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Sustainability from an Evidence Integration Triangle Perspective

Russell E. Glasgow, Ph.D. Deputy Director, Implementation Science Division of Cancer Control and Population Sciences National Cancer Institute Society of Behavioral Medicine April 2011. Sustainability from an Evidence Integration Triangle Perspective. OVERVIEW. Definitions and Focus

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Sustainability from an Evidence Integration Triangle Perspective

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  1. Russell E. Glasgow, Ph.D. Deputy Director, Implementation Science Division of Cancer Control and Population Sciences National Cancer Institute Society of Behavioral Medicine April 2011 Sustainability from an Evidence Integration Triangle Perspective

  2. OVERVIEW Definitions and Focus Learning Health Care Systems (Setting level) Problem-Solving Ability and Training (Indiv.) Evidence Integration Triangle perspective Implications for Sustainability

  3. Sustainability Focus Definitions Learning Health Care Problem Solving Evidence Integration Triangle Sustainability Issue 1: Activities, Processes, or Outcomes Issue 2: Static vs. Dynamic Conceptualization

  4. D&I: What we know Evidence Integration Triangle Future Directions/D&I Opportunities Current Gap Rapid Learning Health Care Systems Data Collected: With real (and complex) patients By real-world staff Under real-world conditions and settings And evaluated through real-time data (often with Electronic Health Records) Tunis,S.R.; Carino,T.V.; Williams,R.D.; Bach,P.B. A Rapid Learning Health System. Health Affairs (supplement). 2007;26(2):140-149. 4

  5. Evidence on Problem-Solving Training (PST) Definitions Learning Health Care ProblemSolving Evidence Integration Triangle Sustainability Consistent evidence that PST improves long-term outcomes for: Social skills Depression Weight loss Many other behaviors and conditions

  6. Evidence Integration Triangle Translation Across the Continuum Intervention Program/Policy(Prevention or Treatment) (e.g., design; key components; principles; external validity) Feedback Feedback Evidence Stakeholders Practical Measures (e.g., actionable & longitudinal measures) Implementation Process (e.g., stakeholder engagement; team-based science; CBPR; patient centered care) Feedback 7

  7. Definitions Learning Health Care Problem Solving Evidence Integration Triangle Sustainability Implications of Learning Systems, PST, and EIT for Sustainability • To maintain or continue improvement need to adapt and respond to changing content • Iterative cycles of measurement, comparison to goal, adaptation, implementation, measurement, etc.

  8. IF AN INTERVENTION WORKS AND NOBODY CAN USE OR SUSTAIN IT….. DOES IT STILL MAKE AN IMPACT? 9

  9. More Information Glasgow RE, HMC Research Translation…Am J Health Behav 2010;Nov-Dec 34(6):833-840 SBM Symposium on Sustainability: What Does It Mean? (Chambers, Kaplan, Wasserman, Glasgow) Friday April 29, 8:45- 10:15

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