Adapting UCSF Implementation Science Curriculum to Meet the Needs of HIV Focused Public Health Practitioners

Transcription

1 Adapting UCSF Implementation Science Curriculum to Meet the Needs of HIV Focused Public Health Practitioners Margaret Handley PhD MPH Associate Professor, Department of Epidemiology and Biostatistics and Center for Vulnerable Populations, University of California, San Francisco Co-Director UCSF Training Program in Implementation Sciences

2 Today s Objectives I. Present the UCSF Training Program in Implementation Sciences and core components II. Describe adaptation for trainees in diverse settings and across practitioner level -example of HIV-focused public health practitioner training for WHO HIV/AIDS Collaborating Centre for HIV Surveillance III. Next steps for creating flexible models to address local training needs for diverse focus areas

3 EVIDENCE PRACTICE HEALTH UCSF Implementation Science Training Framework: Translating Evidence into Practice, Policy and Public Health Stakeholders Government Payors/Insurers Societies Delivery Systems Individuals Hospitals Clinic/Practices Health Depts, NGOs Providers Patients Public Gonzales, Handley, Ackerman, O Sullivan Accademic Med. 2012

4 Transdisciplinary Sciences: Specific Areas Needed for UCSF Investigators IDS DISCIPLINES Behavioral Sciences Economics Education Engineering Social Sciences PUBLIC HEALTH & CLINICAL SCIENCES Dentistry Medicine Nursing Pharmacy POPULATION SCIENCES Epidemiology Biostatistics Health Policy

5 What are the Design Principles In Effect in the UCSF ImS Training Framework? Design Principle 1: Behavior Change is inherent to translation of evidence into practice, policy, and public health improvements Design Principle 2: Engagement with stakeholders is essential at all stages Design Principle 3: The process of change needs to build in iterative cycles and co-directionality in relationships, collaborations, creation of evidence

6 EVIDENCE PRACTICE HEALTH Curricular Components for Academic and Applied Researchers focusing on Interventions >>>>Intervention Prototype Development>>> Stakeholders Government Payors/Insurers Societies Delivery Systems Individuals Hospitals Clinic/Practices Health Depts/NGOs Providers Patients Public Masters Track/Elective/Certificate Program: Intro (245). Community Engagement (248), Behavior Change Interventions and Individuals (246), Evaluation (242). Systems Interventions (247), Evidence/ Policy (249) Gonzales, Handley, Ackerman, O Sullivan 2012

7 In Which Domains are ImS Skills Needed? Team Science Context Identification Assessment of Evidence Relevant to Topic Community Engagement Behavior Change Tools and Communications Intervention Design and Implementation Evaluation of Effects of Translational Activities

8 Which Competencies are Needed? Domain Team Science Context Identification Competency Formation of multidisciplinary teams that blend discipline-specific language and skills into applications relevant to problem to be addressed Ability to identify range of factors, behavioral, socioecological, institutional, etc that inform implementation question and problem prioritization Community Engagement Capacity to build relationships with communities and stakeholders to engage in multiple approaches Intervention Design and Implementation Selection of frameworks that reflect diverse views to guide intervention design; Integrate change theories into intervention with appropriate outcome and impact measures

9 II. Adaptations for Practitioner Trainees- Implementation Science in HIV Programming, Croatia June 2013 Faculty George Rutherford MD UCSF Ivana Bozicevic MD PhD- WHO Collaborating Center Aleksandar Stulhofer PhD University of Zagreb Margaret Handley PhD MPH- UCSF Expertise Global health, applied public health, epidemiology, HIV/AIDS, sociology, intervention design and evaluation, education, evidence reviews Process ID of priority areas for HIV practitioners w/in UCSF ImS Curriculum and selection of HIV case studies for integration with methods lectures

10 Disciplinary Focus: Epidemiology, sociology, community health, medicine, tech. support, monitoring and evaluation II. Workshop on Implementation Science in HIV Programming, June 2013 Diverse Trainees (n=18): Program Directors/Ministry of Health Consultants/WHO Surveillance and Public Health Epidemiologists Representing Bulgaria, Russia, Ukraine, Russia, Sudan, CDC

11 II. Structure for Workshop on Implementation Science in HIV Programming, June 2013 Week-Long In Residence Course, Cavtat Croatia 1. Fit into sequencing of weeklong trainings conducted over several years: Epidemiology>> surveillance>>meta-analysis>> intervention selection>> monitoring and evaluation and ImS 2. Presentation of priority areas by group, lectures adapted from UCSF ImS Training. Protocol development with faculty mentoring last three days

12 II. Adapted Content from UCSF ImS Courses Focus- Methodologies and Frameworks Focus- Tools and Case Study Community Engagement Strategies Behavior Change Theories Experimental Designs Quasi-Experimental Designs Qualitative Methods Mixed Methods Logic Models Implementation Frameworks Social Marketing- HIV Prevention Prevention of HIV- ADAPT IT Behavioral Economics for Behavior Change Interventions for HIV Testing Task Shifting to Nurses Implementing System Change- HIV Education in Schools Tailoring PMTCT Interventions Designing Implementation Protocols

13 Course Evaluation Summaries High ratings: Most >=4.5 on 5 point scale (not useful to very useful). No scores lower than 4 (useful) Greater usefulness indicated for most specific methods frameworks, designs, logic models mixed methods, intervention selection than process oriented lectures Recommendations: on-line forums, more interactive strategies for content, integrating local data into examples>> suggests importance of local projects and local expertise as well as more genera; methods expertise

14 Fit of Training - Relevance for Group Identified Overlap with ImS Training Goals Recent Frameworks reflect ImS Approaches Group was methodologically and practically ready for content Coates et al, 2008

15 III. Next Steps flexible models of training to address local HIV prevention needs Partner with active training programs or practice groups with focused interest in ImS *Prioritize strategy to involve participants in selection of case studies, specific methods Determine format and pre-training needs Select blended or sequenced approaches Identify faculty and practitioner leadership

16 Acknowledgements UCSF Implementation Science Program CTSI UCSF TICR UCSF Global Health Sciences WHO Collaborating Center in Croatia UCSF Center for Vulerable Populations at SFGH