROLLING AND RANDOMIZED
PATIENTS TO A PATIENT-DIRECTED
SELF-MANAGEMENT INTERVENTION FOR
THEIR SELF-MANAGEMENT OF BENIGN
PARITISMAL VERTIGO.
OUR INTERVENTIONS THAT TREST FOR
BENIGN POSITIONAL VERTIGO AND
CONSIDERED CONTEXT LOGISTICS FOR
BARRIERS AND FACILITATORS TO BE
USED IN EMERGENCY ROOM MAINLY
TIME AND PRIORITIES.
OUR IMPLEMENTATION SS --
STRATEGIES ARE FOR PROVIDERS AND
CHAMPION AND OUR PATIENT-LEVEL
INTERVENTION IS A SEPARATE
WEBSITE DESIGN FOR PATIENTS TO
SELF-DIAGNOSIS AND MANAGE
DIZZINESS IN THE TIME AFTER THE
ED VISIT AND FOLLOW FOR FOUR
WEEKS TO ASSESS OUTCOMES AND
IMPLEMENTATION OUTCOMES ARE
SIMILAR TO THE FIRST STUDY
DOCUMENTATION OF THE TEST AND
TREATMENT FOR BENIGN POSITIONAL
VERTIGO AND POSITIONAL OUTCOME
AND ED AND HOSPITAL ADMISSIONS
AND EFFECTIVENESS OUTCOMES IS
DIZZINESS SEVERITY THE OTHER
OUTCOMES AND GLOBAL POSITION OF
CHANGE AND LOGISTICAL OUTCOME
SUCH AS DID THEY USE THE TEST OR
TREATMENT FOR BENIGN POSITIONAL
VERTIGO FOR SUBSEQUENT
TREATMENTS OR ADVERSE EVENTS.
THANK YOU VERY MUCH AND I
APPRECIATE THE OPPORTUNITY TO
PRESENT THIS.
>> THANK YOU, KEVIN.
THAT CONCLUDES THE FIRST SESSION
ON WHAT IS D&I AND EXAMPLES.
WE'RE GOING TO KEEP GOING ALONG
FOR THE FIRST PART OF THINGS.
NEXT UP IS OUR NEXT TOPIC WHICH
IS WHERE WE ARE AS A FIELD WITH
DISSEMINATION AND IMPLEMENTATION
AND NATALIE DOUGLAS IS OUR FIRST
SPEAKER.
>> TO BRIEFLY ORIENT TO YOU AND
WHY THE WORK IS IMPORTANT TO ME.
I DO A LOT OF WORK IN NURSING
HOMES FOR PEOPLE LIVING WITH
DEMENTIA.
AND PEOPLE WOULD BENEFIT FROM
THESE TYPES OF INTERVENTIONS ARE
NOT RECEIVING THEM SO IT'S WHAT
SEEMS LIKE VERY BASIC CARE IS
NOT HAPPENING ON THE GROUND.
SO I HOPE TO GIVE YOU THE
RESULTS OF OUR SCOPING REVIEW AS
WELL AS TALK ABOUT THREE
PITFALLS OF IMPLEMENTATION
SCIENCE THAT HAVE BEEN
ELUCIDATED BY SOME OTHER
SCHOLARS AS WELL AS PRESENT SOME
QUESTIONS FOR CONSIDERATION SO
MAYBE THINK ABOUT THROUGHOUT THE
WORKSHOP.
AND THIS IS THE CITATION FOR THE
SCOPING REVIEW I'M REFERRING TO.
I WANT TO ACKNOWLEDGE MY
COLLEAGUES IN THIS WORK,
DR. FIRESTEIN AND JENNIFER
OSHITA AND OUR CENTRAL MICHIGAN
UNIVERSITY LIBRARIAN MARGARET
DANOWSKI WHO IS SADLY NO LONGER
WITH US AND THIS WAS A YEAR'S
LONG UNDERTAKING AND WOULD NOT
BE POSSIBLE WITHOUT MY
COLLEAGUES.
OUR REVIEW STARTED WITH WHAT WE
THOUGHT AT THE TIME WERE
RELATIVELY SIMPLE RESEARCH
QUESTIONS.
ONE, WHAT IS THE DISTRIBUTION OF
IMPLEMENTATION SCIENCE RESEARCH
ACTIVITY IN COMMUNICATION
SCIENCES AND DISORDERS AND IT
WAS BEFORE AND AFTER SOME
TARGETED IMPLEMENTATION SCIENCE
INITIATIVES IN COMMUNICATION
SCIENCES AND DISORDERS.
AND WHAT ARE THE STUDIES BEING
CONDUCTED IN OUR FIELD OF
COMMUNICATION SCIENCES AND
DISORDERS.
AND IMPLEMENTATION STUDIES ARE
INCREASING RAPIDLY.
YOU HAVE THE YEAR AND WE HAD OUR
FIRST INKLINGS OF IMPLEMENTATION
SCIENCE RESEARCH IN THE EARLY
'90s AND MANY PEOPLE WERE
THINKING ABOUT DOING
IMPLEMENTATION SCIENCE BUT NOT
NECESSARILY CALLING IT
IMPLEMENTATION SCIENCE AND WE
STARTED TO SEE A LARGE INCREASE
IN THE STUDIES AFTER 2014.
I THINK THAT'S CONTINUING TO
INCREASE IN THE YEARS FOLLOWING.
WITH THOUGHT ABOUT HOW WE WANT
TO CHARACTERIZE THE STUDIES IN
CSD.
WE DESCRIBED THE NATURE OF
STUDIES ACCORDING TO RESEARCH
AIMS, PATIENT POPULATION,
SETTING, ANY IMPLEMENTATION
FRAMEWORK USED AS WELL AS
IMPLEMENTATION STRATEGIES AND
OUTCOMES.
I THINK THIS FLOWS REALLY WELL
FROM HOLLY'S TALK THE
HIGHLIGHTED RESEARCH TALKED WE
HEARD ABOUT.
WHERE ARE THE STUDIES BEING
PUBLISHED?
WE USED A RELATIVELY STANDARD
SCOPING REVIEW METHODOLOGY AND
I'M HAPPY TO GO OVER THAT OR
ANSWER SOME OF THE QUESTIONS
THAT YOU MIGHT HAVE ABOUT THAT
OFFLINE FOR THE SAKE OF TIME.
I THOUGHT IT WOULD JUMP INTO THE
RESULTS.
SO WHAT YOU CAN SEE HERE IS THE
MAJORITY OF OUR STUDIES, BRIEF
IMPLEMENTATION SCIENCE AND CSD
WE ARE NOT -- WE'RE NOT
PUBLISHED IN ASHA JOURNALS.
THEY WERE PUBLISHED MEANING THE
AMERICAN JOURNAL OF SPEECH AND
LANGUAGE PATHOLOGY AND AUDIOLOGY
AND HEARING AND SPEECH IN THE
SCHOOLS AND SPEECH AND LANGUAGE
RESEARCH.
THE LARGE MAJORITY WERE
PUBLISHED OUTSIDE THE
DISCIPLINE.
THEN THERE WERE A SUBSET OF
STUDIES PUBLISHED IN
COMMUNICATION SCIENCES AND
DISORDERS JOURNALS BUT NOT IN
ASHA JOURNALS AND YOU SEE THEM
REPRESENTED AS WELL.
WE FOUND 82 STUDIES TOTAL.
I SHOULD START BY SAYING THAT.
YOU'LL SEE OVER A THIRD OF THE
STUDIES WERE TESTING
IMPLEMENTATION STRATEGIES IN
TERMS OF THE RESEARCH NAME.
IT SHOULD BE NOTED BY AND LARGE
THIS MEANT TESTING THE IMPACT OF
SOME TYPE OF EDUCATION OR
TRAINING ON THE INTERVENTION OF
THE AND WE HAD A QUARTER CONCEPT
PAPERS INTRODUCING CONCEPTS TO
THE DISCIPLINE OF COMMUNICATION
SCIENCES AND DISORDERS AND
SIMILARLY ABOUT A QUARTER OF
STUDIES USED IMPLEMENTATION
SCIENCE TO ASSESS THE CONTEXT OF
IMPLEMENTATION.
SO PRIMARILY THIS LOOKS LIKE
SURVEYS OR FOCUS GROUPS THAT
HIGHLIGHTED BARRIERS OR
FACILITATORS TO THE
INTERVENTION.
THERE WERE 11% OF STUDIES THAT
AND IMPLEMENTATION STRATEGIES.
THIS USUALLY WAS SOME TYPE WHERE
THE RESEARCHER AND COLLABORATING
PARTNER WOULD COLLABORATE
TOGETHER IN ORDER TO TAILOR WHAT
MIGHT WORK IN THAT PARTICULAR
CONTEXT.
AND THEN THERE WAS ONE
SELF-IDENTIFIED HYBRID STUDY.
AGAIN, WE STOPPED LOOKING AT
STUDIES.
I THINK WE ENDED THE END OF THE
YEAR 2021.
SO WE'RE NOT CAPTURING THE
LAT
LATEST.
SO APHASIA WAS MOST LOOKED AT IN
LANGUAGE DISORDERS IN CHILDREN
FOLLOWING CLOSELY BEHIND AND
SEEING REPRESENTATION FROM THE
FIELD OF DISPHASIA, HEARING
RELATED OR AUDIOLOGY, AUTISM
SPECTRUM AND SPINAL CORD AND
THESE ALSO TOOK PLACE IN IN
PATIENT, OUT PATIENT OR SOME
TYPE OF COMBINATION WHERE THERE
WERE MULTIPLE MEDICAL SETTINGS
INVOLVED.
VERY FEW STUDIES HAPPENED IN THE
SCHOOL SETTING AS YOU CAN SEE
HERE.
SO IS THE LARGE MAJORITY OF
STUDIES DOES NOT INCLUDE
IMPLEMENTATION SCIENCE FRAMEWORK
YOU SEE IN THE PIE CHART.
SOME FRAMEWORKS THAT WERE USED
AND I WAS JUST DOING PREPARING
FOR THE TALK THEY'RE UP TO 150
NOW IMPLEMENTATION SCIENCE FRAME
WORKS AND HERE'S SOME
REPRESENTED IN THE CSD
LITERATURE AND CONSOLIDATED
FRAMEWORK FOR THE CONSOLIDATION
AND IMPLEMENTATION AND HEALTH
SERVICES RESEARCH, DIFFUSION AND
INNOVATION AND OTHER MODELS.
IF THERE WAS AN IMPLEMENTATION
STRATEGY TESTED, IT WAS
PRIMARILY IN EDUCATION OR SOME
TYPE OF TRAINING STRATEGY YOU
SEE HERE.
THINKING BACK TO HOLLY'S TALK
EARLIER TODAY, SOME OF THOSE
OTHER STRATEGIES IN TERMS OF
FEEDBACK OR OTHER INCENTIVES,
STRUCTURAL CHANGES WERE NOT
REALLY PRESENT IN OUR
LITERATURE.
WE LOOKED AT IMPLEMENTATION
OUT.com AND HOLLY AND OTHERS
TALKED ABOUT THE OUTCOMES
ALREADY.
ADOPTION WAS THE OUTOUTCOME
STUDIED IN OUR REVIEW AS WELL AS
ACCESSIBILITY AND FEASIBILITY.
BUT IMPLEMENTATION OUTCOMES THAT
MAY BE CONSIDERED LATER IN THE
IMPLEMENTATION CYCLE LIKE COST,
PENETRATION, SUSTAINABILITY WERE
REALLY QUITE INFREQUENT.
OTHER THEN EDUCATION AND
TRAINING THERE WERE VERY MINIMAL
IMPLEMENTATION STRATEGIES
STUDIED.
ADOPTION IS THE MOST FREQUENTLY
MEASURED IMPLEMENTATION OUTCOME
AND OUTCOMES LIKE COST AND
SUSTAINABILITY WERE RARE.
AND IMPLEMENTATION STUDIES IN
CSD ARE INCREASING AT A RAPID
RATE SINCE 2014.
MOST IMPLEMENTATION SCIENCE
STUDIES ARE TESTING THE IMPACT
OF EDUCATION OR TRAINING ON THE
IMPLEMENTATION OF THEIR
INTERVENTION AND THE OTHERS
MOSTLY ASSESS CONTEXT LIKE
BARRIERS AND FACILITATORS AND A
VARIETY OF PATIENT POPULATIONS
ARE REPRESENTED.
APHASIA IN MEDICAL SETTINGS ARE
THE MOST COMMON.
SO WHAT NOW?
SO REFLECTING ON THE IMMENSE
OPPORTUNITY OF WHAT IT IS TO BE
ABLE TO SPEAK WITH ALL OF YOU, I
WANTED TO FOCUS LESS ON WHAT WE
WROTE IN THE DISCUSSION OF THAT
SCOPING REVIEW AND REVISIT THE
LITERATURE AND THINK ABOUT WHAT
IT THE MOST UPDATED
UNDERSTANDING POSSIBLE ADDS TO
WHAT IS HAPPENING WITH THE FIELD
OF IMPLEMENTATION SCIENCE MORE
BROADLY.
SO WHAT I'D LIKE TO DO TO
CONCLUDE THIS TALK IS PRESENT
THREE PITFALLS OF IMPLEMENTATION
SCIENCE WITH QUESTIONS FOR
CONSIDERATION THROUGHOUT THE
WORKSHOP.
SO, THESE PITT FALLS AS YOU SEE
ARE PRESENTED BY DR. BEIDAS AND
COLLEAGUES AND PROMISES AND P
PITFALLS IN IMPLEMENTATION
STUDIES AND FUNDED STUDIES ABOUT
15 YEARS.
THEY GOT TOGETHER AND BASICALLY
HAD A PREMORTEM OF HOW IS THIS
IMPLEMENTATION SCIENCE BEEN
GOING AND IS IT REALLY MAKING
ANY DIFFERENCE?
SO THEY HAVE SIX PITFALLS IS NOT
ALIGNING INCENTIVES AND
PRIORITIES WITH PARTNERS.
REFLECTING ON THIS BROUGHT ME TO
THIS PAPER ABOUT THE
INTERSECTION OF RESEARCH USE AND
IMPLEMENTATION SCIENCE.
THE STUDY OF RESEARCH USE IS A
FIELD THAT SEEKS TO DEEPLY
CENTER THE INTENDED USERS OF
RESEARCH AND THE CONDITIONS THAT
FACILITATE THE USE OF RESEARCH.
SO IN THE STUDY OF RESEARCH USE,
IT'S COMBINED WITH OTHER FORM OF
KNOWLEDGE AND THERE IS A SEEKING
TO UNDERSTAND HOW ALL THE FORMS
OF EVIDENCE INTERACT TO SUPPORT
DECISION MAKING.
SO INTERACTIONS BETWEEN
RESEARCHERS AND THE USERS OF
RESEARCH AND HOW THEY MAKE SENSE
OF IT AND APPLY IT TO THAT
SPECIFIC CONTEXT IS WHAT THIS
STUDY OF RESEARCH USE IS ALL
ABOUT.
AND ONE OF THE THINGS THAT'S
COME OUT IS HOW RESEARCH IS
PRODUCED REALLY INFLUENCES ITS
UTILITY.
SO SOME QUESTIONS THAT MIGHT BE
ASKED ARE, WHAT DOES IT MEAN TO
USE RESEARCH WELL?
HOW IS RESEARCH ACTUALLY USED IN
CONTEXT AS OPPOSED TO HOW
RESEARCHERS THINK I SHOULD BE
USED?
HOW DOES RESEARCH INFORM
DECISION MAKING AND NOT A
DETERMINISTIC RESPONSE?
I DON'T THINK ANY OF THESE
QUESTIONS CAN BE ASKED OUTSIDE
OF AUTHENTIC PARTNERSHIPS AMONG
RESEARCHERS AND CLINICIANS AND
FAMILIES AND THE CLIENTS WHO ARE
SEEKING OUR SERVICES.
SO I QUESTION I WOULD LOVE TO
ASK ALL OF TO YOU THINK ABOUT IS
WHAT DOES THE INFRASTRUCTURE
LOOK LIKE THAT EQUALLY VALUES
MULTIPLE FORMS OF KNOWLEDGE SUCH
AS THE LIVED EXPERIENCE AND
CLINICAL PARTNERSHIPS?
WHAT MIGHT THAT INFRASTRUCTURE
LOOK LIKE?
WHAT IF WE WERE ABLE TO PAY
COMMUNITY ADVISORS MORE THAN $20
AN HOUR?
WHAT IF WE WERE ABLE TO PAY
TEACHERS OR SPEECH LANGUAGE
PATHOLOGISTS OR NURSES THEIR
CLINICAL TIME WITHOUT JUMPING
THROUGH MULTIPLE LOGISTICAL
CHALLENGES?
WOULD UNIVERSITIES BE ABLE TO
PAY CLINICAL FACULTY, PROJECT
MANAGERS AND OTHER KEY PERSONNEL
WHO WE KNOW ARE KEY TO
IMPLEMENTATION WITH A SALARY
STRUCTURE EQUIVALENT TO SOMEONE
WITH A Ph.D.?
THE NEXT PITFALL, WE DID NOT
IMPACT POPULATION HEALTH OR
HEALTH EQUITY.
AGAIN, THESE ARE RESEARCHERS WHO
SINCE 2006 WERE CONDUCTING
IMPLEMENTATION SCIENCE AND
THERE'S STILL AT LEAST A 30% TO
40% GAP BETWEEN BEST AVAILABLE
EVIDENCE AND CLINICAL PRACTICE.
SO THIS BROUGHT ME TO FIGURE 1
AND THIS ARTICLE BY BAUMMANN
AROUND AND PRINCIPLES IF YOU
WANT TO IMPACT HEALTH EQUITY
USING DISSEMINATION AND
IMPLEMENTATION SCIENCE.
SO YOU SEE HERE RACISM MUST BE
RECOGNIZED AS A FUNDAMENTAL
DRIVER OF HEALTH CARE
INEQUITIES, ACTIVE ENGAGEMENT OF
COMMUNITY MEMBERS AND OTHER
RELEVANT PARTNERS AS NECESSARY.
EQUITABLE HEALTH CARE REQUIRES
MULTI-SECTOR PARTNERSHIPS AND
CONTEXT IS CENTRAL TO HEALTH
CARE EQUITY.
SO THESE ARE ASPECTS THAT I
THINK ARE ESSENTIAL FOR US TO
CONSIDER WHEN WE THINK ABOUT THE
INTERSECTION OF IMPLEMENTATION
AND COMMUNICATION SCIENCES AND
DISORDERS.
SO I WOULD REALLY RECOMMEND THAT
YOU GO TO THIS PAPER BECAUSE
ALONG WITH THE GUIDING
PRINCIPLES THEY PROVIDE EIGHT
SPECIFIC RECOMMENDATIONS WITH
MORE THAN 60 ACTION STEPS FOR
RESEARCHERS.
AND THEY ASSERT THAT MANY
EVIDENCE-BASED PRACTICES MAY NOT
EVEN REALLY BE RELEVANT TO
HISTORICALLY MARGINALIZED
POPULATIONS.
SO THEY SPEAK HOW TO MANY
EVIDENCE-BASED INTERVENTIONS ARE
PUSHED INTO SYSTEMS BY
RESEARCHERS AND IMPLEMENTED
WITHOUT ANY CONSIDERATION OF THE
CONTEXT OR RECIPIENTS INDEED
THAT INTERVENTION MIGHT NOT EVEN
BE NEEDING A NO-NEED IN THE
COMMUNITY.
SO THIS MADE ME THINK OF MY OWN
CURRENT PROJECTS WHERE I WAS
REMINDED OF THIS MODEL OF CARE
THAT IS FREQUENTLY USED.
HERE YOU SEE TO THE STRUCTURE OR
THE ORGANIZATIONAL CONTEXT WHERE
THE HEALTH CARE OCCURS.
THE PROCESS OR THE ACTIONS
COMPLETED DURING THE AND THEN
YOU HAVE THE OUTCOME.
WE'RE ALL HEAR BECAUSE WE WANT
TO POSITIVELY IMPACT PATIENTS
AND POPULATION HEALTH.
SO IN MY WORK, I AM DEVELOPING
AN INTERVENTION CALLED DEMENTIA
COLLABORATIVE COACHING AND THE
STRUCTURE WHERE IT'S IMPLEMENTED
IS NURSING HOMES.
WHAT I'M REALIZE WOING IN THE WK
I CAN IMPROVE THE COACHING.
I COULD MAKE IT MORE TAILORED TO
THE CONTEXT HOWEVER, I'M
RECOGNIZING MORE AND MORE THE
ISSUE HAS TO DO WITH THE
STRUCTURE OR WHERE THE
INTERVENTION IS IMBEDDED.
IN TO THE OUTCOME OF DECREASED
BEHAVIORAL SYSTEMS THERE'S THE
ISSUE OF THE STRUCTURE WHERE
PEOPLE ARE BEGGING FOR STAFF.
THERE'S ALL OF THESE OTHER
PRESSING ISSUES MORE OF ABOUT
THE STRUCTURE AND LESS ABOUT THE
INTERVENTION.
SO A QUESTION THAT I HAVE IS IF
I WALK AWAY FROM A NURSING HOME
THAT'S NOT READY TO IMPLEMENT MY
INTERVENTION, WHAT IS MY
RESPONSIBILITY THERE?
DO I WAIT UNTIL THE SYSTEM
RIGHTS ITSELF BECAUSE IT LIKELY
WON'T?
AND PROVIDERS IN THESE SETTINGS
WANT TO PROVIDE BETTER CARE BUT
FEEL STUCK AND DON'T KNOW HOW TO
GET THERE IN THE CURRENT
STRUCTURE.
A QUESTION I'VE BEEN ASKING
MYSELF IS ARE WE WORSENING AND
CONTRIBUTING TO HEALTH CARE
INEQUITIES BY ONLY IMPLEMENTING
OUR INTERVENTIONS WITH A LEVEL
OF RESOURCE?
WHEN WE CONSIDER THE
INTERVENTIONS WE HAVE TO THINK
ABOUT HEALTH EQUITY AND HOW THAT
WILL IMPACT OUR STUDY DESIGN.
THE LAST PIECE IS WE RECREATED
THE RESEARCH TO PRACTICE GAP.
WE'VE ALREADY TALKED ABOUT THE
MESSAGE AND MESSAGE OF PROMOTE
THE ADOPTION AND INTERVENTION
PRACTICE INTO ROUTINE CARE.
NOW WE HAVE A FIELD KNOWN AS
IMPLEMENTATION PRACTICE WHERE
YOUR TAILORING AND APPLYING
APPROACH AND STRATEGY IN
DIFFERENT CONTEXTS TO MEET THE
NEEDS OF DIFFERENT COMMUNITIES.
WE HAVE TO WONDER HOW TO NOT
RECREATE THE GAP.
THIS BROUGHT ME TO A FASCINATING
PAPER WHO MADE THE CASE FOR
RETHINKING THE RELATIONSHIP
BETWEEN IMPLEMENTATION RESEARCH
AND IMPLEMENTATION PRACTICE
HIGHLIGHTING THE NEED TO BECOME
BETTER AT WORKING WITH CONTEXTS
THROUGHOUT THE ENTIRE RESEARCH
PROCESS FROM PLANNING TO
CONDUCT, ANALYSIS,
INTERPRETATION AND DISSEMINATION
OF RESULTS WHILE MAINTAINING
RELEVANCE AND RIGOR AT ALL
STAGES.
SO ONE OF THE THINGS THEY
REPORTED ON IN A WELL LAID OUT
TABLE IN THIS PAPER IS MOST
IMPLEMENTATION TRIALS ARE NUL
RESULTS.
IT'S HARD TO MOVE THE NEEDLE
WITH THE PRAGMATIC CLINICAL
TRIAL AND NOT BECAUSE THE
INTERVENTION DOESN'T WORK OR
BECAUSE THE STRATEGY DOESN'T
NECESSARILY WORK BUT I THINK
BAYS THE CONTEXT WERE SO
DIFFERENT.
IF YOU THINK YOURS IS CONTEXT
DEPEND
DEPENDENT, THESE ALLOW YOU TO BE
MORE RESPONSIVE ACROSS THE LIFE
OF THE STUDY.
NOT JUST BEGINNING OR END BUT
HAVE THE FLEXIBILITY TO RESPOND
TO THE CONTEXT IN THE MIDDLE OF
THE STUDY AS WELL.
YOU SEE PARTICIPATORY RESEARCH,
REALIST EVALUATION AND QUALITY
OR RAPID PSYCHO IMPROVEMENT AT
MULTIPLE SITES OR SINGLE SITES.
>> THAT'S ONE MINUTE LEFT.
>> THANK YOU, HOLLY.
THESE ARE DESIGNS LESS
RESPONSIVE TO CONTEXT IN A
STUDY.
THESE ARE HYBRID EFFECTIVENESS,
IMPLEMENTATION TRIALS, PRAGMATIC
TRIALS AND PRE AND POST STUDY
DESIGN AND INTERRUPTED TIME
SERIES AND NATURAL EXPERIENCE.
THE LAST QUESTION IS WHICH
IMPLEMENTATION STUDY DESIGNS
WILL WE DEEM TO BE ACCEPTABLE
AND FUNDABLE IN OUR COMMUNITY
AND CAN CONTINUE TO LEARN FROM
THE PEOPLE IN IMPLEMENTATION
SCIENCES DOING THIS A LITTLE BIT
LONGER.
WITH THAT I'LL STOP SHARING AND
TURN IT BACK TO HOLLY.
>> THANKS SO MUCH.
THAT WAS VERY THOUGHT PROVOKING.
MY BRAIN IS PRACTICALLY FULL.
I DON'T KNOW HOW EVERYONE ELSE
IS DOING BUT WE HAVE ONE MORE
SHORT PIECE I'LL SHARE WITH YOU
AND THEN WE'LL BE TAKING A
BREAK.
SO I'M GOING TO STAY A LITTLE
BIT ABOUT D&I AT NIDCD AND
WHAT'S HAPPENING NOW.
THE FIRST THING I WANT TO LOOK
AT ARE THE NIH WIDE
DISSEMINATION OPPORTUNITIES WITH
LINKS ON THE SLIDE ARE THE
CURRENT VERSIONS.
THESE ARE BEEN AROUND A LONG
TIME AND NIDCD HAS BEEN SIGNED
ON SINCE 2006.
THERE'S A SMALLER VERSION THE
R21 AND THE LARGER MULTI-YEAR
GRANT AND BOTH HAVE BEEN AROUND
A LONG TIME.
WHAT HAS THAT YIELDED?
IT TURNS OUT IT HASN'T YIELDED
THAT MUCH.
WHAT I'M SHOWING YOU ARE THE
NUMBER OF UNIQUE AWARDS.
THESE ARE TYPICALLY MULTI-YEAR
AWARDS AND I'M SHOWING THEM AS
ONE PACKAGE.
AND WHAT YOU CAN SEE IS WE'VE
ONLY MADE FOUR AWARDS TO THIS
SPECIFIC FUNDING OPPORTUNITIES
OVER THE LIFE COURSE.
MAYBE IF YOU'RE SUPER OPTIMISTIC
YOU SAY, WELL, IT'S KIND OF
INCREASING.
WE DIDN'T HAVE ANY AWARDS FROM
2006 TO 2012 AND NOW WE'RE
STARTING TO SEE SOME AND MOVING
FROM THE SMALLER TO LARGER
GRANTS.
I WOULD SAY THAT'S PRETTY
OPTIMISTIC.
YOU ALSO MIGHT BE WONDERING WHAT
DOES THIS LOOK LIKE?
WE'RE ONLY LOOKING AT ONE DATA
POINT.
LET'S PUT IT IN CONTEXT.
WE'RE LOOKING AT THE NUMBER OF
UNIQUE AWARDS COUNTING EACH
MULTI YEAR AWARD AS ONE THING
AND LOOKING AT A THREE-YEAR
PERIOD AND ONLY AT THE R01s AND
THIS CAPTURES THE TWO UNIQUE
AWARDS WE SAW IN THE PRIOR SLIDE
IN 2020 AND 2022 OR SOMETHING
LIKE THAT.
YOU CAN SEE SOME OTHER
INSTITUTES WHO MADE WARDS DURING
THE TIME PERIOD AND SOME IN THE
SAME NUMBER OF AWARDS WITH US.
THERE'S ALSO OTHERS MAKING MANY
MORE AWARDS.
I'VE HIGHLIGHTED THE NATIONAL
CANCER INSTITUTE AND NATIONAL
INSTITUTE ON DRUG ABUSE IN BLUE
BECAUSE WE HAVE REPRESENTATIVES
FROM THE PROGRAMS THAT WILL BE
WITH US TOMORROW AND THEY'VE
MADE SOME CONCERTED EFFORTS TO
INCREASE THEIR D&I RESEARCH AND
HOPE TO LEARN SOME LESSONS FROM
THEM AND HOPEFULLY GIVE YOU AN
IDEA WHERE THEY ARE RELATIVE TO
US IN THE LANDSCAPE.
SO THIS SUGGESTS THERE'S SOME
OPPORTUNITY FOR GROWTH WITHIN
NIDCD.
I DO WANT TO ACKNOWLEDGE THERE
ARE CHALLENGES GOING THROUGH
THIS D&I PATHWAY AND SOME OF
THAT WAS ALLUDED TO A LITTLE BIT
IN THE REVIEW.
SO WHAT I PULLED ON THE SLIDE
WHICH I'M NOW GOING TO READ TO
YOU ARE SOME TEXTS TAKEN FROM
THE FUNDING OPPORTUNITIES IN
DISSEMINATION AND IMPLEMENTATION
AND HIGHLIGHT SPECIFIC AREAS
THAT REALLY NEED TO BE IN
ADAPTATION AND FROM WHAT NATALIE
RECORDED SHE SAW SOME ELEMENTS
WERE NOT FREQUENT IN THE
PUBLISHED LITERATURE WHICH
SUGGESTED THIS MAY BE AN AREA
WHERE OUR FIELD IS GROWING AND
NEEDS TO GROW FURTHER.
JUST LOOKING FOR EXAMPLE THE
FIRST BULLET, NATALIE TOLD US A
LARGE PORTION OF THE
PUBLICATIONS DIDN'T NAME THE
MODEL OR FRAMEWORK AND THAT'S
REQUIRED IN THIS FUNDING
OPPORTUNITY CALL.
NOW, THE OTHER SIDE OF THIS IS
TO THINK ABOUT, WELL, SURE THE
FUNDING OPPORTUNITY SAYS
WHATEVER IT SAYS BUT ARE THE
REVIEWERS REALLY LOOKING FOR
THAT AND HOLDING TO THAT?
AND IF YOU LOOK AT THE STUDY
SECTIONS THAT TEND TO REVIEW
THESE IMPLEMENTATION GRANTS, ONE
SHOWN ON THE SLIDE AND IF YOU GO
TO THE LINK YOU'LL SEE SOME OF
THE OTHER STUDY SECTION LABELS,
YOU'LL SEE VERY DEEP
DISSEMINATION AND IMPLEMENTATION
ON THOSE PANELS AND SO THEY DO
TEND TO REALLY HOLD TO WHAT HAS
BEEN OUTLINED IN THE FUNDING
OPPORTUNITY WHICH IS REALLY BEST
PRACTICES IN THE FIELD AND SO IT
REALLY JUST SHOWS THAT TO BE
COMPETITIVE IN THIS KIND OF A
PATHWAY, IT'S IMPORTANT THAT WE
GROW OUR KNOWLEDGE OF
DISSEMINATION AND IMPLEMENTATION
AND THE STRATEGIES AN OUTCOME,
ETCETERA, TO BE CONVERSANT WHEN
WE TALK ABOUT OUR RESEARCH OR
FRAME OUR RESEARCH WITHIN THE
FIELD.
NOW, I WANT TO POINT OUT THIS IS
NOT THE ONLY PATHWAY
DISSEMINATION AND IMPLEMENTATION
FUNDING OPPORTUNITIES.
IN FACT, FROM THE THREE PROJECTS
WE HIGHLIGHTED KEVIN KERBER'S
PROJECT WAS SUBMITTED IN
RESPONSE TO THE FUNDING
OPPORTUNITY FOR EXAMPLE
JESSICA'S PROJECT WAS NOT IT WAS
SUBMITTED TO OUR EARLY CAREER
R21 FUNDING OPPORTUNITY UNDER A
DIFFERENT TOPIC.
>> ONE MINUTE LEFT.
>> SO THERE ARE MANY OTHER
PATHWAYS ONE CAN COME THROUGH TO
FUND THEIR RESEARCH SO WHEN WE
GO THROUGH THESE OTHER PATHWAYS
THAT ARE MAYBE MORE
EVIDENCE-BASED
INNOVATION-FOCUSSED, WE TEND TO
RUN TO THE OPPOSITE PROBLEM
WHERE WE'VE GOT PEOPLE WHO ARE
REALLY FOCUSSED ON THE INTERNAL
VALIDITY AND WE WISH WE HAD SOME
FOLKS WHO KNEW LET MORE ABOUT
EXTERNAL VALIDITY AND
DISSEMINATION AND
IMPLEMENTATION.
SO THE FINAL POINT I'LL MAKE LET
ME MOVE OFF THAT FOOD FOR
THOUGHT.
WHAT I WANTED TO SHARE IS OUR
SYSTEM FOR RESEARCH ON DIFFERENT
TOPICS CALLED THE RESEARCH
CONDITION AND SPEECH CATEGORY
FOR RCDC.
THE FIRST PART IS BLANK BECAUSE
WE DO NOT HAVE A CODE
DISSEMINATION AND IMPLEMENTATION
BUT NOW WE DO AND THERE'S AROUND
$1 BILLION BEING SPENT ON
DISSEMINATION AND IMPLEMENTATION
RESEARCH AT NIH BROADLY.
AND THEN WE CAN ONCE AGAIN LOOK
AT WHERE NIDCD FALLS IN RELATION
TO OTHER INSTITUTES.
WE CAN SEE WE ARE SORT OF ON THE
LOWER END AND YOU MIGHT BE
THINKING IS THIS A FAIR
COMPARISON BECAUSE THERE'S A
LARGER BUDGET THAN NIDCD AND ON
THE NEXT SLIDE ON THE LEFT ARE
THE D&I GRANTS AND ON THE RIGHT
ARE THE TOTAL BUDGET.
YOU CAN STILL SORT OF SEE THE
RELATIVE SPENDING OVER ALL
VERSUS THE D&I SPENDING AND
STILL SEEMS LIKE THERE'S ROOM
FOR GROWTH AT NIDCD.
NOW, ARE THERE BARRIERS?
I WOULD SAY NO.
WE HAVE A SIMPLE FUNDING
STRATEGY.
BASICALLY WE FUND THE BEST
GRANTS AND THAT ALLOWS US TO
PIVOT AND FUND WHATEVER TOPIC IS
COMING THROUGH IT TAKE ADVANTAGE
OF WHATEVER IS IMPORTANT TO THE
FIELD IN THE MOMENT WE NEED MORE
MERITORIOUS D&I APPLICATIONS.
THE MONEY IS HERE IN SOME SENSE
NIH HAS A COMMITMENT TO D&I AND
NIDCD HAS AS WELL WITH OUR
STRATEGIC PLAN.
WE NEED TO FIGURE OUT HOW TO GET
MORE APPLICATIONS IN THE SPACE
AND MAKE SURE THEY'RE
COMPETITIVE IN THE REVIEW
PROCESS.
THAT'S SOMETHING I HOPE WE'LL
HAVE TIME TO TALK ABOUT OVER THE
REST OF THE WORKSHOP DURING SOME
DISCUSSION PERIODS.
THAT BRINGS US TO OUR BREAK.
WE'LL HAVE A BREAK TO 1:45
EASTERN.
EVERYONE CAN TURN OFF MICS AND
CAMERAS.
JOIN US BACK AT 1:45.
THAT BE THE START OF THE
INTERACTIVE SESSION.
WHAT ARE UNDERINDIVIDUAL
NEEDS FOR THE RESEARCH AND KATHY
WILL BE MODERATING THE SESSION
AND INTRODUCE OUR PANELISTS.
A NOTE, WE'VE BEEN STOPPING THE
VIDEO OF THE SLIDES BUT FOR OUR
FIRST WE'LL HAVE EVERYBODY ON
CAMERA AND SEE HOW THAT LOOKS.
IF SOMEONE TURNS ON THE VIDEO
LET'S GO WITH IT.
LET'S START WITH VIDEOS ON AND
SEE HOW THAT GOES.
>> THE TOPIC IS INDIVIDUAL NEEDS
IN CONDUCTING DISSEMINATION AND
IMPLEMENTATION RESEARCH.
EVERYONE ON THE PANEL IS DOING
DISSEMINATION AND IMPLEMENTATION
RESEARCH AND WE HAD NOTABLE
OVERLAP IN THE TOPICS WE WANTED
TO BRING THE VOICES OF THE
PEOPLE QUOTE UNQUOTE OF DOING
D&I RESEARCH TO SHARE THEIR
EXPERIENCE AND HOPEFULLY LATER
SPEAKERS WILL ADDRESS ISSUES
THAT COME UP.
I'LL SAY YOUR NAME AND YOUR
POSITION AND INSTITUTE.
>> MY NAME IS CRYSTLE ALONZO AN
ASSISTANT PROFESSOR AT SAN DIEGO
STATE UNIVERSITY.
>> JEN OSHITA RESEARCH ASSOCIATE
AT THE UNIVERSITY OF COLORADO.
>> GENESIS ARIZMENDI AT THE
UNIVERSITY OF ARIZONA.
>> LAURA COCO ASSISTANT
PROFESSOR AT SAN DIEGO STATE
UNIVERSITY.
>> MATT BUSH PROFESSOR
DEPARTMENT OF LARYNGOLOGY.
>> I'M MICHELLE ARNOLD IN
COMMUNICATION DISORDERS AT THE
UNIVERSITY OF SOUTH FLORIDA.
>> THANK YOU VERY MUCH.
THE FIRST QUESTION IS ABOUT
COMMUNITY BUILDING.
COMMUNITY BUILDING IS A HUGE
COMPONENT OF BEING ABLE TO
IMPLEMENT SUCCESSFUL
IMPLEMENTATION RESEARCH AND WE
DECIDED AS A GROUP TO LEAVE THIS
FREE FORM.
RAISE YOUR HAND IF YOU WANT TO
ANSWER AND I'LL CALL ON YOU.
WITH WE CAN START ON COMMUNITY
BUILD
BUILDING.
>> JEN: MY INTEREST IN RESEARCH
IS IMPROVING HEALTH CARE ACCESS
FOR PATIENTS WHO HAVE
COMMUNICATION DISABILITY AND
THIS TAKES PLACE IN REAL WORLD
HEALTH CARE SETTING SO I NEED
HEALTH CARE ORGANIZATIONAL
PARTNERS AND A NEW RESEARCHER,
BUILDING PARTNERSHIPS CAN BE A
CHALLENGE YOU CAN IMAGINE WITH
THE NATURE OF HEALTH CARE TODAY
AND EVER CONSOLIDATING
ORGANIZATIONS, THERE'S MANY
LEVELS OF LEADERSHIP THAT YOU
NEED TO GET THROUGH TO HAVE THAT
ENGAGEMENT IN PARTNERING AND
AGREEING TO IMPLEMENT
INTERVENTION IN A BUSY HEALTH
CARE SETTING WHICH HAS MANY
LAYERS OF FACTORS THAT CAN
IMPACT THAT INTERVENTION.
THE MODEL I THINK OF IN TERMS OF
NOT RECREATING THE MODEL BUT
LOOKING TO NEIGHBORS AND AND
WHAT I THOUGHT WAS HELPFUL IS
THERE'S A LEARNING RESEARCH
NETWORK THAT IS FUNDED BY THE
NICHD AND
LOOK TO PARTNER WITH THE
IMPLEMENTATION SCIENCE REALM AND
CREATE THE PARTNERSHIPS THEN
FUND RESEARCHERS WHO WANT TO
TAKE PART IN THAT.
THAT'S AN INSPIRING MODEL I'D
LOVE TO SEE MORE OF IN OUR
SPACE.
>> ANY THOUGHTS ON THAT.
>> CRYSTLE: I THINK SPECIFICALLY
MY WORK IS CENTERED IN
SCHOOL-BASED SYSTEMS AND SO I
THINK TRYING TO BUILD
RESEARCHER, PRACTITIONER
PARTNERSHIPS IS KEY BUT WE'VE
HAD A LOT OF CHALLENGES THAT
HAVE HAPPENED WITH THE GLOBAL
PANDEMIC, THE WAY SYSTEMS HAVE
BEEN IMPACTED.
BUILDING COMMUNITY TAKES TIME
AND TRYING TO FIND PARTNERS AND
BUILD THE TRUST IF YOU WANT THEM
SOB SUSTAINABLE AND AUTHENTIC.
I THINK THEY'RE ADMIRABLE GOALS
FOR OURSELVES BUT ARE CERTAINLY
CHALLENGING AND TAKE A LOT OF
EFFORT AND SOMETIMES YOU'LL HAVE
SPENT A LOT OF TIME TRYING TO
CULTIVATE CERTAIN RELATIONSHIPS
AND THEN BUILD A DIFFERENT TEAM
BUT DEPENDING ON HOW PRIORITIES
SHIFT OR CHANGE OR MOVEMENT
HAPPENS, I THINK THAT CAN THEN
YOU'LL HAVE TO START FROM SQUARE
ONE AGAIN.
IT CAN BE MY NOT FAVORITE PART
TO KEEP GOING AND HAVING
MOTIVATION TO CONTINUING TO
BUILD COMMUNITY PARTNERSHIPS,
ORGANIZATIONAL LEVEL
PARTNERSHIPS BUT ALSO FINDING
RESEARCHERS WHO WANT TO
COLLABORATE WITH YOU TO DO THIS
WORK WHEN WE KNOW IT CAN BE A
LOT OF EFFORT THAT MAYBE
SOMETIMES DOESN'T ALWAYS YIELD
THE OUTCOMES WE'RE HOPING FOR.
I GUESS I'M GOING TO START US
OFF THERE.
>> THE DISCUSSION IS FOR HELPING
US TO LAY THE GROUND WORK SO
PEOPLE LATER IN THE WORKSHOP CAN
ANSWER ALL THE QUESTIONS.
SOLVE ALL THE PROBLEMS.
CRYSTLE, THAT REMINDED ME
SOMEONE ERL TODAY WAS TALKING
ABOUT THE LACK OF IS THE LIMBED
NUMBER OF EXPERTISE IN
COMMUNICATION SCIENCES AND
DISORDERS AND THE IMPACT CAN BE
A BARRIER AS WELL.
SOME OTHER THINGS YOU WERE
TALKING ABOUT WE'LL GET INTO
NEXT WHEN WE GET INTO ACADEMIC
BARRIERS THAT ARE IN PLACE.
MAT
MATT.
>> MATT: I FEEL CLINICALLY AS AN
OT
OTTOLARYNGOLOGIST PEOPLE WOULD
RATHER TALK ABOUT SURGICAL
COMPLICATIONS OR THINGS RELATED
TO HEAD AND NECK PROCEDURES.
I FELT LIKE AN OUTLIER.
THIS WORKSHOP AND COLLECTION OF
BRILLIANT PEOPLE TOGETHER IS A
BIT OF THE PRESCRIPTION THE
DOCTOR ORDERS.
THIS IS GOOD.
GEF GEF
I'M THANKFUL NIDCD SEES THE
VALUE IN THIS COMMUNITY KOLLING
TOGETHER TO TALK ABOUT THINGS
AND EVEN THOUGH THERE'S
NEGATIVES THERE'S POSITIVES THAT
CAN COME THROUGH THIS.
I WANT TO COMMENT ON THE OTHER
ASPECT OF BUILDING TEAMS AND
TRANS-DISCIPLINARY TEAM AND THE
INFANT EARLY DETECTION
INTERVENTION PROGRAM WITH PUBLIC
HEALTH ASPECTS THEY AGREE WITH
THE PRINCIPLE OF BEING PATIENT
TO BUILD TRUST AMONG
STAKEHOLDERS AND THE OVER ALL
LONG-TERM IMPACT.
AND BEING PART OF ACADEMIC
ACTIVITIES SUCH AS A KEY PROGRAM
LEADER IN OUR STATE KENTUCKY,
EHDI PROGRAM WE INVITED TO BE
PART OF THE RESEARCH TEAM AND
PUBLISH WITH US THOUGH SHE
MAINTAINS HER POSITION AND EHDI
PROGRAM WE'LL PUBLISH TOGETHER
AND SHE AS WELL AS OTHERS
MAINTAINED KEY AUTHORSHIP ROLES
IN THE RESEARCH OUTPUT NOT JUST
ACTIVITIES.
THAT WAS A HELPFUL THING HOPES
TO THEN GARNER MORE TRUST AND
SUPPORT FOR FURTHER POLICY
MAKERS.
I THINK THAT'S WHERE YOU'LL HAVE
AN OPPORTUNITY TO TAKE D&I WORK
AND PRAGMATIC CLINICAL RESEARCH
INTO POLICY CHANGE IF YOU ALLOW
POLICY MAKERS AND INFLUENCES TO
BE A PART OF THE INNER WORKINGS.
>> AND HONORING THE PARTNERSHIPS
THROUGH THE PROCESS AND THE
IMPORTANCE OF THAT.
MICHELLE, ONE MORE COMMENT OR
QUESTION ON THE TOPIC AND THEN
WE'LL GO ON TO THE NEXT SO GO
AHEAD, MICHELLE.
>> MICHELLE: THANKS.
I WANTED TO ECHO WHAT EVERYONE
HAS SAID SO FAR PARTICULARLY
SOME THINGS MATT BROUGHT UP IN
TERMS OF INCORPORATING COMMUNITY
MEMBERS FROM STUDY CONCEPTION TO
DISSEMINATION OF RESULTS.
I THINK ONE OF THE NEEDS IN
HELPING BUILD THE COMMUNITIES
WOULD BE A WAY IN WHICH TO
REPRESENT THESE INDIVIDUALS IN
NOT JUST THE DISSEMINATION
EFFORTS BUT IN THE APPLICATION
EFFORTS AS WELL.
SOMETHING OUTSIDE A SIMPLE
RECRUITMENT AND RETENTION PLAN
WHICH IS NOT TRULY A
COMMUNITY-BASED -- JUST WORKING
WITHIN A COMMUNITY FOR THE SOLE
PURPOSE OF RECRUITING AND
RETAINING PARTICIPANTS ISN'T
GENUINE COMMUNITY PARTNERSHIP.
IT WOULD BE WONDERFUL TO SEE THE
WAY WE'RE SEEING COMMUNITIES
REPRESENTED AND ACKNOWLEDGED AND
VALUED FROM DIFFERENT FUNDING
AGENCIES.
>> GREAT, THANKS, MICHELLE.
THAT LEADS TO THE NEXT TOPIC
WHICH IS HOW DISSEMINATION AND
IMPLEMENTATION IS IN DIFFERENT
VENUES.
WE HAD A LONG CONVERSATION ABOUT
THIS.
WE LOOKED AT THE TIME AND BURDEN
OF COMMUNITY PARTNERSHIPS.
WOULD YOU LIKE TO SHARE HOW THAT
FITS IN TO YOUR ACADEMIC
INSTITUTION.
>> LAURA: WE'RE BOTH AT SAN
DIEGO STATE BUT I DON'T THINK
IT'S UNIQUE TO OUR INSTITUTION.
I THINK IT'S PROBABLY COMMON
ACROSS ACADEMIA BUT I JUST
STARTED HERE LAST YEAR SO I'M
STARTING MY SECOND YEAR ON THE
TENURE TRACK AND REALIZING MY
RESEARCH NOT THE SAME AS
EVERYONE ELSE'S AND IT TAKES A
LOT TIME TO BUILD COMMUNITY,
CRYSTLE MENTIONED, STARTING AT
SQUARE 1.
AT MY PREVIOUS INSTITUTION I HAD
RELATIONSHIPS ESTABLISHED YEARS
PRIOR BY MENTORS I HAD AT THOSE
INSTITUTION AND NOW I'M START
FROM SCRATCH AND FIGURING OUT
WHO I NEED TO CONTRACT AND THE
LOCAL POLITICS IN SAN DIEGO AND
THE COMMUNITY TO TIE INTO AND
TYING INTO THAT ALL TAKES SO
MUCH TIME.
IN THINKING ABOUT PUBLICATION
GRANTS APPLICATIONS THE, TENURE
CLOCK IT'S EXTENDED FOR FOLKS
WHO DO D&I COMMUNITY-BASED
RESEARCH BUT WE'RE ALL ON THE
SAME CLOCK.
SO, IT'S IMPORTANT THAT PEOPLE
WHO ARE JUDGING TENURE AND
PROMOTION AND GRANTS UNDERSTAND
THIS TYPE OF WORK IS INCREMENTAL
AND TAKES A LONG TIME, NOT
DECADES HOPEFULLY BUT YOU GET
OUT WHAT YOU PUT IN AND NEED TO
DEDICATE THAT TIME IN ORDER TO
BUILD THE TRUSTING RELATIONSHIPS
AND TO DO THE PRELIMINARY
RESEARCH THAT IS SO IMPORTANT
PRIOR TO JUMPING FEET FIRST INTO
D&I.
I'M FEELING THAT A LOT AS AN
EARLY CAREER INVESTIGATOR WHO IS
JUST STARTING OUT ON THE TENURE
CLOCK BUT WONDER WHAT OTHERS ARE
THINKING.
>> AS A FIRST-YEAR ASSISTANT
PROFESSOR COMING IN NOW TOO AND
STARTING TO ESTABLISH THOSE
CONNECTIONS WITH THE COMMUNITY
AND UNDERSTAND WHAT THE NEEDS
ARE OF THE COMMUNITY CERTAINLY
DOES TAKE TIME.
FOR THE WORK THAT I DO WITH
HISTORICALLY EXCLUDED
COMMUNITIES AND MARGINALIZED
COMMUNITIES THERE'S A STATE OF
DISTRUST BECAUSE ONGOING
PARTNERSHIPS HAVEN'T RESULTED IN
ANYTHING BACK TO THE COMMUNITY.
AND SO WHAT IS IT WE CAN DO TO
BUILD THAT TRUST ESTABLISH THAT
TRUST, FOSTER THE LONG TERM
COLLABORATION WITH THE COMMUNITY
AS WELL AS THE NEEDS OF
PERSONNEL IN BEING ABLE TO
DEVELOP CULTURALLY RESPONSIVE
COMMUNICATIONS IF THEY'RE IN A
LANGUAGE NOT ENGLISH.
ALL THE CONSIDERATIONS THAT GO
ALONG WITH THE TIME AND
INVESTMENT TO BUILD COMMUNITY
REALLY DO COME TO THE FOREFRONT
AND BALANCING OUT ALL THE OTHER
JOBS WITH TEACHING RESEARCH,
PUBLICATIONS AND PUBLICATIONS IN
JOURNALS THAT VALUE THE WORK
THAT IS COMING FROM THIS TIME
INVESTED IN THE COMMUNITY IS
REALLY IMPORTANT TO BRING TO THE
FOREFRONT.
>> MICHELLE: I WAS THINKING HOW
INDIVIDUALS ENTRUSTED IN D&I
WORK ALMOST HAVE TO HAVE ANOTHER
SET OF TRICKS, RIGHT.
THEY TEND TO PUBLISH WHILE
THEY'RE WORKING ON THE
COMMUNITY-BASED WORK OR D&I WORK
WHICH TENDS TO BE TIME
CONSUMING.
SOME OF THE POLICY ANALYSIS WORK
I DO IS EXTREMELY DIFFICULT TO
AND IT TAKES A LONG TIMES WHILE
YOU READ REGULATIONS AND
ALLOWANCES ACROSS 50 STATES AND
FOUR TERRITORIES AND ALL
DIFFERENT MEDICAID PLANS AND
PROGRAMS, YOU STILL HAVE TO BE
ABLE TO PUBLISH TO BE
COMPETITIVE ARE FOR TENURE AND
PROMOTION AND NEW JOB
OPPORTUNITIES AND FOR FUNDING
OPPORTUNITIES AS WELL TO SUSTAIN
THE FUNDING ACROSS TIME.
IT STARTS TO BECOME REALLY
DIFFICULT TO JUGGLE LIKE OH, I
HAVE TO BE AN EPIDEMIOLOGY TO
CREATE THIS DATA AND BE
INTERVENTIONIST TO COLLABORATE
WITH THIS PROJECT AND OPPOSED TO
FOCUSSING ON D&I AND ITSELF.
>> WITHIN HEARING LOSS
SPECIFICALLY AGAIN REFERRING TO
THE TOPIC EARLIER FEELING LIKE
AN OUTSIDER BECAUSE D&I RESEARCH
ISN'T WELCOME WITHIN OUR
MAINSTREAM JOURNALS AND THAT
COULD BE CHALLENGING BECAUSE WE
CARE ABOUT COMMUNICATING WITH
OUR COMMUNITY PERHAPS COMMUNITY
IS NOT QUITE READY TO HEAR THE
MESSAGE AND THE THINGS WE'RE
LEARNING THROUGH D&I SCIENCE IS
CHALLENGING.
SOME MAINSTREAM JOURNALS DON'T
KNOW WHAT TO DO WITH MIXED
METHODS OR QUALITATIVE RESEARCH
AND SOMETHING OUR EDITORS AND
EDITORIAL STAFF ARE AWARE OF BUT
TRYING TO BRING THE COMMUNITY
FORWARD IS A LITTLE BIT OF A
CHALLENGE.
I'LL SPEAK TO THE SENIOR MEMBERS
OF THIS PANEL.
I GUESS I'VE NAVIGATE THROUGH
THE SHARK INVEST ED WATERS OF
TENURE NO -- HAVE GIVEN ME A
SENSE OF CONTRIBUTING AND VALUE
TO MEMBERS OF THE COMMUNITY AND
DEMONSTRATE AND WAS EXCITED TO
LEARN FROM AND LISTEN TO AND THE
COLLABORATE WITH PARTNERS IN
BEHAVIORAL HEALTH OR OTHER
DEPARTMENTS INTERESTED IN
SIMILAR CONCEPTS, PRAGMATIC
WORK, TRYING TO EXPLORE HYBRID
TRIALS.
SO I THINK I'VE BEEN ABLE TO BE
AN AGENT OF CHANGE WITHIN MY
INSTITUTION TO TRY TO HELP
PREACH THE GOSPEL OF D&I
RESEARCH AND THE VALUE THAT IT
HAS IN YOUR CAREER TRAJECTORY.
FOR THOSE WORRIED ABOUT IS D&I
GOING TO TAKE MY CAREER AND
SMASH IT AGAINST THE ROCKS, I
WOULD HOPE AND PRAY NOT AND MAY
BRING YOU TO SAFE HARBOR AND
OPPORTUNITY FOR CAREER
ADVANCEMENT.
>> THANK YOU FOR THOSE WORDS OF
WISDOM, MATT.
THAT ENCOURAGEMENT OF HAVING
MADE IT THROUGH AND MADE IT
THROUGH THE PROCESS AT A TIME
WHEN WE WEREN'T QUITE AS FAR AS
ALONG AS WE ARE NOW.
WE STILL HAVE A LONG WAY TO GO.
WE'RE HOPEFULLY ON A PATH WHERE
THAT GETS EASIER RATHER THAN
HARDER FOR PEOPLE.
THE CHALLENGES OF TENURE AND
FEELING LIKE YOU HAVE TO HAVE
MORE THAN ONE LINE OF RESEARCH
OR SOMETHING OTHER THAN
IMPLEMENTATION SCIENCE TO GET
YOU THROUGH IS A REAL CHALLENGE.
I WONDER IF ANYONE ELSE WANTED
TO SAY ANYTHING ELSE ABOUT THAT
PARTICULAR ISSUE.
>> OTHER THINGS WE TALKED ABOUT
WITH HOW D&I IS VALUED IN
ACADEMIC AND PUBLIC TEACHING
VENUES.
WE TALKED ABOUT BETTER SUPPORTS
FROM ORGANIZATIONS LIKE ASHA THE
AMERICAN SPEECH, LANGUAGE AND
HEARING ASSOCIATION AND THE NEED
FOR ORGANIZATIONS LIKE THAT TO
BE INVOLVED IN D&I WORK AND
HEALTH CARE ORGANIZATIONS.
CAN SOMEBODY ELABORATE OR TALK
ABOUT THAT MORE.
>> GEN: THERE WAS A GRANTS
WRITING WORKSHOP AND AT THAT
CONFERENCE THERE WERE PHYSICAL
THERAPISTS, OCCUPATIONAL
THERAPISTS AND TWO SLPs OUT OF
LIKE 30 PEOPLE AND WE LISTENED
TO FUNDING AGENCIES THAT FUND
IMPLEMENTATION SCIENCE WORK IN
REHABILITATION AND WE LISTENED
TO THE ALTA LIKE WHERE'S ASHA OR
OUR REPRESENTATION.
WE THOUGHT THAT WAS AN
INTERESTING DESCRIPTIVE
UNDERSTANDING OF THE SPACE AND
FUNDING FOR D&I WORK.
>> THIS BRINGS UP A THEME WE
TALKED ABOUT BEFORE WHICH IS NOT
SPECIFIC TO OUR PROFESSIONAL
ORGANIZATIONS BUT ALSO I'VE SEEN
WITH INDIVIDUALS, SLPs,
AUDIOLOGISTS WHERE I HAVE TO
STAY IN MY LANE.
D&I IS NOT SOMETHING I DO AND
MAY BE BECAUSE THEY FEEL AS
INDIVIDUALS AND PROFESSIONAL
ORGANIZATIONS, THEY DON'T HAVE A
PRE DEFINED LEVEL OF EXPERTISE
THEN IT'S SOMEONE ELSE'S ROLE OR
JOB.
THAT'S A DANGEROUS PLACE TO BE
AND DRET DETRIMENT TO ALL OF US
BECAUSE WE ALL NEED TO BE SOME
LEVEL OF IMPLEMENTATION
SCIENTISTS TO LEARN MORE AND DO
BETTER AND HAVE A ROLE TO PLAY
IN THIS.
IN PARTICULAR, ASHA AND OTHER
PROFESSIONAL ORGANIZATIONS THAT
HAVE SO MUCH AND WE HAVE SO MUCH
TO BRING TO THE TABLE AND I
HEARD THIS FROM PEOPLE WHO SAY
THEY DON'T KNOW ANYTHING ABOUT
IT OR CONSIDER THEMSELVES TO
KNOW ANYTHING ABOUT
IMPLEMENTATION SCIENCE BUT IT
TURNS OUT THEY'RE DOING A LOT OF
WHAT IMPLEMENTATION SCIENCE IS.
AND SOME STARTS WITH THE
WORKSHOP WHICH IS FANTASTIC AND
MAKING IT A PRIORITY AT NIDCD
AND I THINK THERE'S AN
ASSUMPTION THAT IT'S AN ELITE
CLUB OR PRIVATE CLUB AND SOMEONE
HAS TO ANOINT YOU FOR YOU TO
JOIN BUT THAT'S NOT TRUE.
>> IT'S INTERESTING ISN'T IT,
ONE THING WE BROUGHT UP THE
OTHER DAY IS THERE ARE NO HARD
AND FAST CREDENTIALS FOR BEING
AN IMPLEMENTATION SCIENTIST.
I SAID I'M NOT AN IMPLEMENTATION
SCIENTIST AND THEY SAID NO, YOU
ARE AND THAT FELT UNCOMFORTABLE.
IT'S THE OPPOSITE OF AN ELITE
CLUB.
IT'S A CLUB WE WANT EVERYONE IN
AND ALL WANT TO BE A PART OF.
BEFORE WE MOVE ON TO THE FUNDING
TOPIC WHICH IS THE NEXT TOPIC
THERE'S ONE OTHER COMPONENT OF
THIS TOPIC I WANTED TO TALK
ABOUT A LITTLE BIT WHICH IS
CHALLENGES IN WORKING WITH OVER
BURDENED PARTNERS.
WE HAVEN'T TALKED ABOUT THAT AT
ALL.
IF YOU CAN TALK ABOUT THAT
AND/OR EXPERIENCES AND HOW DOES
THAT TIE INTO YOUR ACADEMIC --
GO AHEAD, MICHELLE.
>> MICHELLE: THANK YOU.
I HAVE SOME EXPERIENCES WORK
WITH OVER BURDENED PARTNERS
[INAUDIBLE] AND MARGINALIZED
UNDER REPRESENTED GROUPS.
THE ISSUE WHEN IT COMES TO THE
TOPIC OF OVER BURDENED IS
THERE'S SUCH A LACK OF
REPRESENTATION ON INDIVIDUALS
FROM THESE DIFFERENT GROUPS IN
ACADEMIA AND UP POSITIONS OF
LEADERSHIP AND COMMUNITIES AND
IF YOU ARE NOT A MEMBER AND
DIFFICULT TO RECRUIT OTHER
COLLEAGUES WHO ARE INTERESTED IN
THIS TYPE OF WORK WHO ALSO FUND
SOME OF THESE UNDER REPRESENTED
GROUPS OR IDENTIFY UNDER
REPRESENTED GROUPS GOING BACK TO
THE CONCEPT OF MISTRUST GENESIS
WAS DISCUSSING.
IT CAN BE DIFFICULT TO BUILD
PARTNERSHIPS AND TO DEVELOP
RELATIONSHIPS WITH COLLABORATORS
SO YOU CAN HAVE A DIVERSE
COLLABORATIVE GROUP WHICH I
VALUE GREATLY AND FIND VERY
IMPORTANT BUT EVEN IF YOU LOOK
AT SOME OF THE ASHA DEMOGRAPHIC
REPORTS LIKE THERE ARE --
THERE'S SUCH A LACK OF
AUDIOLOGISTS AND SPEECH
PATHOLOGIST THAT ARE NOT
HISPANIC PEOPLE.
IT'S DIFFICULT TO FIND
COLLABORATORS AND IT TURNS INTO
AN ISSUE WHERE PEOPLE ARE OVER
BURDENED.
I PERSONALLY CAN'T CAN SPEAK
FROM THE PERSPECTIVE OF BEING
THE OVER BURDENED PARTNER BUT I
APPRECIATE IT'S SOMETHING THAT
HAPPENS FREQUENTLY.
>> I WANT TO REITERATE THE
VARIOUS LEVELS AT WHICH WE CAN
DO THIS WORK AND HOW WE CAN HAVE
AND BRIDGING THE RESEARCH GAP
AND WHAT DOES YOUR PRACTICE LOOK
LIKE AND WHAT ADAPTIONS ARE YOU
MAKING CAN LEAD TO THEM AND WHEN
AN APPROACH THEY WANT TO KNOW
THE ASK.
I'M LIKE I DON'T HAVE AN ASK
YET.
I'M TRYING TO LEARN MORE ABOUT
WHAT THEY'RE HAPPENING HERE AND
THEY'RE SOMETIMES SO OVER
BURDENED BY RESEARCHERS WHO IN
THE PAST HAVE HISTORICALLY COME
THROUGH AND BEEN CAN YOU PASS
OUT FLYERS OR HELP US RECRUIT
AND THEIR IMMEDIATE RESPONSE IS
ON THE DEFENSIVE OF LIKE WHAT DO
YOU MEAN AND WHY ARE YOU HERE?
TO THEM WHICH IS STRANGE.
I DON'T HAVE TIME -- I GOT FIRES
TO PUT OUT.
I HAVE ADMINISTRATIVE BURDENS.
THINKING AT ALL THE LEVELS OF
ORGANIZATIONAL COMMUNITIES.
IT'S CHALLENGING TO THINK ABOUT
WHERE TO INSERT OURSELVES OR
MAKE OURSELVES BE KNOWN TO HELP
AT ALL LEVELS AND IT GOES BACK
TO THINKING ABOUT OUR CARD
CARRYING IMPLEMENTATION
SCIENTISTS AND I'M JUST TRYING
TO AND USED TO BE A CLINICIAN
AND HAVE CLINICAL QUESTIONS.
IT'S A CHALLENGE AT ALL THE
LEVELS THAT PERHAPS NOT EVERYONE
SEES OR ENTRY POINT
>> CATHY: AS AN ACADEMIC
STARTING OUT WILL THE TIME
INVESTMENT PAY OFF IN TERMS OF
THE CURRENCY VALUED IN ACADEMIA
AND FINDING WAYS TO COPE AND
KEEP GOING BECAUSE YOU'RE ALL
PASSIONATE ABOUT DOING RELEVANT
WORK.
>> GEN: THAT RESONATES WITH ME
KNOWING WE WORK IN THE SCHOOL
SYSTEMS AND THEY'RE STILL TRYING
TO RECOVER AFTER THE LAST TWO
YEARS OF TEACHER STAFF TURNOVER,
ADMINISTRATIVE TURNOVER.
THINKING ABOUT ALL THE DIFFERENT
WAYS WE NIGHT BE ABLE TO
ESTABLISH AN OPEN LINE OF
COMMUNICATION WITH OUR COMMUNITY
PARTNERS BUT ALSO HAVE THAT OPEN
LINE OF COMMUNICATION WHILE
STILL ATTENDING TO OTHER PARTS
OF OUR PRACTICE AND RESEARCH AND
READING AND WRITING AND HOW WE
CAN UTILIZE THE PARTNERSHIPS TO
UNDERSTAND THERE'S A NEW WAY OF
APPROACHING WHAT WE'RE
ATTEMPTING TO WORK WITH THE
COMMUNITY PARTNERS.
I'M IN THE HERE TO JUST HAVE YOU
DISTRIBUTE THE FLYERS, I WANT TO
KNOW WHAT YOUR NEEDS ARE AND SEE
WHAT I CAN DO TO ADDRESS THOSE
NEEDS OR WORK WITH YOU TO
ADDRESS THOSE NEEDS BUT THAT'S
ALSO A LEARNING PROCESS TOO WITH
PREVIOUS EXPERIENCES WITH OTHER
RESEARCH TEAMS.
LOTS OF RESONANCE THERE.
THANK YOU.
>> CATHY: LAURA?
>> LAURA: I'M GOING TO ECHO WHAT
CRYSTLE AND GENESIS SAID AND IN
KEEPING WITH THE THEME OF TIME,
THE TIME IT TAKES SAY YOU'RE
PLANNING AND SUBMITTING A GRANT
IN ORDER TO GET RESOURCES TO
TEST THE IMPLEMENTATION OF THIS
INTERVENTION IN A COMMUNITY AND
YOU'VE DONE YOUR GROUND WORK AND
RESEARCH AND COMMUNITY BUILDING
IT TAKES BUT THE TIME LINE FOR A
GRANT IS SO LONG.
COMMUNICATING THAT BACK TO THE
COMMUNITY AND MAINTAINING THE
RELATIONSHIP FOR THE TIME IT
TAKES TO WRITE THE GRANT, SUBMIT
IT, REVISE IT, RESUBMIT IT AND
GET THE FUNDS THAT TIME LINE IS
SO LONG.
THAT'S OFTEN A CONFLICT WITH
COMMUNITY NEEDS AND PRIORITIES
AND ONCE YOU'VE INTERVIEWED AND
AGREED UPON IT WITH THE
COMMUNITY IT'S LIKE SAYING OKAY,
NOW IN TWO YEARS IT WILL
ACTUALLY HAPPEN.
I'M STILL GETTING A FEEL FOR
WHAT THAT PROCESS IS LIKE.
>> CATHY: THAT'S A GOOD POINT,
LAURA, AND THE NEED TO LOOK AT
MULTIPLE LEVELS OF FUNDING
MECHANISMS, INTERNAL MECHANISMS
FOR THE SHORTER TERM WORK WHILE
YOU'RE GATHERING THE DATA TO GET
THE LONGER TERM MECHANISM BIGGER
FUNDING KIND OF THINGS OR
FOUNDATION MONEY AND ALL OF THAT
AND FIGURING THAT OUT.
SOME OF THIS GOES BACK TO
MENTORSHIP AND FOR THOSE START
OUGHT TO HAVE GOOD MENTORSHIP IN
PLACE TO HELP YOU SORT THROUGH
THOSE THINGS BECAUSE YOU'RE
TRYING TO BUILD IT SOMETIMES IT
FEELS LIKE ON YOUR OWN.
SOME OF THAT TAKES US NICELY TO
OUR NEXT MAJOR MEATY TOPIC,
M-E-A-T-Y.
WE HAD A LIVELY DISCUSSION ABOUT
FUNDING CHALLENGES AND THE NEED
FOR FUNDING AND REVIEW MECHANISM
SUPPORT D&I WORK.
ONE THING I WANTED TO START OFF
SAYING WAS SOMETHING MAYBE MATT
CAN TALK ABOUT IS THE
APPRECIATION FOR CURRENT NIDCD
CULTURE AND THE LEADERSHIP
THAT'S IN PLACE.
IF YOU WANT TO TALK ABOUT THAT A
LITTLE BIT, MATT, BEFORE WE GET
INTO THE CHALLENGES.
>> MATT: WE LOVE THE NIDCD.
THEY HAVE A PASSION FOR THE
THINGS WE CARE ABOUT.
WE HAVE THE GOOD FORTUNE TO HAVE
A LOT OF BRILLIANT SCIENTISTS
AND LEADERS IN RESEARCH AT THE
HELM FOR THE NIDCD.
THE CAN'T CHAMPION THE WORK
WITHOUT THE MERITORIOUS
APPLICATIONS THAT WERE CLEARLY
DESCRIBED.
THE ONUS IS ON US IN THE
RESEARCH COMMUNITY TO REALLY
BRING THE HEAT AND BRING QUALITY
APPLICATIONS AND REALLY BE
COLLABORATIVE AND INNOVATIVE
ABOUT WHAT WE DO.
I'M HOPEFUL EVEN AS A RESULT OF
THIS WORKSHOP WE'LL HAVE CHATTER
AND COMMUNICATION BACK AND FORTH
ABOUT YOU DO THIS AND I'M
INTERESTED IN THIS AS WELL.
COULD WE FIND WAYS TO PUT
SOMETHING TOGETHER EVEN IF OUR
EXPERTISE IS VERY DIFFERENT.
THAT'S ACTUALLY THE GREATEST
OPPORTUNITY FOR COLLABORATION.
ONE THING I'LL SAY IS INSTEAD OF
VERY SUPPORTIVE INSTITUTION, WE
STILL MAY HAVE VERY CHALLENGING
SECTIONS TO NAVIGATE THROUGH.
I HAVE FOUND THE STUDY SECTION
THAT REVIEWS A LOT OF D&I
RESEARCH IS REALLY LOOKING FOR
SOME VERY HARDCORE COMPLEX
INNOVATIVE METHODS AND
ADVANCEMENTS WITHIN D&I SCIENCE
AND THAT MAY BE A LITTLE BIT
CHALLENGING TO JUST TAKE YOUR
CLINICAL QUESTION AND APPLY CFOR
AND EVALUATE IMPLEMENTATION
OUTCOME MAY NOT BE ADEQUATE TO
NAVIGATE THROUGH THE STUDY
SECTION WITH A FUNDABLE SCORE.
I HAD AN APPLICATION THAT WAS
REVIEWED THROUGH COMMUNITY LEVEL
HEALTH PROMOTION OR CLIP.
THAT NO LONGER EXISTS NOW BUT I
THINK WE NEED TO BE
COMMUNICATIVE AND OPEN ABOUT
WHERE WE MAY SEE CHALLENGES IN
SOME OF THE STUDY SECTIONS WHERE
WE FEEL LIKE THIS IS A SECTION
THAT DIDN'T HAVE A STUDY SECTION
IN D&I SCIENCE VERSUS THE BEST
OF THE BEST IN THE WORLD IN DIBE
RESEARCH THAT WE REALLY MAY NOT
BE BRINGING THE HEAT AS I SAY.
THESE ARE CHALLENGES AND THOUGHT
I HAD.
>>
>> CATHY: I TOOK A NOTE WHILE
YOU WERE TALKING AND IT SEEMED
THERE'S A GAP BETWEEN THE D&I
STUDY SECTION AS YOU SAID THAT'S
LOOKING FOR THE ELITE D&I AND
THEN WE'RE JUST TRYING TO GET
STARTED AND SO WE'RE NOT TO BE
PUSHING THE D&I METHODOLOGY.
WE'RE TRYING TO BRING THE D&I
METHODOLOGY TO OUR OWN SCIENCE.
SO WHERE TO GO AND HOW TO FRAME
THAT CAN BE A CHALLENGE.
I SEE SOME HEAD NODS.
>> I HAVE SOME SPECIAL EMPHASIS
PANELS MAY BE SOMETHING THAT WE
COULD EXPLORE THAT MAY ALLOW A
PLACE OF SAFETY WITHIN
COMMUNICATION SCIENCE DISORDERS.
THAT'S MY THOUGHT.
I'M SURE MY COLLEAGUES --
>> CATHY: IF WE GET AN AVALANCHE
OF APPLICATIONS MAYBE WE CAN GET
THAT GOING.
ANYONE WANT TO ADD ANYTHING TO
THAT TOPIC?
OKAY.
I'LL MOVE US ON.
SOMETHING WE TALKED ABOUT WAS
CATCH 22.
THE NEED FOR BUILDING COMMUNITY
IN ORDER TO GET FUNDING AND YOU
NEED FUNDING TO GET COMMUNITY.
THAT'S COME UP A LITTLE BIT
ALREADY TODAY.
ANYBODY WANT IT TALK ABOUT THAT
A LITTLE BIT MORE FROM THE
FUNDING PERSPECTIVE AND ANY
CHALLENGES YOU HAD WITH THAT?
THERE'S COMMUNITY BASED THINGS
THAT YOU MIGHT WANT TO PUT INTO
GRANT APPLICATIONS LIKE PAYING
FOR CARD TABLES AND CHAIRS AND
THINGS TO DO COMMUNITY EVENTS.
THOSE ARE HARD TO PUT INTO GRANT
APPLICATIONS SOMETIMES.
>> I CAN SPEAK ON THIS.
SO THERE ARE SOME RESTRICTIONS
TO SOME OF THE FUNDING THAT'S
AVAILABLE TO US THAT DEFINITELY
ALLOW FOR THE TYPES OF RECEIVERS
YOU NEED TO BUILD A COMMUNITY OR
TO BUILD COMMUNITY PARTNERSHIPS
AND THINGS YOU WERE SAYING.
A COMMUNITY PARTNER AND THERE'S
NOT VALUE IF YOU'RE BRINGING
LIKE A BUNCH OF MISMATCHED STUFF
TO THE EVENT AND NOT ABLE TO
PURCHASE LIKE LUNCHES FOR
EXAMPLE FOR COMMUNITY PARTNERS
OR THINGS TO SET UP EVENTS TO
ENGAGE COMMUNITY PARTNERS YET
THERE ARE BUDGET LINE THAT CAN
COST THOUSANDS OF DOLLARS AND
IT'S LIKE WELL, I JUST NEED $50
FOR PIZZA BUT I HAVE TO PAY FOR
THAT OUT OF MY OWN POCKET
BECAUSE THERE'S NOT A BUDGET
LINE THAT ALLOWS ME TO BRING
PIZZA TO MY COMMUNITY PARTNERS
TO COLLECT FEEDBACK ON MATERIALS
I'M DEVELOPING.
I DON'T KNOW IF ANYONE WANTS TO
OFFER THEIR EXPERIENCES WITH
THAT.
>> GEN: PARALLEL TO WHAT
MICHELLE WAS SAYING IN THE
HEALTH CARE WORLD WHICH MICHELLE
IS IN THE HEALTH CARE WORLD THE
PATIENT CENTERED PCORI
ENGAGEMENT AWARD.
THE PATIENT-CENTERED OUTCOMES
INSTITUTE HAS PATIENT ENGAGEMENT
AWA
AWARD DEDICATED TO THAT AND
GREAT TO SEE MORE OF THAT.
>> CATHY: AND THE ABILITY TO BUY
A COPY MACHINE OR THE THINGS
VALUABLE FOR TRUE COMMUNITY
ENGAGEMENT.
>> I'M AT
>> CHRIS
>> CRYSTLE: I THOUGHT IT WAS
LIKE SO LONG AS I'VE LISTED IT
IN THE BUDGET AND YOU APPROVED
IT I CAN GO FORTH AND PURCHASE
BUT THE $50 COFFEE MACHINE CAN'T
BE PURCHASED.
MY CURRENCY HERE IS WITH TRYING
TO I DON'T NEED AN MRI MACHINE
AND I THINK I GOT STRANGE LOOKS
LIKE WHY ARE YOU HIRING A
MARKETING BRANDING PERSON?
WHY DO YOU WANT TO HAVE A COFFEE
MAKER?
I'M LIKE BECAUSE I HOPE TO BRING
COMMUNITY MEMBERS HERE AND HOPE
TO GO OUT TO THE COMMUNITY AND
HAVE A PRESENCE AND BUILD A
WEBSITE AND THINGS THAT ARE
DIFFERENT AND STRANGE FROM WHAT
IN THEIR MIND IS RESEARCH AND I
WAS A CHEAP HIRE IN TERMS OF
STARTING FUNDS AND I THINK IT'S
INTERESTING IN TERMS OF
EVENTUALLY AFTER MANY
CONVERSATIONS AND TALKING TO
FOLKS IT'S GETTING THINGS
APPRESSED AND DONE AND ALSO
REALIZIING A LOT OF THIS IS
CONSUMABLE.
AT LEAST WHEN I SPEND $45,000 ON
THE FANCY MACHINE AND BELONGS TO
THE UNIVERSITY EVEN IF YOU
LEAVE.
SO THAT HAS BEEN AN INTERESTING
WAY TO THINK OF HOW TO PRESENT
THIS WORK AND IT'S IMPORTANCE
AND SAME BUDGETARY LINES AND
GRANT FUNDING.
IT GOES BACK TO THE VALUE THAT
IS SEEN FROM THIS WORK I THINK
ACROSS WHERE WE MIGHT BE GETTING
THIS MONEY FROM.
I JUST WANTED TO REITERATE THAT.
IT'S POSSIBLE.
A POSITIVE.
>> CATHY: THAT MAKES ME THINK OF
HOW WE HAVE TO BE GOOD WE HAVE
TO BE ABLE TO CONVEY THE
IMPORTANCE OF OUR WORK IN ALL
KINDS OF VENUES LIKE WITHIN OUR
INSTITUTIONS, OUTSIDE OF OUR
INSTITUTIONS AND GRANT WRITING.
ALL THESE THINGS ARE AN
IMPORTANT PIECE OF CONTINUING TO
GROW THE D&I WORLD.
ONE MORE SUBTOPIC THAT CAME UP
THAT IS SOMETHING I WOULD HAVE
NEVER THOUGHT OF WAS FUNDING AT
INSTITUTES LIKE THEY FOCUS ON
CLINICAL POPULATIONS BUT THERE'S
CRITICAL D&I WORK THAT FOCUSES
ON NON-CLINICAL OR NON-PATIENT
POPULATI
POPULATIONS THAT WAS A HARD AND
FAST FUNDING ISSUE THAT IS
IMPORTANT WE TALK ABOUT IN THE
ISSUE.
>> I THINK THAT WAS ME.
I WAS WONDERING HOW TO WORK THAT
IN.
I'M WRITING A GRANT AND THINKING
HOW TO THEY LINE WITH NIDCD IT'S
HONESTLY KIND OF A STRUGGLE
BECAUSE I DO FEEL -- I'M AN
AUDIOLOGIST.
I FEEL AT HOME AT THE NIDCD AND
THIS WAS COMMUNITY BASED AND
COMMUNITY ENGAGED AND SO I'M
VERY PROUD TO BE SUPPORTED BY
THE NIDCD BUT IN LOOKING AT THE
STRATEGIC PLAN IT FEELS
BIOMEDICAL.
I DONT SEE HOW MY RESEARCH HAS
ANY SPECIFIC PLACE THERE BECAUSE
EVEN A D&I STRATEGIC AIM IS
FOCUSSED ON CLINICAL POPULATION.
AND FOR AUDIOLOGY THIS MAYBE
RELEVANT FOR SPEECH PATHOLOGY
AND WE HAVE SUCH A LIMITED
WORKFORCE RECENTLY WE'RE LOOKING
FOR NON-CLINICIANS TO PART UNDER
WITH AND EXPAND RESOURCES SO
WE'RE ABLE TO REACH A GREATER
POPULATION AND DECREASE
INEQUITIES.
SOME OF THE D&I WORK THAT'S
GOING TO BE DONE CURRENTLY AND
IN THE FUTURE DOESN'T HAVE TO
DO -- NOT IS SET IN A CLINIC.
DOESN'T HAVE TO DO WITH
PATIENTS.
SO I WOULD HOPE IN THE FUTURE WE
COULD HAVE A MORE EXPANDED
DEFINITION OF WHAT D&I IS AND
WHAT AUDIOLOGY IS IT DOESN'T
ALWAYS HAPPEN IN THE CLINIC.
AND TO ENCOURAGE RESEARCH THAT
IS ALL ENCOMPASSING BUT RELEVANT
TO THE NIDCD.
>> CATHY: AND YOUR PARTICIPANTS
ARE PER SE COMMUNITY WORKERS AND
ALL OF PEOPLE.
OTHER THING THAT WAS PREVENTION
WORK SOMEONE BROUGHT UP
CONVENTION WORK AND THE
CHALLENGES OF FUNDING WITH THAT
AND I DON'T REMEMBER IF THAT WAS
YOU OR SOMEBODY ELSE THAT
BROUGHT THAT UP.
THOSE INDIVIDUALS ARE NOT
PATIENTS.
THAT'S NOT HAPPENING IN THE
CLINIC.
SO IT'S SEMANTICS BUT WHEN YOUR
WRITING A GRANT THAT'S ALL IT IS
FOCUSSED ON THE SPECIFIC WORDS
AND TRYING TO ALIGN THEM WITH
THE STRATEGIC PLAN SO STUDY
SECTION GREEN LIGHTS EVERYTHING
YOU'RE DOING AND IS ON BOARD
WITH WHAT YOU'RE TRYING TO SAY.
IN MY MIND AND IN MY HEART I
KNOW THIS IS WHAT THE NIDCD
WANTS TO FUND BUT MAKING THAT
CONNECTION IS SOMETIMES
CHALLENGING BETWEEN THE
STRATEGIC PLAN IS WRITTEN SO IN
MY READING OF IT IT READS AS
PRETTY BIOMEDICAL.
>> THAT MAY TAKE US NICELY INTO
THE LAST TOPIC WHICH IS TRAINING
AND I DON'T KNOW THIS IS THE
WHOLE SOLUTION BUT PERHAPS PART
OF THE SOLUTION IS BEING ABLE TO
WORK WITH SOMEBODY WHO HAS MORE
D&I FUNDING EXPERIENCE AND
SUCCESSFULLY FUNDED WITH THE
POPULATIONS TO HELP GUIDE THE
WAY AND SO THE LAST BIG TOPIC
THAT CAME UP WHEN WE TALKED WAS
THIS LACK OF D&I EXPERTISE IN
COMMUNE SCIENCES AND DISORDERS.
ANYBODY WHO WANTS TO TALK ABOUT
THAT TOPIC A LITTLE BIT WOULD
LOVE TO HEAR YOU FROM ABOUT
THAT.
>> I HAVE A RECENT EXPERIENCE.
LAURA AND I SUBMITTED AN R01
TOGETHER AND A CRIT D&I WORK.
-- CONSIDER IT D&I WORK.
A COUPLE MONTHS LATER I GOT AN
E-MAIL INVITING ME TO BE PART OF
THE STUDY SECTION I WAS EXCITED
AND I HAVE A GRANT BEING
REVIEWED DURING THE SAME TIME
PERIOD AND I DIDN'T FIND THAT
UNTIL SHE DISINVITED ME BECAUSE
THEY WERE REVIEWING THE GRANT.
I HAVE A PRETTY GOOD FEELING THE
REASON SHE INVITED ME TO ARE
REVIEW REVIEW THE GRANT AND
DIDN'T REALIZE I WAS THE P.I. OF
THE GRANT.
AND ASKING ME TO REVIEW LAURA
AND THE GRANT WHO ELSE ARE THEY
GOING TO ASK?
I'M THE ONE THEY REACHED OUT TO
REVIEW WHO ELSE ARE THEY GOING
TO ASK TO REVIEW IT.
THE HYPOTHESIS COULD BE
INCORRECT BUT SEEMS LIKE A
STRANGE COINCIDENCE THAT'S A
FUNNY AND RECENT STORY.
>> CATHY: THANKS, MICHELLE.
HAVE THE REST OF YOU HAD
CHALLENGES WITH FINDING PEOPLE
WHO HAVE D&I EXPERTISE?
MORE EXPERTISE THAN YOU FEEL
LIKE YOU DO TO HELP YOU PUTTING
TOGETHER GRANT PROPOSALS AND
THINGS LIKE THAT?
GO AHEAD, GEN, YOU'RE UNMUTED.
>> GEN: WHEN I WAS GETTING MY PD
DOESN'T HAVE ANYONE IN MY
UNIVERSITY THAT WAS IN THIS
HEALTH SERVICES RESEARCH SO
REACHING OUT ACROSS INSTITUTIONS
AND FOUND DR. MORRIS AND I WANT
TO MAKE A PLUG FOR HEALTH
SERVICES RESEARCH THAT I THINK
WAS KIND OF LIKE THE SEED OF
PLANT OF IMPLEMENTATION SCIENCE
AND IT'S THE STUDY OF ALL THE
STRUCTURES AND CONTEXT NATALIE
WAS TALKING ABOUT LIKE THERE'S
ONLY SO FAR YOU CAN GO WITH
LIMITATIONS AND THAT'S ANOTHER
VACUUM IN OUR FIELD SERVICE USES
THE SAME E.H.R. DATA AND
POPULATION LEVEL DATA MIXED
METHODS AND BECAUSE WE DON'T
HAVE THAT HISTORY OF THOSE REAL
WORLD DATA TYPES I THINK WE'RE
STARTING FROM SCRATCH KIND OF
WHEREAS OTHER FIELDS HAVE
STARTED TO BUILD THE FOUNDATION
WITH THE HEALTH SERVICES
RESEARCH AND HAVE TOOLS TO USE
AND GO AND IMPLEMENT WITHIN A
REAL-WORLD SETTING BECAUSE THE
HEALTH CARE RESEARCH IS LIKE
REAL WORLD RESEARCH METHODS YOU
NEED TO STUDY REAL WORLD
OUTCOME.
>> GO AHEAD, MATT.
>> SO TWO OF THE INDIVIDUALS A
PART OF THIS WORKSHOP ARE KEY
COLLABORATORS OR CO-P.I.s WITH
WORK I'VE DONE.
AS FAR AS SUCCESS STORIES I'M
HOPEFUL WE'RE REALIZING WHERE
SOME OF OUR CHALLENGES ARE AND
THAT MAYBE WE CAN SEE WHAT'S THE
OUTPUT OF THIS WORKSHOP BUT
MAYBE AS WE'RE OFTEN ABLE TO
NETWORK WITH PEOPLE IN PERSON.
OF COURSE WE'RE MAKING THE MOST
OF THE TIME AND RESOURCES WE
HAVE BY DOING THIS VIRTUALLY BUT
IF WE CAN NETWORK AFTER THE
WORKSHOP I'D WELCOME IT.
I'D LOVE TO HAVE A FRESH
PERSPECTIVE AND SOME ONGOING AND
NEW OPPORTUNITIES FOR
COLLABORATION.
I WOULD WELCOME IT AND LOOKING
AT WHY THERE ARE AREAS OF
STRENGTHS ARE HELPFUL.
I KNOW -- I FEEL IN SPIED OF THE
MIXED METHODOLOGY PART OF MY
RESEARCH GRANTS I FEEL VERY
UNSETTLED ABOUT MY QUALITATIVE
RESEARCH EXPERTISE AND LEARNING
FROM PARTNERS AND COLLEAGUES WHO
DO WORK METHODOLOGICALLY AND
QUALITATIVE STRAINS AND A PART
OF IMPLEMENTATION OUTCOMES IS
SOMETHING I COULD DO AND I WOULD
SAY LET'S TALK.
LET'S FIND WAYS TO PUT TOGETHER
AND ME AS AN OLD SCHOOL
QUANTITATIVE RESEARCH EVER I
VALUE THE MIXED METHOD APPROACH
BECAUSE I DON'T FIND IT IN OT
OTTO -- OTOLARYNGOLOGY.
>> CATHY: WE'VE HAD A SUCCESS
STORY OF COMMUNITY BUILDING OUR
OWN RESEARCH COMMUNITY TO HELP
OURSELVES THROUGH THE PROCESS.
SO GO AHEAD, CRYSTLE AND WE'LL
WRAP UP AND START TAKING
QUESTIONS AND ANSWERS FROM THE
CROWD.
GO AHEAD.
I WAS GOING TO DO THE ISSG SHOUT
OUT.
IT LEADS TO THE TOPIC OF LACK OF
D&I EXPERTISE.
WE HAD TO SEEK IT OUT OURSELVES
AND FOUND OUR EXPERTS AND I FEEL
LIKE THEY'RE ALSO OVER BURDENED
AND I WORRY ABOUT THEY'RE
CONSTANTLY REACHED OUT AND WE
HAVE SO FEW ALWAYS ON THE PANELS
OR ALWAYS ON THE IS FOR ALL
CONFERENCE.
THEY'RE THE ONES WHO ARE ALSO
BEING ASKED TO BE KEY NOTES.
WE'RE CONSTANTLY SEEKING THEM
OUT AND THEY'RE SO WONDERFUL AND
GREAT AND WANTING TO SHARE THAT
KNOWLEDGE AND EXPERTISE BUT I DO
ALSO THINK ABOUT THIS FROM A
PERSPECTIVE OF TRYING TO PUT
TOGETHER A K AWARD OF WHAT WILL
THE STUDY SECTIONS OR REVIEW
MECHANISMS THINK WHEN IT'S THE
SAME FEW PEOPLE BEING ASKED TO
KIND OF MENTOR BUT MATT WAS JUST
SAYING ADJACENT LIKE WORK IN
NURSING HOMES AND I WANT TO DO
STUFF IN SCHOOLS AND SO LIKE IS
THAT EXPERTISE FOR MENTORING AND
TRAINING OB A TRAINING GRANT
GOING TO BE SEEN AS APPROPRIATE
OR REACHING OUT TO THE
CARD-CARRYING D&I SCIENTISTS AND
SAYING SO YOU DO WORK IN
COMMUNITY AND CLINIC SETTINGS
BUT I WANT TO DO THIS IN SCHOOLS
AND THEY'RE STILL HESITANT OF
SAYING YOU HAVE TO FIND THE
INTERVENTION EXPERTISE MENTOR
WHO WILL BE PRIMARY.
I CAN CONSULT ON SOME FRAMEWORKS
OR SOME METHODS IF THAT'S WHAT
YOU NEED BUT IT IS CHALLENGING,
WHERE'S MY QUALITATIVE
METHODOLOGISTS.
I NEED THAT PERSON AND HOW DO I
FIND THEM WHEN I HAVE NO IDEA
WHERE TO START?
IT'S BEEN A CHALLENGE FOR ME AS
WELL AS REACHING OUT AND THEN
HEARING NOTHING BACK.
LAURA CAN TALK ABOUT THAT AND MY
WORK MAY NOT BE INTERESTING FOR
THEM TO ADD ON TO THEIR C.V. AS
SOMETHING THEY'D WANT TO START A
LINE FOR BECAUSE IT'S SO FAR TO
THE LEFT FOR THEM.
THAT HAS BEEN CHALLENGING.
IT'S LIKE SHOULD I GO GET
TRAINED IN QUAL TASTIVE ME IIVE
QUALITATIVE METHODS?
THAT'S.
I DON'T WANT TO DO THAT.
I WOULD LIKE TO FIND A
COLLABORATOR TO DO THAT.
THAT FOR ME HAS BEEN I THINK A
CHALLENGE TO TRYING TO FIND
THESE LEADERS INTERESTED IN THE
WORK I WANT TO DO.
>> AS WE'RE IN THE INTERIM
PERIOD OF TRYING TO BUILD THIS
BUT WE DON'T HAVE THE LEADERSHIP
AND ALL OF YOU ARE GOING TO
BECOMING THOSE PEOPLE AND GET
FROM HERE TO THERE AND PUT THE
PIECES TOGETHER AND HOW DO YOU
SELL AN APPLICATION WHEN THE
METHODOLOGY TO BE FRONT AND
CENTER.
THAT'S DIFFERENT TOO.
NEEDING THE EXPERTISE AND THOSE
ARE INTERESTING CHALLENGES.
THAT WRAPS UP OUR CATHY BINGER
GUIDED REVIEW OF SOME TOPICS WE
HAVE AND I THINK WE'RE READY TO
GO INTO OUR Q&A SECTION.
>> WE HAVE SOME IN THE CHAT AND
IF YOU'RE WILLING TO SAY THEM
OUT LOUD RAISE YOUR HAND.
AND CATHY WILL MODERATE THIS
PART AND WE'LL CALL ON FOLKS
WITH THEIR HANDS UP.
JILL YOUR FIRST.
>> HI, THANKS SORE THE GREAT
BEGINNING OF THE MEETING.
IT'S REALLY GREAT.
AND IT'S SO LOVELY TO HAVE THIS
NICE YOUNG PANEL AS I FACED THE
END OF MY CAREER I'VE BEEN DOING
IMPLEMENTATION SCIENCE RELATED
RESEARCH FOR ABOUT 30 YEARS
WITHOUT KNOWING THAT'S WHAT I
WAS DOING.
AND IT'S HARTENING TO SEE THE
NEW GENERATION OF PEOPLE VERY
INTERESTED.
AS I FACED SO MANY SO MUCH
DISCOURAGEMENT OVER THE YEAR IN
TRYING TO GET HEALTH SYSTEMS
INTERESTED IN MY WORK AND HAD
PEOPLE WHO WORK IN HEALTH
SYSTEMS AND IT SEEMS TO ME AND I
WANT TO KNOW IF I'M RIGHT ON
THIS OR NOT THAT COUNTRIES THAT
HAVE NATIONAL HEALTH SYSTEMS IN
WHICH PRACTICE ARE BASED ON
EVIDENCE SEEM TO HAVE MORE
SUCCESSFUL IN DOING D&I RESEARCH
AND GETTING AND THEN
IMPLEMENTING NEW EVIDENCE-BASED
PRACTICES INTO THE SYSTEM.
I WANT TO KNOW IF I'M RIGHT ON
THAT.
RELATED TO THAT, THE V.A. SYSTEM
SEEMS THE CLOSEST WE HAVE TO
THAT AND IT DOES SEEMS LIKE IT
HAS BEEN EASIER TO GET D&I
RESEARCH IMPLEMENTED THERE AND
THEN MY FINAL HAVE VERY DE
PRESSING THOUGHT IS HERE WE ARE
IN 2023 IN THE U.S. HEALTH CARE
SYSTEM WHERE PRACTICES AND
HOSPITALS ARE BEING BROUGHT BY
PRIVATE EQUITY WHO JUST WANT TO
MAKE MONEY AND THEN GET RID OF
IT.
HOW DO WE START GETTING --
IMPLEMENTING EVIDENCE-BASED
PRACTICES IN THE U.S. HEALTH
SYSTEM WHEN THIS IS WHAT'S
HAPPENING?
THANK YOU AND SORRY FOR BEING SO
DE PRESSING.
>> CATHY: ANYBODY WANT TO TACKLE
ANY OR ALL OF JILL'S THOUGHTS OR
QUESTIONS?
>> I CAN RELATE MY RESEARCH IS
VERY MUCH MEETING THE HEALTH
ORGANIZATIONAL PARTNERSHIP AND
SPEAKING TO YOUR QUESTION OF HOW
TO GET HEALTH CARE ORGANIZATIONS
WHICH ARE VERY VERTICALLY
ALIGNED THESE DAYS INTERESTED IN
BEING PARTNERS THE WAY THAT --
TE ONLY WAY I UNDERSTAND IT WITH
THE INCENTIVES THAT HEALTH CARE
ORGANIZATIONS ARE BEING DRIVEN
BY THESE DAYS IS YOU HAVE TO
ALIGN YOUR OUTCOMES WITH WHAT
THEIR INTERESTED IN WHICH IS NOT
SOMETHING WE'VE TRADITIONALLY
DONE SO THOSE ORGANIZATIONAL
OUTCOMES LIKE PREVENTIVE CARE OR
REDUCTION OF E.D. VISITS OR
LENGTH OF STAY REDUCTION, THAT'S
LIKE THE BOTTOM LINE FOR HEALTH
CARE OHS AND I THINK THAT THAT
AGAIN IS WHERE WHERE MY HEALTH
RESEARCH SERVICES HAT COMES IN
WHERE WE DON'T HAVE ALL THOSE
METHODS AND EXPERTS IN MEASURING
THOSE TYPES OF OUTCOMES AND THE
DATA CAPACITY RIGHT THERE FOR US
TO MEASURE THE OUTCOMES THAT
ORGANIZATIONS ARE INTERESTED IN
AND WE CAN SHOW OUR
INTERVENTIONS IMPROVE YOUR
BOTTOM LINE AND THE OUTCOMES
YOU'RE INTERESTED IN IN
PARTNERING TOGETHER BUT IT'S A
CHICKEN AND EGG THING BECAUSE WE
DON'T YET HAVE THAT AND THE LAST
THING IS THAT I KNOW BACK TO
THAT LEARNED HEALTH SYSTEMS
NETWORK THEY'RE TRYING TO DO
THAT WITH BUILDING INROADS AND
GET ACCESS.
>> THERE'S A LOT OF GOOD
QUESTIONS AND I'M NOT GOING TO
TRY TO ANSWER THE SECOND
QUESTION BUT IT'S SOMETHING
GREAT TO THINK ABOUT.
THE FIRST QUESTION I THINK
YOU'RE TOTALLY ON THE RIGHT
TRACK AND I'M A TELEHEALTH
RESEARCHER AND IT'S BEEN
CHALLENGING TO IMPLEMENT
TELEHEALTH AND SPEECH
PATHOLOGISTS ARE WAY AHEAD OF US
BUT IN THE V.A. THEY IMPLEMENTED
IT BETTER AND IT'S A COORDINATED
HEALTH SYSTEM INTO FUNDING AS
NOT AS MUCH OF AN ISSUE IN THE
V.A. AND THEIR AUDIOLOGISTS WILL
PROVIDE TELEHEALTH BECAUSE IT'S
BUILT INTO THEIR SYSTEM AND A
GREAT POINT TO BRING UP.
>> JARRAD: I WANTED TO THROW MY
HAD IN AND SAY REINFORCE SOME OF
THE BARRIERS I'VE EXPERIENCED
LIKE THE FUNDING ASPECT AND I
AGREE THE FUNDING FOR D&I WORK
PRIMARILY GOES THROUGH THE PAR
AND WHILE IT'S AN OPTION AND
NIDCD IS ON IT IT GOES THROUGH
D&I HARDCORE PEOPLE.
WE WANT TO SEE D&I PUSH AHEAD
THE TECHNIQUES AND MAY NOT
ALWAYS BE SOMETHING THAT RIGHT
NOW OUR FIELD IS READY FOR BUT
WE CAN USE THE TOOLS ALREADY
THERE OR SOMETHING THAT IS D&I
SPECIFIC WOULD BE A GOOD WAY TO
FUND WORK THAT'S D&I AND BUILD
CAPACITY AND BE COMPETITIVE FOR
THAT STUFF IN THE FUTURE.
THERE'S ALSO THE D&I PEOPLE I
TALK TO IN THE PANEL SAYING
WHERE PEOPLE DIE OR GET SICK AND
COMMUNICATION AND REHAB IN
GENERAL TENDS TO LOOK LOWER ON
THE SIGNIFICANCE LEVEL ON THE
PANEL.
AND ASHA I AGREE THERE WOULD BE
MORE TO SUPPORT IT MAYBE A SIG
OR SOMETHING BASED ON THAT
BECAUSE AT THE AMERICAN CONGRESS
OF REIMPLEMENTATION MEDICINE
THERE'S GROUP SURROUNDING JUST
D&I.
IT'S BROUGHT A BUNCH OF
MULTI-DISCIPLINARY PEOPLE
TOGETHER.
I JUST WANTED TO FLUSH OUT SOME
THINGS FROM MY EXPERIENCE ON
THAT.
>> AND START A SIG AND PUSHING
FORWARD AND TRYING TO WORK ON A
SIG AND SASHA ON IMPLEMENTATION
SCIENCE.
MAYBE THAT'S SOMETHING WE NEED
TO COME BACK TO AGAIN.
GOOD THOUGHTS.
AND I REMEMBER WHAT YOU GAVE AT
THE CONFERENCE THAT STARTED MANY
INTEREST AT THE ASHA FOUNDATION
WONDERFUL CONFERENCE.
IT WAS NICE TO SEE YOU.
>> THANK YOU.
I GUESS I AM THE OLD GUY IN THE
GROUP BECAUSE THERE WAS NO
IMPLEMENTATION SCIENCE WHEN WE
STARTED MUCH OF THE WORK IN
PEDIATRIC HEARING LOSS.
THERE WERE NO SYSTEMS DEVELOPED
AND 142 HADN'T BEEN PASSED EVEN
EARLY CHILDHOOD SPECIAL ED
WASN'T PASSED UNTIL THE 1980s.
AND THEY DIDN'T HAVE MONEY
ATTACHED TO IT AND THE SYSTEMS
WERE BUILT THAT WAY BECAUSE AS
YOU KNOW ONCE THE PUBLIC LAWS
CAME IN AND EVERYTHING WAS
LOCALLY BASED, EVERY SCHOOL
DISTRICT CAN DECIDE ON THEIR OWN
NOT -- THEY DON'T HAVE TO WORK
WITH ANYBODY ELSE.
THEY CAN JUST MAKE THEIR OWN
DECISIONS OR ANYTHING IN SPECIAL
ED.
NOW, PERHAPS BECAUSE WHAT WE
WERE WORKING ON WAS A
LOW-INCIDENCE DISABILITY AND
DEAFNESS WAS SOMETHING ALL THE
DISTRICTS ESPECIALLY THE SMALL
DISTRICTS STRUGGLED WITH, IT WAS
GOOD AND EASY RELATIVELY EASY TO
GET ALL 52 SCHOOL DISTRICTS IN
THE STATE TO VOLUNTARILY
COOPERATE IN A STATE-WIDE
SYSTEM.
THAT STARTED UNTIL EARLY 1970s
AND IT WAS VOLUNTARY IN 1970 AND
VOLUNTARY IN 2023.
WE STILL HAVE A STATEWIDE SYSTEM
IN WHICH TO DISSEMINATE
INFORMATION AND ROLL OUT
INTERVENTIONS AND COLLECT DATA
MANAGEMENT FROM VIRTUALLY EVERY
TITLE IN THE POPULATION OF
COLORADO THAT IS DEAF AND HARD
OF HEARING.
ALL THE WORK WHICH IS COMMUNITY
BUILDING HAPPENED BEFORE THERE
WAS ANY TECHNOLOGY TO DO
ANYTHING WITH DEAF AND HARD AND
HEARING.
COLORADO THE MOST SOCIALIZED
SYSTEM ANYWHERE IN THE WORLD
FROM BIRTH THROUGH 18 YEARS OF
ABLE AND WANTED TO COMMENT ON
JILL'S COMMENTS.
I WORKED WITH SYSTEMS ALL OVER
THE WORLD, MANY OF THEM DIVERSE
SOCIALIZED SYSTEMS AND WOULD NOT
SAY IT'S EASIER TO IMPLEMENT.
THERE ARE SOME THINGS EASIER TO
IMPLEMENT IN SOCIALIZED SYSTEMS
BUT THEY'RE ALSO FRAGMENTED AND
IT DOESN'T WORK WITH EARLY
INTERVENTION OR WITH THE SCHOOL
SYSTEMS.
THEY'RE ALL LOCALLY BASED.
THEY MAY BE ABLE TO ROLL
SOMETHING OUT IN ONE SEGMENT BUT
EVERY SYSTEM THAT I'VE WORKED
WITH HAS HAD PROBLEMS BECAUSE
THEY TRIED TO PUSH SOMETHING
DOWN FROM THE TOP WITHOUT HAVING
THE BUY IN FROM THE BOTTOM.
YOU CAN REP ANY SYSTEM BUT IF
YOU DON'T FOLLOW THE SYSTEM YOU
DON'T GET PAID SO THERE'S HIGH
INCENTIVE AND IF THEY'RE NOT
BROUGHT IN AND DON'T BELIEVE IN
WHAT YOU'RE DOING OR AGREE WITH
WHAT YOU'RE DOING, THERE'S ALL
KINDS OF PROBLEMS THAT CAN
DEVELOP BECAUSE OF THAT SO WHAT
YOU'RE TALKING ABOUT MAKES ME
EXCITED BECAUSE I HAD A VERY
HARD TIME WHEN WE WERE APPLYING
FOR RESEARCH GRANTS OR SYSTEMS
DEVELOPMENT GRANTS GETTING
COMMUNITY PARTNERS AS STAFF IN
THOSE GRANT PROPOSALS BECAUSE WE
HAD DEAF AND HEARD OF HEARING
LETTERS AND HAD PARENTS THAT
DEVELOPED PARENT SUPPORT.
WE WERE WORKING ON RESERVATIONS
AND WORKING ON INNER CITIES AND
IN THE RURAL AREAS THEY HAVE
TOTALLY DIFFERENT COMMUNITY
SYSTEMS.
IT MAKE ME EXCITED TO HEAR
THAT'S A BASIC PART OF ALL THE
IMPLEMENTATION SCIENCE AND WE
HAD TO REACH OUT TO OTHER
PARTNERS LIKE PETE TRICKS AND --
PEDIATRICS AND NURSING AND EAR
NOSE AND THROAT THEY HELPED US
AND THE FORMULA HAS WORKED IN
EVERY COUNTRY WE PROVIDED
SUPPORT FOR UNIVERSAL INFANT
SCREENING.
THERE'S SOMETHING ABOUT THE
U.S. SYSTEM THAT REINFORCES
CREATIVITY TO BUILD SYSTEMS THAT
CAN BE DISSEMINATED NOT ONLY
THROUGHOUT THE UNITED STATES BUT
GLOBALLY.
IT WASN'T A QUESTION BUT A
RESPONSE MAINLY TO JILL'S.
ONE OTHER COMMENT AND THAT IS
THAT ALL OF YOU HAVE SAID PEOPLE
HAVE TOLD ME DON'T DO THIS AND
MY CAREER THEY'VE TOLD ME DON'T
DO TEACHING GRANTS AND I'VE
IGNORED IT AND ALL THE PIECES
MADE IT POSSIBLE TO BUILD THE
SYSTEMS AND WITHOUT THOSE PIECES
IT WOULDN'T HAVE HAPPENED.
>> I WAS TOLD NOT TO DO
INTERVENTION RESEARCH OR YOU
WON'T GET TENURE AND I SAID I
WILL AND I'LL GET TENURE.
WATCH ME.
THE INITIAL STAGES ARE SIMILAR
AND STILL TAKES SOME OF THAT
CHUTZPAH TO BUILD THE SYSTEM AS
WE MOVE ALONG HERE.
>> I HAVE ONE QUICK COMMENT AND
I'LL TRY TO BE BRIEF.
AS I WAS LISTENING ONE THING
THAT CAME TO MIND AS WE CONSIDER
D&I RESEARCH AND I'M NOT AN
EXPERT BUT TYING EVIDENCE WITH
LEVEL 1 EVIDENCE ALLOWS FOR CMS
CLAIMS TO BE MADE.
THERE'S A MEDICARE COVERAGE
PROCESS OR THE NATIONAL
DETERMINATION NCD WHETHER IT'S
MEDICARE OR MEDICAID THAT ALLOWS
FOR THE IMPLEMENTATION OF
PROCEDURES TO BE DONE IN A WAY
THAT'S AVAILABLE.
IT'S LIKELY GOING TO BE COVERED
BASEBALL THE INSURANCE PAYERS
AND THERE'S A LOWER LIKELIHOOD
IT WILL BE BUILD FOR AND WITHOUT
THE ABILITY TO BILL FOR IT
REDUCES THE FACT PEOPLE WILL
HAVE TIME TO DO IT.
SO THIS IS ALSO TO EMPHASIS THE
NEED FOR LEVEL 1 EVIDENCE AND
THE PHASED 1 OR CLASSIC EVIDENCE
SOMETIMES NOT THE SEXIEST ONE
BUT ON THE INITIAL TRIAL THEY'RE
NECESSARILY WITHOUT THOSE WE
CAN'T GET ACCREDITATION AND
BUILD OR IMPLEMENT.
I'M SURE YOU GUYS HAVE MORE
EXPERIENCE THAN I HAVE WITH THIS
BUT THOUGHT I'D PUT IT OUT
THERE.
>> ANYONE HAVE THOUGHTS OR
RESPONSES TO THAT?
I THINK THAT WAS MORE A COMMENT.
MEGAN, GO AHEAD.
JESS, DID YOU HAVE YOUR HAND UP?
>> JESS: I DID BUT I DON'T HAVE
A VOICE.
CAN YOU HEAR IS THE
>> CATHY: WE CAN HEAR YOU.
>> JESS: CANADA HAS PARTNERSHIPS
WITH PEOPLE IN CANADA, U.S.,
FRANCE ALL AROUND AND IT'S
DEVELOPING THAT EVIDENCE THAT
WAS TALKED ABOUT TO HAVE SOCIAL
PRESCRIPTIONS FOR THESE
INTERVENTIONS.
THE WAY THEY'RE TRYING TO GO
ABOUT THEIR RESEARCH IS LINKED
TO WHAT WE'RE TALKING ABOUT HERE
AND SORRY ABOUT THE VOICE.
>> CATHY: THANKS FOR CHIMING IN.
MEGAN, GO AHEAD.
>> MEGAN: I WANTED TO RETURN TO
THE ACADEMIC OR STRUCTURAL
BARRIERS MANY OF US FEEL LIKE
YEAR UP AGAINST AND MANY
DESCRIBED YOU HAVE TO DEVELOP
THESE TWO LINES.
ONE TO GET YOU TO TENURE AND
BUILD ON THE COMMUNITY
RELATIONSHIPS AND EVENTUALLY DO
THE D&I WORK AND WHY ARE WE
DOING THAT?
HAVE YOU GIVEN THOUGHT OR TRIED
STRATEGIES YET DOCUMENTING WHAT
YOU'RE DOING IN THAT PROCESS
THAT PUTTING OTHER THINGS INTO
PLACE THAT COULD BE USED INSTEAD
OF THE CURRENT OCCURRENCE OF
GRANTS AND PUBLICATIONS TO
DOCUMENT THE WORK WE ARE DOING
IN DISSEMINATION AND
IMPLEMENTATION.
>> GREAT QUESTION AND A STARTED
APPROACHING A LOT OF THE THINGS
I DO VERY QUANTITATIVELY.
IN REACHING OUT TO THE SCHOOL
PARTNERS AND PRINCIPLES,
ADMINISTRATION, I LOG WHEN I
REACHED OUT, WHO I REACHED OUT
TO, WHAT THEIR POSITION IS, DID
I GET A RESPONSE, WHAT DID THE
RESPONSE LOOK LIKE AND IT COULD
BE YES, NO, YES, NO, YES, NO.
WHAT'S THE SAMPLE OF FOLKS I
REACHED OUT TO THAT CAN GIVE US
MORE INFORMATION AS TO WHAT THE
BARRIERS ARE IN ESTABLISHING THE
PARTNERSHIPS AND RESPONSE RATE
AND I'VE CONTINUED TO THINK
BEFORE WHERE I'M INVESTING MY
TIME AND HOW IT CAN LEAD TO MORE
INFORMATION FOR THE FIELD.
>> THANKS, GENESIS.
MATT.
>> MATT: JUST WANTED TO COMMENT
WITH THE PROMOTION AND TENURE
PROCESS.
WHEN YOU'VE SEEN ONE
UNIVERSITY'S SYSTEM FOR APT
YOU'VE SEEN ONE UNIVERSITY
SYSTEM AND THEY'RE ALL DIFFERENT
AND ALL OF US ON THIS PART OF
THE CALL'S PATH OF SUCCESS IS
VERY DIFFERENT.
I'VE SURFED ON THE APT COMMITTEE
FOR OUR INSTITUTION AND MANY OF
THESE PRACTICE PLANS AND
PROMOTION LINES FOR DEPARTMENTS
AND COLLEGES ARE BASED ON
REGIONAL AND NATIONAL PROMINENCE
AND SO THIS IS WHERE YOU CAN
DEMONSTRATE AND SOMETIMES
REGIONAL IS DEFINED BY WITHIN
THE UNIVERSITY OUTSIDE OF YOUR
DEPARTMENT.
SOMETIMES IT'S WITHIN A CERTAIN
REGION OF THE STATE YOU MIGHT BE
IN BUT IF YOU CAN DOCUMENT OR
HAVE LETTERS OF RECOMMENDATION
FROM COMMUNITY ADVISORY BOARDS
AS WELL AS PARTNERS IN DATA AND
EDUCATIONAL ORGANIZATIONS THAT
IN A SENSE CAN REPRESENT EITHER
PROXIES OR AS ATTESTATIONS TO
THE WORK THAT YOU'VE DONE TO
TAKE RESEARCH AND TRANSLATIONAL
WAY DEMONSTRATING TRANSLATIONAL
VALUE, THAT HAS SAT VERY WELL AT
LEAST IN OUR APT COMMITTEE AND
DEMONSTRATES IT DOESN'T JUST
HAVE TO BE A CLINICIAN SEEING
PATIENTS FROM OTHER PART OF THE
STATE OR FROM OTHER STATE TO
DEMONSTRATE THAT RECOGNITION AND
NAME BUT AS A RESEARCHER AND
ACADEMICITION YOU DEVELOPED
THAT.
>> I THINK TINA HAS SOMETHING TO
SHARE TOO.
>> TINA: I WAS GOING TO POP IN
ABOUT PROMOTION AND TENURE AND
DEMONSTRATING THE VALUE OF THE
WORK YOU DID.
I DIDN'T WANT TO PUT IT IN THE
CHAT BECAUSE PEOPLE ON THE
VIDEOCAST CAN'T SEE THE CHAT.
FOR PEOPLE SHARING RESOURCES, I
JUST WANT TO MENTION NO ONE CAN
SEE IT EXCEPT FOR THE ZOOM
AUDIE
AUDIENCE AND SOME WE'LL SHARE
LATER IN THE WEBINAR AND THERE'S
THE TOOL CALLED THE
TRANSLATIONAL SCIENCE BENEFITS
MODEL AND IF YOU GOOGLE
TRANSLATIONAL SCIENCE MODEL IT
WAS DEVELOPED BY DOUG LUKE AT
WASH U WILL BE A PANELIST IN THE
SESSION TOMORROW.
IT'S A WAY -- THIS PRETTY COOL
FRAMEWORK WITH AN INTERACTIVE
TOOL TO DEMONSTRATE.
YOU CAN BASICALLY TACK TAKE A
PROJECT YOU DID AND LOOK AT HOW
MANY PEOPLE RECEIVED THIS AND
ACCESSIBILITY AND IF YOU HAVE A
SCHOOL THAT ADOPTED A PROGRAM
YOU DID AND THAT'S A REAL WORLD
IMPACT MOST OF OUR RESEARCH
NEVER ACHIEVE.
ALL THE STUFF THAT HOLLY
PRESENTED IN THE BEGINNING GOES
INTO JOURNALS AND THE SITS ON
THE LAB LIKE IT'S NOT IN THE
LIBRARY ANY MORE.
IT'S JUST SITTING THERE FOR NO
ONE TO READ OR DO ANYTHING
ABOUT.
IT'S A COOL WEBSITE I RECOMMEND
BECAUSE THERE ARE PLACES AND
PEOPLE WHO ARE MAKING ARGUMENTS
THAT THIS IS THE TYPE OF STUFF
THAT SHOULD BE ABOUT LIKE IN OUR
ANNUAL EVALUATION OR REVIEWS.
IT'S NOT PUBLICATION AND GRANTS.
IT'S DOING THIS STUFF WHICH IS
KIND OF THE GOAL OF ALL OF D&I
AND TRANSLATIONAL SCIENCE.
IF YOU HAVEN'T SEEN IT TAKE A
PEEK AT IT.
>> THANKS, CATHY.
>> CATHY: THANK YOU, TINA.
STEVEN.
>> IT'S BEEN A GREAT SESSION.
I LEARNED A HUGE AMOUNT AND
WANTED TO POP IN AND REPRESENT
ANOTHER NIDCD FAMILY THE SENSORY
PEOPLE AND WE ARE FAR BEHIND
WHERE THINGS ARE IN AUDITORY
RESEARCH AND SPEECH LANGUAGE.
I CAN'T THINK OF A PERSON IN OUR
FIELD DOING D&I RESEARCH BUT
IT'S GOING TO BE COMING DOWN THE
PIKE FOR US.
AS A MATTER OF FACT, THERE'S A
CONFERENCE FOR HOW TO GET THE
TESTING INTO THE U.S. AND
SCHOOLS AND OTHER LOCATIONS
WHERE WE CAN START TO ASSESS
THIS AND RIDE THE WAY TO CHEMO
SENSORY DISORDERS THAT HAVE COME
UP WITH COVID.
TRYING TO BETTER UNDERSTAND
WHAT'S NEEDED TO GET INSURANCE
COVERAGE FOR CHEMO SENSORY
TESTING AND ALL THE ISSUES
BROUGHT UP AND BRING THEM TO THE
FORE FOR SMELL AND TASTE
RESEARCH AND DISORDERS WELL.
I THINK HOPEFULLY MORE PEOPLE IN
OUR FIELD WILL BE JUMPING IN.
AND I WANT TO BRIEFLY BRING UP I
WOULD LIKE TO REITERATE ON PUT
IN MY BID FOR NIDCD SUPPORT
BEING AN INSTITUTE SPECIFIC FOA
IN TERMLY REVIEWED AND SPECIAL
SECTION WITHIN DCD.
I DON'T THINK FROM EVERYTHING
THERE'LL BE A SUBSTANTIVE
MOVEMENT IN THE CARDIO WORLD OR
WHATNOT.
IT WON'T BE AS PROGRESSIVE AS IT
IS IN OTHER FIELD.
THAT'S IT, THANKS.
>> WE'RE RUNNING OUT OF TIME.
THIS IS GOING SO FAST BUT WE
HAVE TIME FOR TEDDY.
>> THANK YOU FOR ALLOWING ME TO
BE PART OF THIS WONDERFUL PANEL.
I THINK THERE'S A LOT OF PEOPLE
HERE ON THE EARLY STAGES OF
CONSIDERING IMPLEMENTATION
RESEARCH AND THE FEAR OF
ENTERING THE AREA AND YOU'RE ALL
EXPERTS IN THE FIELD.
MY QUESTION TO ANYONE IS WHAT
ARE THE FIRST STEPS YOU TOOK TO
GET INVOLVED IN D&I RESEARCH AND
WHAT DID YOU FIND TO BE THE MOST
HELPFUL?
>> THE FIRST REALIZATION I HAVE
I WAS ENTRUSTED IN DIP -- D&I
WORK WAS WORKING IN THE CLINIC.
I'M A LICENSED AUDIOLOGIST AS
WELL AND DOING COMMUNITY-BASED
EVENT AND PARTICIPATING IN OUR
BRIDGE CLINIC WHICH PROVIDES
LOGISTIC AND REFERRAL AND SOME
TREATMENT SERVICES TO IN UNSURED
ADULTS AND GETTING INVOLVED WITH
THOSE GROUPS AND LIKE MINDED
PEOPLE INTERESTED IN WORKING
WITHIN THE COMMUNITY AND
IMPROVING CLINICAL OUTCOMES.
I DON'T KNOW IF THAT'S A GREAT
ANSWER BUT HOW I GOT STARTED AND
I WAS LIKE OH, I REALLY LIKE
THIS.
I WONDER IF ANYONE'S RESEARCHED
ON THIS AND IT'S LIKE, WELL THEY
HAVEN'T.
I'M GOING GET A Ph.D. AND I'M
GOING TO WRITE A BOOK AND THEN
ANOTHER GRANT AND ASK THIS
PERSON TO ASK THIS PERSON TO
HELP ME WRITE A GRANT BUT IT
STARTED IN THE COMMUNITY
PROGRAMS.
>> CATHY: THANKS, ANYBODY ELSE?
>> MATT: I'LL SAY I ATTENDED
TIDAR WORK TRAINING PROGRAMS.
THAT WAS MY BAPTISM INTO D&I
SCIENCE AND THE FIELD AND
METHODS AND THE GRANTS AND WAYS
TO GET CLEARER SENSE OF WHAT IT
IS AND ISN'T AND FORMALIZED
TRAINING WAS HELPFUL.
>> CATHY: GREAT.
I THINK WE'LL HEAR ABOUT MORE
OPPORTUNITIES THERE'S A NUMBER
OF D&I ONLINE AND TRAINING
OPPORTUNITIES OUT THERE.
ANYONE ELSE HAVE ANY QUICK
STORIES TO SHARE HOW YOU GOT
STARTED?
WHEN JOE MENTIONED SHE'S BEEN
DOING D&I RESEARCH 30 YEARS AND
DIDN'T REALIZE IT AND I HAVEN'T
BEEN DOING IT THAT LONG BUT IN
GRADUATE SCHOOL I WAS USING
TELEHEALTH.
THAT WAS D&I AND IN MY Ph.D.
PROGRAM I STARTED TO LEARN ABOUT
COMMUNITY-BASED PARTICIPATORY
RESEARCH AND LATER I STARTED TO
LEARN ABOUT FROM FOLKS IN AND
OUT SIDE THE FORMAL STRUCTURE OF
DAYNE AND HELPED ME REFLECT ON
WHAT I HAD BEEN DOING AND WHAT
MY MENTORS HAD BEEN DOING IN THE
PAST AND HELPED STRUCTURE AND
LEARN WHERE THE GAPS WERE AND
LEARNING ABOUT D&I FOR THE
FUTURE.
>> THANK YOU.
IT'S ABOUT TIME FOR A BREAK.
SORRY, I DIDN'T GET TO ALL YOUR
QUESTION AND A REMINDER FOR
THOSE ON THE ZOOM THE CHAT IS
JUST FOR A SMALL GROUP OF PEOPLE
AS TINA SAID.
IT'S NOT FOR EVERYONE WHO IS OUT
THERE LISTENING TO LET YOU KNOW
IT'S ONLY A SMALLER SUBSET OF
PEOPLE SEEING WHAT'S GOING ON IN
THE CHAT SECTION.
HOLLY DO YOU WANT TO INTRODUCE
THE BREAK?
>> WE'LL BE ON BREAK TO 3:30
EASTERN.
TAKE A BREAK.
IF YOU HAVE QUESTIONS WRITE THEM
DOWN BEFORE THE BREAK BECAUSE
THE NEXT SESSION WILL CONTINUE
ON THE THEME.
THEY'LL BE AN APPROPRIATE TIME
TO ASK THOSE QUESTIONS OR MAKE
COMMENTS IN OUR NEXT SEGMENT FOR
AUDIENCE PARTICIPATION.
THANKS SO MUCH EVERYONE.
LET'S GO AHEAD AND GET
STARTED AND WE INVITED FOUR
FOLKS TO TALK BRIEFLY ABOUT SOME
OF THE RESEARCH THEY'RE DOING IN
THE CONTEXT OF HOW THEY HAVE
OVERCOME SOME OF THE CHALLENGES
THAT THEY'VE FACED IN DOING THIS
TYPE OF WORK AND WE'RE HOPING
THIS WILL BE A LITTLE BIT OF A
RESPONSE TO SOME OF THE THINGS
WE JUST HEARD IN THE LAST PANEL.
SO EACH SPEAKER WILL HAVE ABOUT
10 MINUTES TO DO A PRESENTATION.
I'LL GIVE YOU A TIME CHECK AT 10
MINUTES BECAUSE WE'RE NOT
PRESSED FOR TIME SO WHEN I GIVE
YOU THE TIME CHECK YOU CAN HAVE
A COMFORTABLE ONE TO TWO MINUTES
TO WRAP UP YOUR FINAL THOUGHTS.
ONCE THE PRESENTERS ARE DONE,
WE'LL SEE WHERE WE ARE.
WE DIDN'T GET TO ALL THE
QUESTIONS IN THE LAST SECTION SO
WE MIGHT OPEN UP OUR AUDIENCE
PRESENTATION A LITTLE BIT EARLY
OR I MAY TAKE A MOMENT TO ASK
OUR PANELISTS SOME QUESTION CAME
UP IN THE LAST SEGMENT.
WE'LL SEE HOW THAT GOES.
WE'LL HAVE ANOTHER CHANCE FOR
AUDIENCE PARTICIPATION AT THE
END OF ALL THIS.
WE'LL BE FOLLOWING THE ORDER IN
THE AGENDA.
THE FIRST PRESENTER WILL BE
MEGAN MORRIS.
>> MEGAN: THANK YOU.
THANK YOU FOR INVITING ME AND
GIVE A BRIEF OVERVIEW OF THE
RESEARCH ARENA.
I'M A RESEARCHER AT IN COLORADO
AND SLP BY TRAINING BUT SIT IN
INTERNAL MEDICINE AND THE AIM OF
MY RESEARCH IS ADVANCING
EQUITABLE HEALTH CARE FOR PEOPLE
WITH COMMUNICATION DISABILITIES.
I'LL START BROAD.
THIS WAS SOME OF MY FIRST
RESEARCH IN THE AREA THAT WE I
PARTNERS WITH SOMEONE WITH
EPIDEMIOLOGICAL SKILLS AND
LOOKED AT LARGE DATABASES AND
I'M SHOWING DATA FROM THOSE WITH
SPEECH, LANGUAGE OR VOICE
DISABILITY ACROSS A WIDE RANGE
OF HEALTH CONDITIONS ARE MORE
LIKELY TO HAVE CHRONIC
CONDITIONS.
AND NOT ONLY DO THEY HAVE HIGHER
RATES OF CHRONIC CONDITIONS BUT
THEY ALSO HAVE MORE DIFFICULTY
FINDING A PROVIDER WILLING TO
SEE THEM.
WE FOUND THIS IS A POPULATION
WITH HIGH RATES OF INSURANCE BUT
HAVE DIFFICULTY FINDING A
PROVIDE WITH SPEECH, LANGUAGE
AND VOICE DISABILITIES ARE THREE
TIMES MORE LIKELY TO REPORT
HAVING TROUBLE FINDING A
PROVIDER AS OPPOSED TO THOSE
WITHOUT COMMUNICATION
DISABILITIES.
MYSELF AND MANY OTHERS HAVE
EXPLORED THIS FURTHER.
MOSTLY THROUGH QUALITATIVE
RESEARCH AND COMMUNICATION
DISABILITIES.
WHAT, FYI, MY VIDEO STOPPED
BECAUSE THE HOST DISABLED THAT.
PATIENTS WITH DISABILITY
DISORDERS REPORT EXPERIENCES OF
BEING EXCLUDED FROM DECISIONS
ABOUT THEIR CARE ABOUT
ASSUMPTIONS BEING MADE ABOUT
THEIR COGNITIVE ABILITIES AND
THIS IS INCREDIBLY FRUSTRATING
FOR PATIENTS.
AND BEING UNCERTAIN HOW IT BEST
COMMUNICATE WITH PATIENTS WITH
DISABILITIES AND IT'S LIKELY
CONTRIBUTING TO THE POOR HEALTH
AND HEALTH CARE OUTCOMES WITH
PEOPLE WITH DISABILITIES.
YOU MAY NOT BE AWARE THERE'S
MULTIPLE FEDERAL LAWS THAT
REQUIRE HEALTH CARE TEAMS TO
PROVIDE ACCESSIBLE CARE TO
PEOPLE WITH DISABILITIES
GENERALLY AND ALSO THOSE WITH
COMMUNICATION DISABILITY.
I PULLED OUT HERE SECTION 1557
OF AFFORDABLE CARE ACT WHICH
REQUIRES HEALTH CARE TEAMS TO
PROVIDE EFFECTIVE COMMUNICATION
WHICH INCLUDES PROVISION OF
SERVICES AND THE NUMBER ONE ADA
LAWSUIT IN THE HEALTH CARE
SETTING IS DUE TO A LACK OF
PROVISION OF EFFECTIVE
COMMUNICATION.
WE HAVE THIS GAP OF OKAY, WE
KNOW PATIENTS WITH DISABILITY
HAVING POORER EXPERIENCES AND
POORER OUTCOMES AND OUR HEALTH
CARE TEAMS AREN'T AWASH OF HOW
BEST TO COMMUNICATE BUT YET HAVE
LAWS AND POLICIES REQUIRING
EQUITABLE CARE.
WE HAVE DONE TWO IMPLEMENT
STUDIES AREA AND I FIRST WANT TO
MENTION THE FIRST STUDY THAT WE
ARE COMPETING WHICH IS A STUDY
FUNDED BY PCORI AND THIS WAS A
TYPE 1 EFFECTIVENESS HYBRID
IMPLEMENTATION TRIAL.
IT THE AIM OF THE STUDY WAS TO
INCREASE PRIMARY CARE PROVIDER'S
USE OF EFFECTIVE COMMUNICATION
STUDIES THROUGH PRIMARY CARE
ENCOUNTERS WITH PATIENTS WITH
ALL KINDS OF COMMUNICATION
DISORDERS THE INTERACT TRIAL.
AND I'LL GIVE A SHOUT OUT TO OUR
IMPLEMENTATION SCIENCE ON THE
TRIAL WAS DR. GLASGOW WHO WILL
BE SPEAKING AS PART OF THIS
WORKSHOP.
AND JUST AGAIN TO PCORII IS
WHERE AS THE FUNDED AND CONCLUDE
THE STUDY AND THERE'S A NEXT
LEVEL OF RESEARCH.
IF YOU HAVE A COMPARATIVE
DEAFNESS TRIALS THE NEXT STAGE
IS AN IMPLEMENTATION TRIAL WE'RE
THINKING ABOUT IMPLEMENTATION
WHICH WILL BE MORE IN THE HYBRID
TYPE 3 RANGE.
TODAY I WANT TO SPEND TIME ON AN
RO 1 FUNDED TRIAL AND LOOKING AT
IMPLEMENTATION HEALTH AND THE
D&I STUDY SECTION AT NIH AND
FOCUS ON COMMUNICATION
DISABILITIES FUNDED THROUGH
REVIEWED POSITIVELY BY THE STUDY
SECTION.
I JUST WANTED TO GIVE A WIDE
TIME LINE TO IT'S THE A FEW
PIECES.
IT DID TAKE TIME AND HIGHLIGHT
HOW WE'VE ENGAGED STAKEHOLDERS
ALONG THE WAY.
11 YEARS AGO I STARTED THINKING
ABOUT DOCUMENTING DISABILITY
STATUS PARTICULARLY PATIENT'S
COMMUNICATION DISABILITY STATUS
IN THE ELECTRONIC HEALTH RECORD
AND WHY I WAS DOING THIS WAS
RECOGNIZING THAT I WAS
INTERESTED IN TRACKING THE
QUALITY OF CARE AND MAKING SURE
PEOPLE WITH COMMUNICATION
DISABILITIES RECEIVE EQUITABLE
CARE BUT YOU CAN'T LOOK AT THAT
ORGANIZATION LEVEL IF YOU DON'T
KNOW WHO HAS THE COMMUNICATION
DISABILITY.
WE NEED TO BEING DOCUMENTING
THIS CONSISTENTLY IN THE
ELECTRONIC HEALTH RECORD OR
E.H.R.
AND SO IN 2012 I STARTED WRITING
THE ISSUE AND DID MY FIRST
UNFUNDED STUDY LOOKING AT
CURRENT DOCUMENT AND THE LACK OF
THAT IN THE E.H.R. AND I WILL
TELL YOU I WORKED WITH A
CLINICAL INFORMATICISTS AND SAID
SOME TODAY WE'LL HAVE DISABILITY
STATUS IN THE E.H.R. AND HE
LAUGHED BUT I DECIDED IT'S THE
MOUNTAIN TO STAND ON.
IN 2013 I LOOKED AT WHAT
DISABILITY QUESTION WE SHOULD BE
ASKING BUT PATIENT'S ATTITUDE
DISORDER DISCLOSING DISABILITY
TO HEALTH CARE TEAM AND IT'S
IMPORTANT TO NOTE I FELT VERY
STRONGLY ABOUT THE TOPIC AREA
PARTLY BECAUSE ONE THE STANDARDS
FOR HOW WE LOOK AT POPULATION
ESTIMATES OF DISABILITY DO NOT
INCLUDE A COMMUNICATION.
YOU LOOK AT THE CENSUS
PERCENTAGE OF PEOPLE WITH
DISABILITIES, THAT DOESN'T
INCLUDE THOSE WITH COMMUNICATION
DISABILITIES BECAUSE PEOPLE WITH
COMMUNICATION DISABILITIES
AREN'T INCLUDED.
THAT'S NOT A QUESTION THERE.
SO THAT'S WHY I WANTED TO MAKE
SURE HOW DO WE AT A HEALTH CARE
ORGANIZATION LEVEL MAKE SURE
PEOPLE WITH COMMUNICATION
DISABILITIES DON'T GET LEFT OUT?
THEN BETWEEN 2014 AND 2019 I
APPLIED LOOK AT MECHANISMS
WITHOUT A WHOLE LOT OF SUCCESS
AND IN 2018 I STARTED GETTING
CALLS FROM HEALTH CARE SYSTEMS
AROUND THE COUNTRY INTERESTED IN
TERMS OF DOCUMENTING DISABILITY
AND HEALTH SYSTEMS WERE WANTING
TO IMPLEMENT COLLECTION OF
DISABILITY STATUS IN THEIR
E.H.R. BUT WEREN'T QUITE SURE HU
TO DO IT.
SO WE'RE HAVING CONVERSATIONS
AND THEN I THOUGHT ABOUT
LESSONED LEARNED AND IN 2019 WE
RECEIVED SOME FUNDING TO DEVELOP
A COLLABORATIVE AROUND THIS.
IN 2019 I ED INTERNAL FUNDING TO
IMPLEMENT COLLECTION IN THE
E.H.R. HEALTH SYSTEM HERE AND IN
MARCH OF 2022 WE RESUBMITTED THE
RO1 AND WE RESUBMITTED IN MARCH
OF LAST YEAR AND IN APRIL I GOT
A CALL FROM THE OFFICE FROM THE
FEDERAL BODY THAT OVERSEES
E.H.R.s AND THEY WERE
CONSIDERING CREATING A STANDARD
FOR DOCUMENTING DISABILITY
STATUS IN THE E.H.R.
I WAS ABLE TO SHARE MY RESEARCH
THUS FAR AND IN JULY 2022 THEY
PASSED A STANDARD AND WE WORKED
WITH THE NATIONAL COLLABORATIVE
INCLUDING EPIC THE LARGEST
VENDOR FOR E.H.R.s AND AS OF
NOVEMBER ALL EPIC USERS IN THE
COUNTRY NOW HAVE STANDARDIZED
HAVE DISABILITY ELEMENTS
INCLUDING THE COMMUNICATION
QUESTION.
I'LL PAUSE AND HAPPY TO TALK
FURTHER ABOUT OUR SUCCESS AND
CHALLENGES BUT I WANTED TO
HIGHLIGHT HOW TO THIS IS A
LONG-TERM PROCESS AND WE'VE
ENGAGED LOTS OF STAKEHOLDERS
ALONG THE WAY.
>> IT POINTS TO PERSEVERANCE AND
HAVING THE STRUCTURE TO GET THE
CRITICAL DATA YOU NEED
>> NEXT UP IS MOLLY RAMONO.
START SHARING YOUR SLIDES.
>> MOLLY: HI, EVERYBODY.
THANK YOU FOR FOR HAVING ME.
I'M AN ASSOCIATE PROFESSOR AT
FLORIDA STATE UNIVERSITY IN THE
SCHOOL OF COMMUNICATION SCIENCE
DISORDERS AND DIRECTOR OF THE
COMMUNICATION EARLY CHILDHOOD
PRACTICE AND RESEARCH CENTER.
I'LL GO QUICKLY THROUGH HOW I
GOT INTO D&I AS A LINE OF
RESEARCH.
I FEEL LIKE A MAYBE RARE DUCK
AND JULIE IS ONE OF THOSE
DESPITE HER YEARS IN RESEARCH
NEVER LEFT BEHIND HER CLINICIAN
HAT.
I GOT TO SEE HER FORMING
PARTNERSHIPS WITH LOCAL
INTERVENTION AGENCIES, SEEING
HOW SHE STRUCTURED PROFESSIONAL
DEVELOPMENT APPROACHES AND WOVE
THE TWO TOGETHER AND I WAS
FORTUNATE TO HAVE THAT ADDS A
FOUNDATION TO CONTINUE ON BUT
THEN ALSO BRANCH OUT INTO NEW
DIRECTIONS AS WELL.
BUT REGARDLESS OF THE WORK WE DO
WE'RE GUIDED BY A SINGULAR
VISION THAT TODDLERS AND THEIR
FAMILIES PARTICIPATE IN SERVICES
THAT ENGAGE CAREGIVERS AS
EXPERTS AND PARTNERS AND LEADERS
IN INTERVENTION AND REFLECT THE
VALUES WHILE ENHANCING THE
OUTCOMES.
AND IF WE WERE TO BREAK THEM A
PART WE CAN SEE THERE'S LOTS OF
PIECES THERE AND REQUIRING
PRACTITIONERS IN THE FIELD
PARTICULARLY FROM FIELD ACROSS
THE LIFE SPAN AND WORK ACROSS
THE BIG NINE HAVING THE SPECIFIC
INTERVENTION MAY NOT BE AT THE
FOREFRONT.
THERE'S GAPS IN RESEARCH AND
PRACTICE.
AS WE THINK ABOUT THESE AS THEY
RELATE TO EARLY INTERVENTION WE
LIKE TO FRAME AND THINK OF THE
GAPS NOT SO MUCH AS A RESEARCH
TO PRACTICE GAP BUT GAPS IN
RESEARCH AND PRACTICE THAT SORT
OF GO BI-DIRECTIONALLY.
THERE'S REALLY OBVIOUS WAYS
WHERE OUR RESEARCH SPACE IS
LACKING.
FOR US SPECIFICALLY A LOT OUR
RESEARCH AND WIDE BODY OF
CAREGIVER IMPLEMENTED
INTERVENTIONS THAT DO ENGAGE
CAREGIVERS ARE DOING IT WITH
MORE RESEARCH-BASED STAFF AND
NOT EARLY INTERVENTIONISTS OF
THE COMMUNITY.
BY NATURE THAT MEANS WE ARE
CREATING THAT DISCONNECT THAT IS
LEADING TO PERHAPS INTERVENTIONS
THAT DON'T TRANSLATE IMMEDIATELY
INTO COMMUNITY-BASED SETTINGS
AND WE HAVE A REAL
REPRESENTATION ISSUE WHERE
STUDIES LOOKING TO INVESTIGATE
CAREGIVER COACHING MODELS ARE
SOMEWHAT MONOLITHIC IN TERMS OF
THE FAMILIES ENGAGED IN RESEARCH
AND ALSO PROVIDERS.
WE TEND TO BEING QUITE OVER
REPRESENTED IN TERMS OF RACE AND
ETHNICITY AND PROVIDERS AND
FAMILIES, RACE, ETHNICITY, HOME
LANGUAGE AND STRUCTURE IN MANY
DIMENSIONS.
THOSE ARE AREAS THE RESEARCH
COMMUNITY NEEDS TO FOCUS ON AND
OF COURSE WE HAVE GAPS IN
PRACTICE TOO.
PROVIDERS COMING THROUGH
TRAINING PROGRAMS WHERE THEY'VE
BEEN TOLD THEIR ROLE IS AN SLP
IS TO WORK WITH THE CHILD
DIRECTLY TO INCREASE LANGUAGE
STILLS HAS A BIG TASK AHEAD IN
RECONCEPTUALIZING THE ROLE AND
CHANGING THE PERCEPTION AS THEIR
ROLE AS A COACH TO THE
CAREGIVER.
THE SYSTEM OF INTERVENTION IS
COMPLEX LIKE HEALTH CARE SYSTEMS
ARE AS WELL.
IT INTERFACES WITH HEALTH CARE
SYSTEMS AS WELL BECAUSE IT'S
ADMINISTERED BY DEPARTMENTS OF
HEALTH AND DEPARTMENTS OF
EDUCATION IN OTHERS.
THERE'S COMPLEX ARTH CASELOADS
AND STRUCTURES OR NOT THAT WE
DON'T KNOW ABOUT IF WE'RE NOT
ENGAGING THE COMMUNITY-BASED
PROVIDERS.
OVER THE YEARS I'VE BEEN ABLE TO
PARTICIPATE ALONG SIDE HER AND
WE HAVE PROVIDERS SHARING IN THE
VISION OF WHAT IT WOULD LOOK
LIKE TO CHANGE THE SYSTEM SO
EVERY CHILD NO MATTER THE STATE
THEY LIVE IN OR ANTIBODY IS
INTERACTING WITH AN EARLY
INTERVENTION PROVIDER WHO SEES
THE STRENGTHS IN THE FAMILY AND
COLLABORATES AND BUILDS ON THE
FAMILY'S NATURAL ASSETS AND
CULTURE.
STATE LEVEL PARTNERSHIPS IS
DIFFICULT TO THINK ABOUT
STARTING IN D&I RESEARCH AND
WANT TO KEEP THE BIG PICTURE
VISION IN MIND BUT DO IT
LOCALLY.
A SINGLE SCHOOLED OR NURSING
FACILITY WITHIN A HOSPITAL OR
HANDFUL OF PROVIDERS OR WHATEVER
YOUR AREA IS DOESN'T HAVE TO BE
LARGE TO BE IMPORTANT AND
SOMETHING WE TO REMIND OURSELVES
AGAIN AND AGAIN WHEN WE TALK
ABOUT SUCCESSFULLY FUNDED
RESEARCH.
TYPICALLY THOSE GROW TO BE QUITE
LARGE BUT I PROMISE MOST OF THEM
STARTED VERY SMALL.
THINKING LOCALLY AND BUILDING
PARTNERSHIPS LIKE WE TALKED
ABOUT EARLIER IS KEY.
TO GIVE EXAMPLES HOW THE
RESEARCH GOT TRANSLATED TO
PRACTICE.
I'LL GIVE A FEW EXAMPLES BASED
ON SOME OF JULIAN WOODS' WORK
HAD A DEVELOPMENT AND INNOVATION
GRANT CALLED EPIC IN 2014 OR SO
THAT BUILD OR PRIOR MODELS THAT
TESTED THE PROFESSIONAL
DEVELOPMENT SEQUENCE WITHIN THE
SCOPE OF THE DEVELOPMENT AND
INNOVATION PROJECT AND THEN IN
SUBSEQUENT YEARS THE STATE OF
THERE ARE A SITE THAT
PARTICIPATED IN THE STUDY
DECIDED, WE'RE BEING ASKED TO
MAKE CHANGES AND AND MAKE
PROGRESS ON CHILD OUTCOMES AND
SEE WE NEED TO MAKE TRACTION FOR
CAREGIVER COACHING AND WANT TO
PARTNER WITH YOU.
WE STARTED A CONTRACT WITH PAT
SNIDER ON THE EPIC GRANT TO
TRANSLATE THAT WORK INTO A STATE
DEVELOPMENT MODEL CALLED FLORIDA
EPIC.
THEN AFTER YEARS OF THAT MODEL
ROLLING OUT AND SCALING UP WE
THEN APPLIED FOR A LARGER GRANT
AN EFFICACY TRIAL TO EXAMINE THE
PROFESSIONAL DEVELOPMENT USED IN
THE STATE.
WE STARTED RESEARCH TO PRACTICE
TO RESEARCH.
YOU CAN IMAGINE IT CONTINUING
ONWARD FROM THERE.
TO OUR EARLIER POINT WE CAN TAKE
IDEAS USED IN PRACTICE AND TEST
THEM AND SEE WHETHER IT'S
SOMETHING WE WANT TO DEIMPLEMENT
OR INCREASE IMPLEMENTATION OF WE
CAN TAKE THE COMMON PRACTICES
AND TEST THEM AS WELL.
THIS IS WHERE WE PICK UP IN IOWA
BASED ON THE MODEL THAT STANLEY
GUIDED ROUTINE BASED
INTERVENTION WHERE FOLKS IN IOWA
AND ATHEIR PROGRAM THEIR EARLY
INTERVENTION PROGRAM LEADERS
IDENTIFIED THIS AS THE MODEL TO
IMPLEMENT STATEWIDE AND
CONTRACTED WITH US TO INSTALL
AND SCALE UP THAT MODEL BY USING
A DISTANT COACHING MODEL AS AN
IMPLEMENTATION STRATEGY.
SO HOW DO WE GET PROVIDERS THERE
AND THEN WE THOUGHT, WELL, WE'RE
DOING THIS AND KNOW IT WORKS
BASED ON INTERNAL PROGRAM
EVALUATION DATA AND THE EVIDENCE
WE SEE BUT WOULDN'T IT BE COOL
TO GET EXPERIMENTAL DATA.
WE GOT THIS FROM IES AND
EVALUATION GRANT WHERE WE DID A
SERIES OF SINGLE CASE
EXPERIMENTAL DESIGNS TO SEE
WHETHER THE COACHING PIECE
WORKED.
THINK OF IMPLEMENT STRATEGIES
AND DOES PEER COACHING HELP AND
THE WORK SHIFTS BACK TO THE
PROGRAM ITSELF THE EARLY ACCESS
PROGRAM AN WHAT TAKES TO SUSTAIN
THE SCALE AND HAVE A STATEWIDE
PROGRAM TO HAVE THE CAPACITY TO
KEEP IT GOING.
THE LARGE SCALE STUDIES DON'T
ALWAYS HAVE TO BE THE STARTING
PLACE AND HEADING INTO NEW
FRONTIERS.
I'LL JUST HIT ON THESE BRIEFLY.
THERE'S WORK ON GOING WITH EMILY
WIN USING SFRGI AS A FRAMEWORK
ON AN R21 AND WE ALSO HAVE NEW
WORK PIGGYBACKING ON THE FOLKS
THAT SAY MAKE USE OF YOUR
INTERNAL FUNNEL FUNDING AND
CAREGIVER COACHING WITHIN AN
INFANT FEEDING PROGRAM AND
PUTTING TOES IN THE WATER ON
WHAT A THINK OF IS SOCIAL MEDIA
AS AN AVENUE FOR CAREGIVERS AND
PREVENTIVE APPROACH TO SUPPORT
CHILD OUTCOMES AS WELL.
WE USED A RANGE OF METHODOLOGIES
AND I KNOW WE TALKED ABOUT THAT
EARLIER TODAY TOO THAT YOU DON'T
HAVE TO BE A JACK OF ALL TRADES
AND MASTER OF NONE BUT A POSTURE
OF BEING WILLING TO TRY
DIFFERENT METHODS IS IMPORTANT
AND YOU CAN MAKE FRIENDS WITH
PEOPLE WHO DO DO THOSE THINGS
AND I KNOW SOMETIMES THEY'RE
HARD TO FIND BUT THEY'RE OUT
THERE.
THERE'S ROOM FOR TRADITIONAL
QUANTITATIVE METHODS AND MORE
AREAS TO LEARN ABOUT LIKE COST
ANALYSES TO DEEP EN OUR WORK.
POTHOLES AND BARRIERS WE FOUND.
WE'LL CONTINUALLY STRUGGLE WITH
RECRUITMENT IN A POST COVID
WORLD I THINK BECAUSE EARLIER
INTERVENTION WE'RE BUILDING BACK
THE WORKFORCE THAT TOOK A HIT
DURING COVID AND HOW AS THE DEAL
WITH CONSTRAINTS AND EARLY
INVENTION LIKE IN FLORIDA PEOPLE
MOONLIGHT AS EARLY INVENTIONISTS
OUTSIDE OF SCHOOL HOURS AND HAD
TO THINK OF CASE LOAD
CONSIDERATIONS AND HOW MUCH IS
ENOUGH TO PARTICIPATE AND KEEP
ON TOP OF POLICY CHANGES THAT
MAY IMPACT US.
A STATE OF FLORIDA POLICY THAT'S
NOW INCENTIVIZING THE FLORIDA
EPIC PROJECT HAD AN INTERESTING
TIMING AND INCENTIVIZING PEOPLE
TO DO IT STATEWIDE BUT THEY CAN
DO IT SOONER AND GET AN INCREASE
IN THEIR HOURLY RATE IF THEY GO
AHEAD AND DO THE PROFESSIONAL
DEVELOPMENT EARLIER RATHER THAN
LATER.
IT COULD BE TOUGH WAITING ON A
PAY INCREASE AND PARTNERING WITH
THE ADMINISTRATORS TO EVERYBODY
HAS AN INVESTMENT AND SO
UNDERSTAND THE CONTEXT AND I A
BI-DIRECTIONAL WAY WE'RE SHARING
RESEARCH DESIGN AND
CONSIDERATIONS.
THESE PROVIDERS PEOPLE IN IOWA
CAN EXPLAIN SINGLE CASE DESIGN
AND KNOW MORE ABOUT RANDOMIZED
CONTROL TRIALS THAN ANY PROVIDER
ON THE STREET WHICH IS SO COOL
AND DO HELP EXECUTE IT.
OTHER CONSIDERATIONS IS FINDING
MEASURES THAT MATTER IN THE REAL
WORLD EASY ENOUGH TO IMPLEMENT
AND GET CHILD DATA IN A WAY THAT
ISN'T TOO BURDENSOME TO DO BUT
STILL MEANINGFUL AND THAT'S BEEN
TOUGH FOR US.
CON SUFLTING AT -- CONSULTING AT
THE PLANNING PHASES DURING COVID
AND IT UPEND THE WAYS WE WERE
DOING MEASUREMENT AND LEARNING
ABOUT TOOLS AND RELATED
DISCIPLINES THAT CAN APPLY TO
OUR WORK.
THERE'S SO MUCH TO BE LEARN FROM
RELATED FIELD AND CERTAINLY
MEASUREMENT IS ONE WAY AND
METHODOLOGY AND CONTENT TOO.
THANK YOU FOR JOINING US TODAY
AND FOR CONSIDERING AN OPTIMIST
IB VIEW WHERE TO TAKE YOUR D&I
RESEARCH AND WE HAVE 2,000
PROVIDERS WITH OVER 100 COACHES
ACROSS THE STATES AND SOME AT
THE IT TIPPING POINT AND SOME
STARTING BUT AT THE END OF THE
DAY KEEPING OUR EYES ON THE
PRO
PRIZE ENSURING FAMILIES GET THE
SERVICE THEY DESERVE IS ONE THAT
KEEPS US GOING DAY TO DAY.
THANK YOU VERY MUCH.
>> THANKS, MOLLIE.
THAT WAS INSPIRING SEE THE
VARIETY OF PARTNERSHIPS AND
LEVERAGE OVER TIME.
NEXT IS BRIAN BOYD.
TAKE IT AWAY.
>> BRIAN: I'M GOING TO TALK
ABOUT THE ACTUAL IMPLEMENTATION
STRATEGIES WE'VE USED WITHIN THE
CONTEXT OF SCHOOL-BASED RESEARCH
WE DO FOCUS ON AUTISTIC STUDENTS
BECAUSE SCHOOLS ARE UNIQUE
ORGANIZATIONAL UNITS WITHIN A
BROADER EDUCATIONAL SYSTEM.
THEY FACE SOME PARTICULAR
CHALLENGES AND SUCCESSES RELATED
TO IMPLEMENTATION WORK.
I'LL SHARE EXAMPLES OF RESEARCH
WE'VE DONE AND SOME STRATEGIES
USED AND WHAT'S BEEN HELPFUL AND
NOT HELPFUL DOING THE WORK.
FIRST I'LL PROVIDE CONTEXT
BECAUSE I'M ASSUMING NOT
EVERYONE DOES SCHOOL-BASED OR
WORK WITH STUDENTS WITH AUTISM
AND BRIEF CONTEXT TO UNDERSTAND
THE WORK WE'RE EMBARKING UPON
AND TALK ABOUT TWO SPECIFIC
STUDIES.
ONE THAT WAS WIN -- WITH
EFFICACY SUPPORT AND ONE IS
HYBRID WITH IMPLEMENTATION
OUTCOMES AS WELL AS
STUDENT-LEVEL OR CHILD-LEVEL
OUTCOMES WITHIN THE CONTEXT OF
THE TRIAL.
WITH THE FOCUS ON THE
IMPLEMENTATION STRATEGIES WITHIN
THE STUDIES AND WHAT WAS
HELPFUL.
CONTEXT HERE, THERE'S FEDERAL
LEGISLATION THAT CALLED FOR THE
USE OF SCIENTIFICALLY BASED
RESEARCH SUCH AS THE INDIVIDUAL
WITH DISABILITIES AND EDUCATION
ACT IN THE SUPPLEMENT.
WE ALSO WITHIN THE CONTEXT OF
SPECIAL EDUCATION DEAL WITH HIGH
RATES OF TEACHER BURNOUT AND
ATTRITION AND AFFECTS OUR
ABILITY TO DO CAPACITY BUILDING
WITH INTERVENTIONS WITHIN THE
CONTEXT OF SCHOOL SYSTEMS AND
LOOK AT CAPACITY AND LOOK AT 28
PRACTICES FOR CHILDREN BETWEEN
THREE AND 21 RECEIVING SERVICES
AND THAT'S A LOT OF SCHOOL-BASED
PRACTITIONERS POTENTIALLY HAVE
TO LEARN AND IMPLEMENT AND
SUSTAIN.
THE OTHER THING IN THINKING
ABOUT SCHOOLS, THEY'RE SITUATED
IN SYSTEMS AND OFTEN REQUIRE
MULTIPLE LEVELS OF BUY IN AND
YOU CAN'T SAY I WANT YOU TO
IMPLEMENT THIS THEY NEED
PERMISSION HAVE PRINCIPLES AND
OFFICIALS HIGHER UP IN THE
SCHOOL DISTRICT IN ORDER TO JUST
HAVE PERMISSION TO WORK TO
IMPLEMENT A PARTICULAR PRACTICE
AND THERE'S APPROVAL OF ACQUIRE
AND WE KNOW BECAUSE OF THE WAY
SCHOOLS ARE FUNDED WITHIN THE
U.S. THERE'S INEQUITABLE ACCESS
TO RESOURCES AND FUNDING AND THE
ABILITY TO TRAIN PROVIDERS TO
HAVE TIME FOR PROFESSIONAL
DEVELOPMENT TO DEVELOP AN
INTERVENTION CAN DIFFER BECAUSE
OF THE ISSUES.
AND RELATED TO FUNDING WE CAN
SEE DIFFERENCES IN COMPETENCIES
AND SCHOOL STAFF SO THEIR
CAPACITY THEIR KNOWLEDGE BASE
CAN BE QUITE DIFFERENT ACROSS
CON SCHOOLS.
-- ACROSS SCHOOLS.
WITHIN THAT LENS WE LOOKED AT
THE INNOVATION GRANTS.
THIS IS ONE FUNDING MECHANISM
DUE TO THE THIS INSTITUTE OF
SCIENCES TO ALLOW YOU TO HAVE
TIME AND SPACE TO DEVELOP AN
INTERVENTION AS WELL AS COLLECT
PILOT DATA IN PREPARATION FOR A
LARGER-SCALE EFFICACY TRIAL.
WE HAD A GRANT CALLED ADVANCING
SOCIAL COMMUNICATION AND PLAY
FOR PRE-SCHOOL AGED AUTISTIC
CHILDREN IMPLEMENTED WITHIN THE
CONTEXT OF THEIR CLASSROOMS.
THIS INTERVENTION THOUGH WAS
BASED ON PRIOR EFFICACY TRIAL
CONDUCTED AT UCLA.
THERE WAS EXISTING EVIDENCE FOR
THE INTERVENTION WE WERE GOING
TO MANUALIZE.
THE ORIGINAL STUDY WAS WITHIN
CLINIC STUDIES.
WE WERE ADOPTING THE
INTERVENTION TO BE IMPLEMENTED
WITHIN THE CONTEXT OF CLASS
CLASSROOMS.
WHAT WERE PRE-IMPLEMENTATION
STRATEGIES AS PART OF THE
DEVELOPMENT PROCESS?
THERE WAS A SCHOOL-BASED
PSYCHOLOGIST IN THE SCHOOL
SYSTEM WHERE WE'D DO THE
DEVELOPMENT WORK.
AND SHE WE INCLUDED HER AS THE
RESEARCH TEAM AND INVOLVED IN
DECISIONS AND SELECTING
CLASSROOMS AND TEACHERS TO
PARTICIPATE AND WE CHOSE HER
BECAUSE SHE WAS QUITE WELL
RESPECTED WITHIN TEACHERS WITHIN
THIS PARTICULAR SCHOOL DISTRICT.
WE ALSO DID LOTZ OF FOCUS GROUPS
AND INTERVIEWS WITH SCHOOL STAFF
TO DEVELOP THE MANUAL AND I'M
HAPPY TO TALK ABOUT WHAT WE
LEARNED FROM DOING THAT
PROFESSION AND HOW IT ALL FED
INTO THE MANUAL BUT THOSE ARE
PRE-IMPLEMENTATION STRATEGIES
AND THE ACTUAL IMPLEMENTATION
STRATEGIES IMPLEMENTING THE
INTERVENTION I'LL FOCUS ON THE
COACHING AND IT'S AN EFFECTIVE
IMPLEMENTATION STRATEGY AND WE
DID IT DIFFERENTLY SINCE IT WAS
WITHIN THE SCHOOL TEAM AND
CLASSROOMS ASAP IS A TEAM-BASED
APPROACH.
IN ORDER TO BE IN THE STUDY
THERE HAD TO BE AT LEAST ONE
TEACHER OR CO-TEACHER AND ONE
OCCUPATIONAL PROVIDER OR SPEECH
LANGUAGE PATHOLOGIST AND AGREED
TO FORM A TEAM TO BE COTRAINED
AND A TRAINING FOR THE CONTENT
AND BOOSTER TRAINING AFTER THE
HOLIDAYS BECAUSE THERE'S OFTEN A
BREAK FOR STUDENTS AND STAFF AND
WANTED TO BOOST THEM FOR THE
IMPLEMENTATION.
WE WANTED TO HAVE A CRITICAL
MASS IN THOSE TRAINED WITHIN THE
CONTEXT OF INTERVENTIONS WITHIN
SCHOOLS AND WE KNOW IT DOESN'T
WORK FOR CAPACITY BUILDING.
HAVING A TEAM WE CAN BUILD
CRITICAL MASS.
WE ALSO WANTED TO REDUCE THE
BURDEN OF THE TEACHER TO HAVE
MULTIPLE ROLES.
OFTEN TIMES THEY HAVE TO BE THE
INFORMER OR TRAINER IN THE
SCHOOL TO LET THEM KNOW ABOUT
THE INTERVENTION WE WERE TAKING
THE BURDEN OFF THE TEACHER IT
PLAY THE MULTIPLE ROLES.
AND WE KNOW IN GENERAL AUTISTIC
STUDENTS OFTEN RECEIVE SERVICES
FROM MULTIPLE PROVIDERS SO THIS
SHOULD FIT IN WITH A TEAM-BASED
APPROACH FOR SERVICES STUDENTS
WERE ALREADY RECEIVING.
WHAT WERE SOME CHALLENGES AND
SUCCESSES?
WE KNOW STAFF TURNOVER DID
OCCUR.
PEOPLE LEAVE THE CLASSROOM FOR A
VARIETY OF REASONS YOU HAD TO
AGREE TO DO THIS AS A TEAM AND
THAT CREATED CHALLENGES.
IF THEY WEREN'T WELL FUNCTIONING
OR COHESIVE AT THE BEGINNING
THAT CAN AFFECT THEIR
IMPLEMENTATION.
HOW DO WE ADDRESS THE
CHALLENGES?
WE DEVELOPED MICRO TRAINING TO
GET NEW TEAM MEMBERS UP TO SPEED
INSTEAD OF THE INITIAL TRAINING
WITH EVERYONE AND DEVELOPED THE
TERMS OF REFERENCE DOCUMENT I
CAN ON THE NEXT SLIDE TO SPELL
OUT THE ROLE AND
RESPONSIBILITIES FOR EACH TEAM
MEMBER AND AT THE MONTHLY
COACHING MEETING ANY TEAM MEMBER
CAN SAY LET'S REVISIT BECAUSE
THE CASE LOAD OR SCHEDULE HAS
CHANGED.
I NEED TO LOOK AT WHAT I CAN DO
AND LOOK AT THE SCHOOL-BASED
ADVISORS TO ATTEND THE MONTHLY
MEETINGS TO TEAM AND PLAN AND
WORK TOGETHER.
THIS IS WHAT IT LOOKED LIKE AND
LOOKED AT THE RESPONSIBILITIES
WITH IMPLEMENTATION AND DOING
ONE-ON-ONE INTERVENTION AND WHO
WILL BE INVOLVED IN COLLECTING
DATA FOR THE PARTICULAR STUDENT.
THIS IS SOMETHING THE TEAM CAN
VERY VISIT AT ANY POINT IN TIME.
>> THAT'S THE 10-MINUTE MARK.
>> SO WE STILL HAVE TRIUMPHS OF
AND THE SERVICE PROVIDERS LIKED
THIS AND THE OTHER IS AND THESE
YFG
INTERVENTIONS HAVE BEEN TESTED
WITHIN THE MULTIPLE RANDOMIZED
CONTROL TRIAL AND USING THE TOOL
KIT TO SUPPORT THE
SUSTAINABILITY WITHIN THE
CONTEXT.
SOMEONE FROM OUR TEAM MEETS FROM
A SCHOOL TEAM LEADER AND WHO
SHOULD BE PART OF THE PARLIAMENT
TEAM TO FORM THE SCHOOL TEAM AND
IDENTIFIES WHO SHOULD BE ON THE
TEAM.
THOSE IN THE NETWORK RESPOND TO
IT AND CAN EITHER ASKED TO
PROVIDE SURVEY QUESTIONS AND CAN
DECLINE TO PARTICIPATE ON THE
IMPLEMENTATION TEAM BUT MAY
NOMINATE OTHERS AND ONES WE HAVE
AN IMPLEMENT TEAM WE HAVE THE
IDEA THAT THERE BE A TAKEOVER IN
FACILITATOR AND TRAINER AND TAKE
ON THE IMPLEMENTATION SUPPORT SO
CREATING A SYSTEM AROUND THE
IMPLEMENTATIONS WITHIN THE
SCHOOLS.
WE'RE MEASURING AND MONITORING
OUTCOMES WITH THE GOAL OF STAGE
8 BEING SUSTAINED INTERVENTION.
SOME OF THE ISSUES HERE IS
POSTCOVID THERE'S LOTS OF SCHOOL
STAFF SHORTAGES AND SOMETIME LOW
RESPONSE RATES FROM SOCIAL
NETWORKS AND FORMING
IMPLEMENTATION TEAMS IS HARDER
WITHIN SMALLER SCHOOLS BUT
ANECDOTALLY THIS A TRIAL STILL
ONGOING.
ONCE THEY FORM THE TEAM THEY
FIND IT QUITE BENEFICIAL TO HAVE
THE EXTRA LAYER OF SUPPORT.
THIS IS THE LAST SLIDE AND WE
PUT TOGETHER A FRAMEWORK USING
THE HOLD HOW YOU THINK THROUGH
THE IMPLEMENTATION GOALS ACROSS
THE PHASES AND WHAT ARE
ACTIVITIES AND STRATEGIES WE
NEED TO ACCOMPLISH WITHIN THAT
PARTICULAR PHASE AND POTENTIAL
OUTCOMES YOU SHOULD BE
MONITORING AS PART OF THAT
PHASE.
THIS IS PART OF THE STUDY WE DID
WE USED AUTISM AS THE CASE
EXAMPLE BUT THE FRAMEWORK HAS
BEEN USED BEYOND THIS AND I WANT
TO ACKNOWLEDGE SOME PEOPLE AND
I'LL STOP THERE.
>> THANK YOU, BRIAN.
OUR NEXT AND FINAL SPEAKER IS
SUSAN EMMETT.
YOU CAN START SHARING YOUR
SLIDES.
>> SUSAN: I'M AN ASSOCIATE
PROFESSOR AT THE UNIVERSITY OF
ARKANSAS OF OTOLARYNGOLOGY AND
LEAD THE CENTER FOR HEARING
HEALTH EQUITY AND WITH OTHERS ON
THE WEBINAR TODAY.
OUR OVER ARCHING GOAL IS TO
ADDRESS HEARING LOSS RELATED TO
POLICY CHANGE.
WE DO THAT THROUGH RESEARCH
DRIVE EN AND PUBLIC HEALTH
DRIVEN AND HOW DOES D&I FIT INTO
THIS?
D&I RESEARCH HELPS BRIDGE THE
GAP BETWEEN EFFECTIVENESS
STUDIES AND POLICY CHANGE AND
ULTIMATE IMPACT.
THAT'S HOW WE AS A GROUP GOT
INVOLVED IN D&I RESEARCH.
I'M GOING TO WALK THROUGH AN
EXAMPLE OF SOME EARLY WORK THAT
WE DID THAT LED US TO D&I AND
THEN TALK ABOUT TWO NIDCD FUNDED
STUDIES IN THE AREA.
WE ALL KNOW ON THE WEBINAR
HEARING LOSS HAS A SIGNIFICANT
LIFE LONG IMPACT AND THE W.H.O.
ESTIMATES 75% OF HEARING LOSS IN
UNDER SERVED COMMUNITIES IS
PREVENTIBLE.
THIS IS SOMETHING THAT SPEAKS TO
THE CORE WHERE WE WANT TO CHANGE
THE LANDSCAPE OF HEARING LOSS IN
CHILDREN AND NEED A BETTER WAY
TO IDENTIFY CHILDREN WITH
UNDIAGNOSED HEARING LOSS AND
ENSURE THEY HAVE ACCESS TO CARE.
MUCH OF THE FOUNDATIONAL WORK
HAS BEEN IN RURAL ALASKA WHERE
THE PREVALENCE OF CHILDHOOD
HEARING LOSS IS SIX TO NINE
TIMES HIGHER THAN THE GENERAL
U.S. POPULATION.
THIS IS REALLY ALL DRIVEN BY EAR
INFECTIONS.
THEY CAN START AS EARLY AS ONE
MONTH OF AGE IN THIS POPULATION.
WE KNOW THERE'S SIGNIFICANT
BARRIERS OF CARE IN ALASKA FIRST
BECAUSE OF THE SIZE OF THE STATE
EQUIVALENT TO THE ENTIRE EASTERN
SEABOARD.
AND FOR OUR PURPOSES THIS
CONNECTS OT OWE -- OTT --
OTOLARYNGOLOGISTS AND WE KNOW
IT'S PREVENTIVE HEALTH CARE FOR
RURAL CHILDREN AND EVEN FOR
CHILDREN IDENTIFIED WITH
SCHOOL-BASED SCREENING NEARLY
THREE-QUARTERS ARE LOST TO
FOLLOW-UP BEFORE EVER RECEIVING
CARE.
WE ASKED THE QUESTION OF CAN
TELEMEDICINE HELP OVERCOME THESE
BARRIERS TO SPECIALTY CARE?
SPECIFICALLY USING THE MODEL OF
HEARING SCREENING.
WE DID THIS THROUGH A PCORI
FUNDED TRIAL THE LARGEST IN THIS
REGION OF NORTHWEST ALASKA AND
ENROLLED ABOUT 1500 CHILDREN AND
15 RURAL COMMUNITIES.
THIS WAS A CLUSTER RANDOMIZED
TRIAL WHERE WE COMPARED A
TELEMEDICINE SPECIAL MEDICINE
REFERRAL PATHWAY TO STANDARD
PRIMARY CARE PATHWAY TO
DETERMINE THE BEST WAY TO ENSURE
FOLLOW-UP AFTER SCHOOL HEARING
SCREENING.
THE RESULTS WERE REMARKABLE.
WE FOUND CHILDREN IN COMMUNITIES
RANDOMIZED TO TELEMEDICINE WERE
TWICE AS LIKELY TO RECEIVE
FOLLOW-UP CARE AND CARE HAPPENED
OVER 17 TIMES FASTER.
THESE ARE ASTOUNDING RESULTS
THAT ULTIMATELY COULD CHANGE THE
LANDSCAPE OF PREVENTIBLE
CHILDHOOD HEARING LOSS BUT THE
CHALLENGE IS HOW DO WE TAKE THIS
WORK AND ENSURE THAT IF WE MAKE
IT ALL THE WAY TO THE FINISH
LINE WHERE WE ARE ACTUALLY
PUSHING TOWARDS POLICY CHANGE
AND ULTIMATE IMPACT AND
SUSTAINED CHANGE IN COMMUNITIES?
AND THE ANSWER TO THAT REALLY
LIES IN D&I WORK BECAUSE THAT
PROVIDE THE BRIDGE FROM EFFICACY
STUDIES TO POLICY CHANGE AND
IMPACT.
FROM THE PCORI TRIAL WE'RE RUNG
TWO NIDCD STUDIES GEARED TOWARDS
BRIDGING THE GAP.
THE FIRST IS THE NORTH STAR
TRIAL.
THIS IS A HYBRID STEP 1
RANDOMIZED TRIAL WITH NEARLY
5,000 STUDENTS IN 25 SCHOOLS.
THE GOAL OF THIS STUDY IS TO
DEVELOP A MODEL FOR SCHOOL-BASED
TELEHEALTH THAT COULD BE SCALED
ACROSS THE STATE OF ALASKA.
WE HAVE HAD KEY INITIATIVES
HAPPENING.
THE FIRST IS SHIFT FROM
TELEMEDICINE IN CLINICS TO ONE
DIRECTLY LOCATED IN SCHOOLS.
THIS WAS DRIVEN BY OUR
STAKEHOLDERS IN THE INITIAL
PCORI FUNDED TRIAL.
WE RECOGNIZED WE WERE ABLE TO
MOVE THE NEEDLE IN THE NUMBER OF
KIDS GETTING FOLLOW-UP AND WENT
FROM TWO-THIRDS WITH THE GOAL OF
100% OF CHILDREN AND WE NEED TO
DO THIS IN THE MOST CHILD
CENTRIC WAY POSSIBLE AND BRING
THE TOOLS DIRECTLY INTO SCHOOLS.
THIS SUPPORTS THE MODEL BETWEEN
THE SYSTEM WHICH IS UNIQUE WHERE
IT'S ALREADY STANDARD OF CARE
BUT NOT TRULY OF ALL OF RURAL
ALASKA IN GENERAL.
ANOTHER PIECE OF THIS STUDY THAT
WAS IMPORTANT IS THREE REGIONS
CHOSEN TO REPRESENT THE BREADTH
AND VARIETY OF LANDSCAPE IN THE
STATE.
AND THIRD AND MOST IMPORTANT IS
THE FOCUS ON SUSTAINABILITY IN
THE TRIAL.
THE GOAL IS TO SCALE STATEWIDE
AT THE CONCLUSION OF THE RO1.
THAT MEANS EVERYTHING WE DO IS
THROUGH A LENS ON
SUSTAINABILITY.
THE SECOND IS THE APPALACHIAN
STAR TRIAL.
THIS TRIAL IS AN EXCITING STUDY
FROM A TRANSFORMATIVE HEALTH
DISPARITIES NESHT
INITIATIVE THAT STARTED IN THE
OFFICE OF THE DIRECTOR TO
TRANSLATE AND SUSTAIN POLICY
CHANGE AND IMPACT.
SOMETHING THAT WE ARE
PARTICULARLY EXCITED ABOUT WITH
THIS WORK IS WE ARE REALLY
TRYING TO EMBRACE THE RAPID
TRANSLATION AND THERE'S A LOT OF
INNOVATIONS IN THE TRIAL BEING
CRAMMED INTO A FIVE-YEAR PERIOD
WHEN NORMALLY LIKE WE HEARD
EARLIER IN THE WEBINAR I WOULD
SEE A METH OL CAL STEP WISE
APPROACH THAT TAKES MANY YEARS
TO GO FROM EFFICACY TO PRACTICE
AND WE'RE TRYING TO DO OVER THE
COURSE OF A FIVE-YEAR PERIOD AND
IT'S LARGE AND INVOLVED OVER
14,000 CHILDREN IN 64 SCHOOLS IN
RURAL KENTUCKY.
WE ARE DEVELOPING TECH
NOVEATIONS IN THE MIDST OF THIS
TRIAL -- INNOVATIONS IN THE
MIDST OF THE TRIAL TO FACILITATE
THE WORK INCLUDING A REALLY
EXCITING INNOVATION CALLED TRIO
CONNECT FACILITATING
COMMUNICATION BETWEEN SCHOOLS,
HEALTH CARE AND FAMILIES TO
REALLY ENSURE EVERY CHILD WHO
NEEDS HEARING CARE HAS ACCESS TO
THAT CARE.
THERE ARE DEFINITELY CHALLENGES
IN TRANSITIONING INTO D&I WORK
AND OVERCOMING THOSE I WOULD SAY
MY NUMBER ONE TWO AND THREE
PIECE OF ADVICE HERE IS CALENDAR
RATE, COLLABORATE.
FIND THE D&I EXPERTS WITHIN YOUR
NETWORK OR BEYOND YOUR NETWORK
OF COLLABORATORS AND THEY CAN
BRING A NEW LEVEL OF EXPERTISE
TO YOUR TEAM.
WE HAVE TWO IMPLEMENTATION
SCIENTISTS PART OF OUR TEAM FOR
BOTH THE PROJECTS.
THE SECOND AREA IS PARTNERSHIP
WITH STATE LEADERSHIP.
WE ALL THINK A LOT ABOUT OUR
COMMUNITY PARTNERS AND
STAKEHOLDERS AND IN THOSE
RELATIONSHIPS ARE REALLY
CRITICAL AND FUNDAMENTAL TO THE
WORK WE'RE DOING IN THE
PROJECTS.
I WOULD SAY EQUALLY IMPORTANT IS
OUR PARTNERSHIP WITH POLICY
MAKERS.
WHEN WE THINK OF CHANGING OUR
LANDSCAPE AND LEADING TO POLICY
CHANGE WITH ULTIMATE IMPACT WE
NEED TO WORK WITH LEADERSHIP
FROM THE BEGINNING FROM NO
CONCEPTION THROUGH TO ACCELERATE
CHANGE.
THIS HAS BEEN TOUCHED ON IS
PERSEVERANCE.
THIS ISN'T EASY.
CONTINUING TO STICK WITH THE
WORK YOU'RE DOING, RECOGNIZING
THAT IT'S REALLY IMPORTANT IS
VAUBL.
AND LASTLY TO TOUCH ON EARLY
SUCCESSES WITH THE WORK.
FIRST IS IN THE AREA OF PRIVACY
PRESERVING DATA LINKAGE.
THERE ARE A LOT OF CHALLENGES
TRYING TO NAVIGATE THE LANDSCAPE
OF HIPAA AND OTHERS TO ENSURE
HEALTH COMMUNICATION AGENCIES
CAN COMMUNICATE WITHOUT LOSING
INFORMATION AND A SECOND AREA IS
EXCITEMENT IN OTHER REGIONS OF
ALASKA FOR THE NORTH STAR TRIAL
WHERE WE'VE BEEN APPROACHED BY
OTHER REGIONS WHO WANT TO JOIN
IN THE RANDOMIZED TRIAL AND
THAT'S SO EXCITING.
IT SPEAKS TO OUR GOAL OF SCALE
UP AND LAST LY IN THE APPALACHIN
STAR TRIAL WE WERE ABLE TO
FACILITATE THE FIRST EVER
AGREEMENT FOR DATA SHARING
ACROSS EDUCATION AND HEALTH
ENTITIES AND THIS SPEAKS TO
SUSTAINED PARTNERSHIP AND
PERSEVERANCE OF FINDING A WAY TO
GET TO YES AND WORKING WITH
LEGAL COUNSELS -- COUNCILS TO
MAKE THIS HAPPEN AND WILL
HOPEFULLY WAIVE THE WAY FOR THIS
WORK IN OTHER STATES AND LOOK AT
LONGITUDINAL OUTCOME FOR
CHILDREN GOING THROUGH THESE
SCREENING AND TELEHEALTH
INTERVENTIONS.
I'LL STOP THERE AND APPRECIATE
EVERYONE'S TIME.
IF YOU HAVE A QUESTION PLEASE
RAISE YOUR HAND I'LL CALL ON YOU
AND IF NO ONE HAS A QUESTION
I'LL GOOD AHEAD AND JUMP IN WITH
MY QUESTION.
I'LL GIVE A MINUTE FOR ANYONE
WHO NEEDS TO FIND THEIR RAISE
HAND FEATURE.
I'LL ASK MY FIRST QUESTION.
I HEARD A LOT ACROSS THE TRUCKS
ABOUT DIFFERENT PARTNERSHIPS AND
THOUGH WE TALKED ABOUT
PARTNERSHIPS BEFORE WITH WHAT
STRUCK ME WAS THERE WERE
PARTNERSHIPS AT MULTIPLE LEVELS
AND GOING BACK TO MY EARLY TALK
AS THE REAL WORLD SYSTEM AND ALL
SORTS OF LEVELS.
I WONDER IF ANY OF YOU COULD
COMMENT ON HOW YOU BUILD
PARTNERSHIPS AT DIFFERENT LEVELS
AND HOW IT WAS DIFFERENT TO
NAVIGATE DEPENDING ON WHICH
LEVEL YOU WERE AT AND WORKING
THROUGH THAT PARTNERSHIP.
GO AHEAD, MOLLIE.
>> MOLLIE: TO SUSAN'S POINT OF
STATE LEVEL LEADERSHIP I AGREE
IT'S CRITICAL FOR MOST THE WORK
WE'RE TRYING TO DO IN DIFFERENT
DISCIPLINES.
IT WOULD BE A BALANCE TO
MAINTAIN AT A STATE LEVEL AND
LOCAL LEVEL AND INDIVIDUAL LEVEL
AT ONCE BUT IT'S KEY.
BOTH FOR THE CONDUCT OF RESEARCH
AND UNDERSTANDING THE ROLE IN
THE STUDY IS SO WE ON THE
RESEARCH SIDE UNDERSTAND THE
CONSTRAINTS FROM EACH OF THOSE
VANTAGE POINTS AND WE CAN
CONNECT AND UNDERSTAND WITH THE
CHALLENGE AND OPPORTUNITIES EACH
STAKEHOLDER HAS IT'S DIFFICULT
TO MAKE IT WORK.
WE CAN HAVE A STRONG STATE-LEVEL
PARTNERSHIP THAT DOESN'T REFLECT
THE REALITY ON THE BOOTS TONE
GROUND FOR US IN D&I WHICH WOULD
MAKE IT COLLAPSE OR WE COULD BE
RESPONSIVE TO E.I. NEEDS BUT
IGNORE THE POLICY CONTEXT AND IT
WOULD ALSO FALL.
HAVING OUR EYES SET AT EVERY
LEVEL AND NOT NEGLECTING THE
LEADERS IN THE MIDDLE TOO ARE
IMPORTANT TOO.
WHATEVER IS THAT MIDDLE LEVEL
LEADER IS IN YOUR PROGRAMS ARE
IMPORTANT FOR INFLUENCING
UPWARDS AND BACKWARDS REGARDLESS
OF WHO SURROUNDS THEM.
>> MEGAN: WHAT ARE THE OUTCOMES
MORE VALUABLE TO THEM AND THEIR
METRICS AND HOW DO WE ALIGN THE
WORK TO MAKE THEM REALIZE THEY
WANTED TO DO AND THAT WAS REALLY
KEY THAT LISTENING TO WHAT ARE
THE OUTCOMES AND METRICS THAT
ARE MOST IMPORTANT TO THEM.
>> SUSAN: LISTENING TO WHAT YOUR
PARTNERS WANT AND VALUE SHOWS
YOUR VALUING THOSE
RELATIONSHIPS.
SOME OF THE WORK I DID IS FROM
WHAT PARTNERS WANTED.
THE DEPARTMENT OF EDUCATION IN
KENTUCKY WANTS TO BE ABLE TO
LOOK AT OUTCOMES OF WHAT IS
HAPPENING BECAUSE OF THESE
SCREENING PROGRAMS WHICH LED TO
DEVELOPMENT WITH A STATEWIDE
AGENCY AND LED TO A YEAR'S WORTH
OF DISCUSSIONS WITH LEGAL
COUNCILS TO ALLOW THE
STATE-LEVEL AND SOME SUCCESS IS
BECAUSE OF WHAT OUR PARTNERS
WANT AND NEED AND SOMETIMES IT
TAKES US IN A DIFFERENT
DIRECTION AND WE PLAN A CERTAIN
ROAD MAP AND SOMETIMES THERE'S
ADDITIONS TO THAT ROAD MAP
BECAUSE OF NEW THINGS THAT
EVOLVE IN THESE RELATIONSHIPS
AND THAT'S OKAY BECAUSE THAT'S
PART OF THIS WORK AND PART OF
THE VALUE OF IT.
>> HOLLY: I DIDN'T HEAR ANYTHING
ABOUT INCENTIVES TO GET CUs
WITHOUT PAYING FOR THEM SINCE
THEY'RE ALL REQUIRED TO DO
CONTINUING EDUCATION FOR
RECERTIFICATION.
ANOTHER TYPE OF INCENTIVE WE
TALKED ABOUT MONEY AND HEARD
ABOUT THAT IN TALKS AND ADDING
IN OTHER TYPE OF INCENTIVES THAT
HELP PEOPLE MEET THEIR
CERTIFICATION GOALS.
ANYONE HAVE A FURTHER COMMENT ON
THAT?
>> BRIAN: WHAT ARE THE
APPROPRIATE REWARDS AND
RECOGNITIONS FOR PARTICIPATING
IN THIS WORK AND THINKING ABOUT
SUSTAINMENT.
WHEN WE'VE BEEN TRYING TO FORM
THE SCHOOL-BASED IMPLEMENTATION
TEAMS HOW DO THESE FOLKS GET
RECOGNIZED AND REWARDED FOR
WORKING AT THE SCHOOL LEVEL?
THEY'RE DOING SOMETHING BEYOND
GENERAL SCOPE OF PRACTICE AND
SOMETIMES WE'VE OFFERED
CERTIFICATE OF COMPLETION FOR
TRAINING OR OTHER THINGS AND
WORK WITH THE SPECIAL EDUCATION
TEACHER, ADMINISTRATOR OR
BUILDING PRINCIPLE TO THINK
ABOUT WHAT ARE TO RECOGNIZE AND
REWARD THE WORK.
IT'S ANOTHER PLACE WHERE
PARTNERSHIPS ARE IMPORTANT AND
FIGURE OUT HOW TO PUT IN A
STRUCTURE THAT'S IMPORTANT FOR
THAT PARTICULAR CONTEXT.
I THINK CEUs ARE A GREAT IDEA WE
JUST HAVEN'T DONE THAT.
>> HOLLY: THANKS, BRIAN.
COME ON AND ASK A QUESTION OR
COMMENT.
>> AMY: I WAS GOING BACK TO CEUs
I WITH YOU INVOLVED IN AN EARLY
STUDY INTERVENTION AND A
CLINICIAN AND WE COULD GET ASHA
CEUs OR GET UNIVERSITY CREDIT
AND THAT'S WHAT THE SLPs CHOSE
TO GET AS PART OF BEING IN THE
INTERVENTION STUDY BECAUSE IT
WOULD MOVE THEM UP ON THE PAY
SCALE.
A PERSONAL EXPERIENCE HOW THAT
COULD LOOK.
>> HOLLY: THANKS.
I WANT TO TOUCH ON SOMETHING
SUSAN HINTED AT WHICH I THINK I
HEARD THREADS ACROSS PEOPLE'S
TALKS AND THAT'S THE ADAPTATION
THAT HAPPENS.
WHEN YOU DO THE WORK YOU'RE
DOING IT IN THE REAL WORLD AND
REAL CRISES HAPPEN AND
OPPORTUNITIES HAPPEN AND HAVE
YOU THE GRANTS GO OUT THE WINDOW
WHEN YOU'RE WORKING IN THE REAL
WORLD LIKE THIS.
I WONDER IF YOU ALL CAN TALK A
LITTLE BIT ABOUT THE ADAPTATIONS
THAT OCCUR AND HOW YOU HANDLE
THAT AND HOW YOU ALSO DOCUMENT
THAT AND HANDLE IT MORE FOR THE
RIGOR AND REPRODUCIBILITY OF
YOUR TRIAL BUT YET ALSO BE
RESPONSIVE TO WHAT'S HAPPENING
BECAUSE YOU STILL WANT IT TO
KIND OF WORK.
>>
>> I CAN SPEAK TO THAT BRIEFLY.
SOMETHING THAT WE WISH WE HAD
DONE WHEN RUNNING THE PCORI
TRIAL IS BUILD IN TIME FOR
ADAPTATION BECAUSE WE RECOGNIZED
IN THE MIDST OF THE TRIAL THERE
WERE BIG CHANGES THAT NEEDED TO
HAPPEN AND WE WEREN'T SET UP TO
ACCOMMODATE THAT SCIENTIFICALLY.
ONE KEY ELEMENT WAS
TRANSITIONING TELEHEALTH FROM
THE CLINIC SETTING TO SCHOOL
SETTING BECAUSE THE TECHNOLOGY
BECAME AVAILABLE WHILE IN THE
MIDDLE OF THE CHILD AND WEREN'T
SET UP TO RESPOND IN REAL TIME
TO OUR STAKEHOLDERS' GUIDANCE.
WE DID THINGS DIFFERENTLY FOR
NEXT TWO STUDIES AND HAVE
PURPOSEFUL TIME POINTS TO MAKE
TRANSITIONS AND ADAPTATIONS.
THAT TOOK GROWTH AND ADJUSTMENT
FROM US.
THIS IS DIFFERENT.
WE LOOKED AT WHAT IMPLEMENTATION
PARTNERS BROUGHT TO GUIDE RIGOR
WHILE IT'S NEW TO US IS WELL
ESTABLISHED IN THE FIELD.
LEANING ON THE EXPERTS IN THE
TEAM CAN HELP.
THERE'S THE FRAMEWORK FOR
ADAPTATIONS THAT CAN BE HELPFUL
TO USE BECAUSE THEY'RE ALMOST
INEVITABLE WITHIN CONTEXT.
IT'S HELPFUL TO KNOW THE ACTIVE
INGREDIENTS OF YOUR PARTICULAR
IMPLEMENTATION AND WHAT ARE THE
PERIPHERY COMPONENTS THAT CAN BE
ADAPTED OR EXPECTED TO BE
ADAPTED TO BETTER FIT THAT
PARTICULAR CONTEXT AND SO TAY
CAN UNDERSTAND THE ADAPTATIONS
AND CHANGING POINTS.
>> IT'S AN ACRONYM FOR THE
REGULAR FRAME F-R-A-M-E BUT THE
"A" IS ADAPTATION.
IF YOU GOOGLE FRAME ADAPTATION
SCIENCE YOU'LL FIND WHAT WE'RE
TALKING ABOUT.
MEGAN, I SAW YOU UNMUTE.
>> MEGAN: I SECOND THE FRAME
HAVING AN UP-TO-DATE ON YOUR
PRAGMATIC TRIAL DESIGNS AND HAVE
A SKILLED BIO STATISTICIAN TO
HELP YOU ALONG THE WAY AND WE
HAD A LOT OF DISCUSSIONS SAYING
WE HAD TO ADJUST THIS AND HOW
DOES THIS CHANGE THE
CALCULATIONS AND THAT WAS KEY.
>> HOLLY: THAT CAME UP IN THE
OTHER SESSION OF HOW DO YOU FIND
THESE TEAM MEMBERS AND BUILD THE
PARTNERSHIPS AND ENTICE SOMEONE
TO BE PART OF YOUR TRIAL.
WHAT WAS YOUR EXPERIENCE LIKE?
YOU CAN COME IN AND ASK
QUESTIONS TOO.
IT'S NOT JUST ME.
WE'RE OPEN TO AUDIENCE
QUESTIONS.
>> MY RO1 WITH TINA STUDST WAS
OUR IMPLEMENTATION SCIENTIST AND
I HAVE AN MPH WITH HEALTH
SERVICES AND SITUATE MYSELF IN
HEALTH SERVICES RESEARCH WITHIN
OUR MEDICAL SCHOOL.
ONE THING I FOUND THAT I HAVE
SKILLS IN QUALITATIVE RESEARCH.
I FOR A WHILE A LOT OF WHAT I
DID WAS BE ON OTHER GRANTS AS A
QUALITATIVE RESEARCHER AND
ASSIST THEY WILL IN THEIR
STUDIES INCLUDING IMPLEMENTATION
TRIALS.
IT GAVE ME A FRONT SEAT IN
LEARNING HOW OTHER PEOPLE WERE
DESIGNING AND IMPLEMENTING THE
TRIALS BUT IT ALSO WENT IT CAME
AROUND TIME FOR -- I NEEDED
CO-INVESTIGATORS AND WOULD SAY,
HEY, WE ALREADY WORKED TOGETHER
ON THIS OR WOULD YOU MIND BEING
ON MY PROJECT.
THAT HAS BEEN SUCCESSFUL FOR ME.
I WOULD SAY A LOT OF PEOPLE THAT
ARE MY CO-INVESTIGATORS ON MY
GRANTS DON'T HAVE A DISABILITY
OR DISABILITY BACKGROUND BUT
THEY KNOW ME AS A RESEARCHER AND
I'VE SLOWLY INDOCTRINATED THEM
TO THE AREA.
>> MOLLIE: I'VE HOOD TO DO HEAD
HUNTING TO BE RESPONSIVE TO SOME
GRANTS INCLUDING COST ANALYSIS
NOT REQUIRED ON THE IES SIDE AND
A LOT OF ASKING AROUND
PARTICULARLY WITH PEOPLE FUNDED
IN THE SAME MECHANISM LED US TO
FIND NEW PARTNERS THAT I HAD
NEVER MET BEFORE AND IT WAS A
GREAT OPPORTUNITY TO BUILD OUT
THAT TEAM INTO NEW AREAS AND ON
A RECENT SUBMISSION WE WERE
LOOKING FOR A METHODOLOGIST WITH
MORE OF AN EQUITY FOCUS AND WERE
ABLE TO FIND SOMEBODY UP AND
COPPING.
THE DESIGN WE WERE THINKING
ABOUT WAS NOT PARTICULARLY
COMPLEX BUT I THINK HIS FOCUS ON
EQUITY ISSUES WAS JUST SO GREAT
TO HAVE HIS PERSPECTIVE AND WAS
ANOTHER WORD OF MOUTH FIND.
>> SOMETHING WE'VE DONE IS TAKE
A TEAM-BASED APPROACH WE'RE
OFTEN LOOKING TO HAVE
PARTICULARLY INDIVIDUALS OF
DIFFERENT LEVELS OF EXPERIENCE
AND WHO BRING DIFFERENT ASPECTS
OF EXPERTISE SO WE HAVE A
SLIGHTLY MORE JUNIOR SCIENTIST
WHO HAS EXPERIENCE IN
SCHOOL-BASED WORK AND A MORE
SENIOR ONE WHO HAS A
RELATIONSHIP WITH OUR TEAM FROM
OTHER WORK OFTEN I THINK FINDING
PEOPLE SAY RELATIONSHIP THING.
IT'S BUILDING ON EXISTING
RELATIONSHIPS AND COLLEAGUES AND
COLLEAGUES AND TRYING TO PIECE
TOGETHER THE RIGHT PEOPLE FOR
EACH PROJECT.
I DON'T THINK THERE'S A SECRET
SAUCE IN HOW TO DO THAT BUT HAS
WORKED WELL FOR US TO HAVE MORE
THAN ONE PERSON BECAUSE YOU GET
MULTIPLE PERSPECTIVES AND THAT'S
BEEN HELPFUL.
>> HOLLY: THANKS FOR THE
ANSWERS.
>> JARRAD: IT'S GREAT TO SEE THE
PROJECTS THAT HAVE SUCCESSFULLY
USED ALL THIS IN OUR FIELD.
THE QUESTION I STRUGGLED WITH A
LOT AND WONDERING YOUR THOUGHTS
ON IS IN REHAB THERE'S NOT A LOT
OF THEORY-DRIVEN FRAMEWORKS AND
IN D&I THERE'S SO MANY AND HOW
DID YOU CHOOSE THE ONES YOU
CHOSE DID YOU HAVE EXPERTS?
I'M CURIOUS HOW YOU WENT ABOUT
IT.
>> YOU CAN FIND THE ONE THAT
FITS YOUR NEEDS.
WE OFTEN USE THE FS FRAMEWORK OR
THE ONE DEVELOPED THROUGH THE
NATIONAL IMPLEMENTATION RESEARCH
NETWORK AWE USED THOSE WITHIN
THE CONTEXT OF AUTISM.
THERE'S PRIOR STUDIES THAT
APPLIED THOSE FRAME WORKS WITHIN
MY FIELD.
SO WE KNOW THEY TELL US ABOUT
THE IMPLEMENTATION OUTCOME AND
THEY SUPPORT THE STUDENT
OUTCOMES.
I LEANED" PRIOR RESEARCH IN MY
PARTICULAR FIELD OF STUDY AND
THAT IS WHY I'VE GONE ALONG AND
CONTINUED TO USE SOME OF THOSE
PARTICULAR FRAME WORKS IN MY
WORK.
THERE'S QUITE A LIST.
>> MOLLIE: FOR OUR PARTNERS SOME
WERE FAMILIAR WITH IT AND THAT
FAMILIARITY THEY HAD HAT HEARD
OF THE FRAMEWORK AND WERE USED
TO THE VOCABULARY AND MADE IT
USEFUL AND A NATURAL FIT FOR US.
IN GENERAL FINDING FRAME WORKS
THAT FIT THE BILL ARE BECAUSE
IT'S ANOTHER WAY OUR PARTNERS IF
THEY CAN UNDERSTAND THE LOGIC
THEY'LL KEEP USING IT AND COOL
TO SEE THE TERMS ENTER IN THE
VOCABULARY OF THEIR WORK HEARING
THEM TALK ABOUT COMPETENCY
DRIVERS AND ALL THOSE DRIVERS
FROM THE FRAMEWORK GIVES
GROUNDING I THINK BUT SOMETIMES
I WONDER IF I'M HAVING TROUBLE
UNDERSTANDING THE COMPLEX ONES.
I'M NOT SURE I CAN EXPLAIN IT
AND HOW THAT MAY HIT.
FOR ME SIMPLICITY IS KEY AND IN
THE RESEARCH.
>> A COUPLE CLARIFICATIONS HERE.
WHEN THEY'RE SAYING NURN THEY'RE
PROVIDING AN ACROMIM N-I-R-M FOR
THE NATIONAL IMPLEMENT RESEARCH
NETWORK AND YOU CAN FIND THAT.
THEY HAVE ONLINE RESOURCES ABOUT
THE FRAMEWORK.
SOMEBODY ELSE PUT IN THE CHAT
THERE'S A TOOL FOR SELECTING
FRAMEWORK.
DISSEMINATION IMPLEMENTATION.org
IT TAKES YOU TO A DATABASE AND
PUT IN FILTERS AND START TO SEE
FRAME WORKS THAT MATCH UP AND IS
THAT WHAT YOU WERE GOING TO
COMMENT ON?
>> TINA: THIS IS PROBABLY THE
MOST COMMON QUESTION IF YOU'RE
AN IMPLEMENTATION SCIENCE PERSON
AND CONSULTING THIS IS THE FIRST
QUESTION PEOPLE HAVE BECAUSE
THEY'VE SEEN THE TOOL OR BEEN
READING AND OVERWHELMED BY TO
THE MODELS AND THEORIES AND
BEFORE YOU CAN USE THEM TOGETHER
AND WHICH ONE IS THE BEST ONE WE
TEACH AN INTER-D&I CLASS WHERE I
AM AND WE SPEND PROBABLY THE
FIRST THREE WEEKS OF THIS CLASS
TRYING TO ALLEVIATE ANXIETY
ABOUT ONE FRAMEWORK THE ONE YOU
SHOULD BE USING BECAUSE REALLY
WHAT BRIAN AND MOLLY SAID IF
SOMEONE KNOWS SOMETHING ABOUT A
FRAMEWORK AND IT'S GOT THE STUFF
IN IT YOU NEED LIKE OUTCOMES OR
CONTEXT AND LEVELED AND WHAT MAY
BE AFFECTING IMPLEMENTATION IS A
GOOD PLACE TO START.
IF YOU HAVE NO ONE THAT KNOWS
ANYTHING ABOUT FRAMEWORK GO IN
THE IMPLEMENTATION LITERATURE
YOUR AREA LIKE BRIAN SAID IPIS
IS A GOOD ONE AND DEVELOPERS
HAVE TOOLS AND ARTICLES TO
REFERENCE.
EPIS HAS ONE AND ONE MENTIONED
EARLIER I THINK BY MATT WHICH IS
USUALLY JUST CALLED CFOR HAS A
NEW VERSION OUT LIKE IF YOU KNEW
THE OLD VERSION IT'S FRUSTRATING
TO HAVE TO LEARN A NEW VERSION
BUT IT'S A NEW VERSION THAT'S
ADDRESSING ISSUES WITH OLD
VERSIONS.
IT'S PROGRESSING AND ADAPTING
AND THE REACH EFFECTIVENESS
MAINTENANCE FRAMEWORK HAS A HUGE
WEBSITE CALLED PRISM.
THE BEST WAYS TO CHOOSE A
FRAMEWORK ARE IT MAKES SENSE TO
YOU AND THE PEOPLE YOU'RE
WORKING WITH AND THING IN IT TOO
BECAUSE SOMETIMES THEY DON'T
HAVE EVERYTHING YOU NEED AND IF
IT'S USED IN YOUR AREA AND YOU
CAN GET LOTS OF GOOD EXAMPLES
AND THE LAST ONE IS GONE.
IF IT MEETS YOUR NEEDS AND IF
THERE'S TOOLS.
SO THIS IS WHY THE ONES USED THE
MOST PROBABLY ARE USED THE MOST
THEY'RE DEVELOPERS HAVE MADE IT
EASY.
MY GREATEST WISH IS ALL PEOPLE
LET GO OF THE HANG UP OF I'M
USING PRISM BUT SHOULD I BE
USING FEFER OR EPIS AND YOU FIND
THE ONE THAT'S THE BEST FIT FOR
YOU.
>> GREAT DISCUSSION.
LOOKING ON THE WEBSITE AND
SEEING THE TOOL AND THERE'S
INTERVUSZ QUESTIONS BUILT OFF
THE FRAMEWORK AND YOU START
READING THOSE AND YOU ARE LIKE
THOSE ARE THE QUESTIONS I WANT
THE ANSWER TO AND YOU'LL GET
MILEAGE AND THAT'S WHAT THE
FRAMEWORK IS THERE FOR TO GIVE
YOU THE MILEAGE AND STARTING
POINT SO YOU'RE NOT BEGINNING
FROM SCRATCH.
GREAT QUESTION.
ANOTHER SLIGHTLY DIFFERENT
DIRECTION, SEVERAL OF YOU BRIAN
AND MOLLY TALKED ABOUT THE
INSTITUTE FOR IMPLEMENTATION
SCIENCE FUNDING AND WE HEARD
ABOUT PCORI TOO AND WONDER IF
FOLKS CAN TALK WITH THE GRANT
MECHANISMS AVAILABLE THERE AND
WHAT THEY ALLOW TO YOU DO MAY
HELP PEOPLE THINK HOW TO BRING A
LARGE PROJECT INTO A STARTING
POINT AND WHAT MIGHT BE SOME
GOOD STARTING POINTS AND GOOD
END POINTS TO GET A SMALL PIECE
GOING THAT THAN CAN LEAD TO A
LARGER PIECE AND ANOTHER WAY FOR
PEOPLE TO KNOW WHAT'S AVAILABLE
OUT IN FUNDING BECAUSE WE TALKED
ABOUT NIH BUT WE DIDN'T TALK
ABOUT ANYTHING ELSE AND NIH
ISN'T THE ONLY THING IN TOWN.
SO COMMENTS ON THE
OPPORTUNITIES?
I THINK MOLLY WAS NOMINATING
BRIAN.
>> HE DID A SPIEL ON THE ARTIST
FORMALLY KNOWN AS INNOVATION.
>> YOU MAY BE MORE FAMILIAR WITH
IT THAN I AM RIGHT NOW.
YOU CAN DO SOME ANALOGY EQU
EQUIVALENT TO AN R21.
I THINK THE FUNDING LEVEL MAY BE
SLIGHTLY HIGHER TO COLLECT
INTERVENTION AND DATA AND APPLY
FOR THE EFFICACY TRIAL WHICH IS
THE NEXT GRANT AND THEY HAVE AN
EFFICACY EFFECTIVENESS TRIAL YOU
CAN APPLY FOR BUT IT DOES GIVE
PILOT LEVEL FUNDING.
OFTEN PEOPLE PLAN A SERIES OF
STUDIES AND I DO BELIEVE NOW
THEY'VE LOOKED FOR
IMPLEMENTATION OUTCOMES AS PART
OF THOSE STUDIES BECAUSE THEY'RE
ING YOU SHOULD BE PROBABLY
ASKING SOME OF THOSE QUESTIONS
WHILE YOU'RE DEVELOPING THE
INTERVENTION BECAUSE YOU'RE
THINKING IT'S GOING TO BE
IMPLEMENTING IN A PARTICULAR
CONTEXT WITHIN THE EFFICACY
STUDY THAT FOLLOWS.
THINK ABOUT IT AS AN R21, R01
BUT THERE'S DEVELOPMENT AND
INNOVATION AND
EFFICACY/EFFECTIVENESS TRIALS.
>> HOLLY: MEGAN UNMUTED FOR
PCORI I HOPE.
>> MEGAN: THERE'S ENGAGEMENT
AWARDS WHICH I THINK WAS
IMPORTANT FOR ME IN MY EARLY
WORK AND CONTINUES TO BE
IMPORTANT WITH THE WORK WE ARE
CONTINUING TO DID BASED OFF THAT
ENGAGEMENT AWARD.
BUT THIS ALLOWS YOU TO BRING
YOUR STAKEHOLDERS TOGETHER.
START TO BUILD PARTNERSHIPS
WHICH IS CHALLENGES SOMETIMES TO
GET FUNDING FOR.
SO THAT'S A GREAT INTRODUCTORY
MECHANISM AGAIN YOUR ACTUALLY
NOT TO DO RESEARCH.
YOU'RE SUPPOSED TO ENGAGE
STAKEHOLDERS AND THERE'S
DIFFERENT FLAVORS OF THAT.
AND THEN THE LARGER AWARDS ARE
THERE COMPARATIVE EFFECTIVENESS
RESEARCH AWARDS AND THIS IS A
LITTLE BIT DIFFERENT.
ONE OF THE THINGS THAT'S
CHALLENGING IS IT'S COMPARATIVE
EFFECTIVENESS OF TWO
INTERVENTIONS IN AND SOME OF US
WORK IN AREAS WHERE THERE'S NOT
A LOT OF RESEARCH OR EVIDENCE
BUT YOU CAN ADAPT INTERVENTIONS
FROM OTHER DISCIPLINES AND
FIELDS TO APPLY TO YOUR AREA.
SO THOSE ARE AGAIN THE TWO MAIN
MECHANISMS.
THEY HAVE A SPECIFIC PRIORITY
AREA ON DEVELOPMENT AND
INTELLECTUAL DISABILITY AND THEY
ARE ALWAYS LOOKING FOR
APPLICATIONS IN THAT AREA.
>> HOLLY: THE NEXT TOPIC I THINK
MOLLIE HINTED AT WAS BUILDING
CAPACITY AND KNOWLEDGE BASE OF
YOUR PARTNERS.
WE TALKED ABOUT WANTING TO
INVOLVE PEOPLE IN PARTNERSHIP
AND WANTING TO WELL I'M GOING
INTERVIEW YOU AND TAKE YOUR DATA
AS A PRCHT BUT HAVING THE FULL
PARTNERSHIP -- AND INTERPRETING
THE DATA AND SO ON BUT MANY
PARTNERS DON'T HAVE A BACKGROUND
AND MOLLIE WAS SAYING NOW WE
HAVE ALL THESE PRACTITIONERS WHO
KNOW SINGLE-SUBJECT DESIGN AND
STUFF LIKE THAT.
I'M WONDERING THAT PROCESS.
HOW DO YOU BUILD THAT CAPACITY
IN YOUR PARTNERS SO THEY CAN BE
FULL PARTNERS AND IS THAT
SOMETHING SOME WANT OR LESS?
ANYONE WHO WOULD LIKE TO TALK
ABOUT THAT PIECE.
WHO DOESN'T WANT TO LEARN
SINGLE-SUBJECT DESIGN?
>> AN AREA THEY NEVER KNEW THEY
NEEDED.
I CAN TALK ABOUT IT A LITTLE
BIT.
I FEEL LIKE WE STILL HAVE GROWTH
TO DOWN TERMS OF A CHOICE OF
RESEARCH DESIGN.
AND WHEN WE DID A SERIES OF
SINGLE CASE BEFORE WE WROTE THE
GRANT THE WAY WE DID, WE DID
CHECK IN WITH THE LOCAL LEVEL
COACH TO EXPLAIN WHAT IT IS.
THERE'S GOING TO BE A GROUP OF
PROVIDERS WHO YOUR COACHING
HANGING ON IN BASELINE FOR A
LONG TIME.
THAT MEANS FOR US THEY'RE
RECORDING THEIR HOME VISITS WEEK
IN AND WEEK OUT IN WHAT CAN FEEL
LIKE A LONG TIME AND THAT'S AN
IMPORTANT CONSIDERATION FOR
THEM.
THEY'LL FEEL LIKE WHY AM I DOING
THIS?
MAKING SURE THAT THEY THOUGHT
THAT WAS SOMETHING THAT THEY
COULD EFFECTIVE COMMUNICATE AND
HELPING THEM TO UNDERSTAND THAT
THE STAGGER IN MULTIPLE BASELINE
IS WHAT GIVES US THE
EXPERIMENTAL CONTROL WITHIN A
SMALL GROUP SO THAT MEANT THEY
NEEDED TO CONSIDER AND COME UP
WITH WAYS THEY THOUGHT IT
COULD -- THEY COULD ACCIDENTALLY
SORT OF CONTAMINATE THAT PHASE.
SO THEY'RE SUPPOSED TO START AT
DIFFERENT TIMES.
SUSIE IS STARTING AT A SEPARATE
POINT THAN JENNEY AND DIFFERENT
THAN TASHA.
HOW DO WE MAKE SURE SHE DOESN'T
COMMUNICATE WHAT SHE'S LEARNING
AND THEY KNOW WHEN THE GROUP OF
THREE PROVIDERS WILL BE TOGETHER
AND HELPING EXPLAIN FROM THE
OUTSET THE POTENTIAL FACTORS
THAT COULD INTERRUPT THE DESIGN
AND HAVE THEM GENERATE IDEAS FOR
OKAY SO HOW CAN WE PLAN FOR HOW
DO WE GET AROUND THAT AND WHAT'S
FEASIBLE TO GET AROUND AND WHAT
ISN'T?
AND THE RANDOMIZED TRIALS THAT A
SIMILAR SITUATION AND I GUESS IT
IS A CHALLENGE.
ANYTIME YOU HAVE A WAIT LIST
GROUP HOW WILL WE HANDLE THAT
FOR FOLKS WAITING.
WILL IT BE FEASIBLE LIKE IN THE
CONTEXT WHERE PEOPLE GOING
THROUGH A TRAINING FIRST ARE
GETTING -- THEY'RE GETTING AN
ADDED STIPEND FIRST SO
PARTNERING WITH THEM TO COME UP
WITH WORK AROUNDS AND HELP THEM
UNDERSTAND THE REASON.
I FOUND OUR PARTNERS THEY'RE
AMAZING AND ONCE THEY UNDERSTAND
THE LOGIC THEY'LL CARRY THE
TORCH FOR WHATEVER THOSE DESIGN
CONSTRAINTS ARE WHEN THEY
UNDERSTAND IT AND IT CLICKS.
THEY DON'T ALWAYS HAVE A CHOICE
OF DESIGN NECESSARILY BUT MAKING
SURE THAT IT'S FEASIBLE AND THEY
UNDERSTAND WHAT THE IMPLICATIONS
MAY BE BECAUSE SEEING THEM BRAIN
STORM AND WALK THROUGH THAT
PROCESS HELPS US UNDERSTAND WHAT
SORT OF LITTLE SAFEGUARDS WE MAY
NEED IN PLACE AS WELL TO PROTECT
THAT DESIGN.
>>
>> HOLLY: THANKS VERY MUCH.
WE'RE AND THE OF OUR TIME AND
THANK YOU TO OUR PANELISTS AND
SUSAN, BRIAN, MEGAN AND MOLLIE.
THIS IS THE END OF DAY ONE.
I WANT TO THANK ALL OF YOU FOR
THE WONDERFUL TALKS AND
WONDERFUL PARTICIPATION AND
GREAT QUESTIONS AND ANSWERS.
IT'S BEEN VERY GENERATIVE.
I'VE LEARNED A LOT AND HAVE A
LOT I'LL BE THINKING ABOUT
OVERNIGHT.
TOMORROW WE'LL BE BACK TOMORROW
STARTING AT 12:00 EASTERN.
TOMORROW WE'LL START TO WIDEN
OUR LENS AND THINK BEYOND THE
INDIVIDUAL AND REALLY BE
THINKING ABOUT HOW WE CAN WORK
COLLECTIVELY TO BUILD CAPACITY
AND OVERCOME SOME OF THE
CHALLENGES THAT WE TALKED ABOUT
TODAY.
SO, EVERYONE HAVE A WONDERFUL
EVENING AND THANKS FOR BEING
HERE AND I LOOK FORWARD TO
SEEING YOU TOMORROW.