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Supporting Evidence-based Practice : Center of Excellence for Training and Research Translation

Supporting Evidence-based Practice : Center of Excellence for Training and Research Translation. SIP 10-04 Cooperative Agreement Number U48-DP000059 Centers for Disease Control and Prevention Division for Heart Disease and Stroke Prevention Division of Nutrition, Physical Activity and Obesity.

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Supporting Evidence-based Practice : Center of Excellence for Training and Research Translation

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  1. Supporting Evidence-based Practice : Center of Excellence for Training and Research Translation SIP 10-04 Cooperative Agreement Number U48-DP000059 Centers for Disease Control and Prevention Division for Heart Disease and Stroke Prevention Division of Nutrition, Physical Activity and Obesity

  2. Center TRT – Promoting Evidence-based Practice • Brief Overview and History • Training practitioners • Obesity Prevention Course • Web-based Training • Translation and Dissemination Products • Translation and Dissemination Methods • Questions and Discussion

  3. Center TRT Leadership Principal Investigator: • Alice Ammerman, RD DrPH Co-Investigators: • Jennifer Leeman, DrPH, MDIV • Tom Keyserling, MD, MPH Project Director: • Janice Sommers, MPH CDC Technical Advisors from DNPAO • Claire Heiser, MS, RD • Diane Thompson, MPH, RD

  4. Center TRT Staff Nancy Aycock AviaMainor Kelly Norby Susanne Schmal Janice Sommers May May Leung (not pictured)

  5. National Advisory Board

  6. Their Advice….. • Use a broad definition of evidence and include evidence from practice in the translation model • The potential public health impact of an intervention is a result of more than effectiveness • Include a feedback loop that provides an opportunity for practice to inform research • Invest time and energy in obtaining input from primary audience (intended users)

  7. Growing the Center-TRT 2008-09 Disseminate Evidence: web-based training, contributing factors, strategies, interventions 2007-09 Interventions reviewed and templates developed 2005-06 Website: designed, tested, launched 2005-06 Methods Developed: criteria, review tools, processes for review, methods for literature reviews 2005-09 Training Courses: Nutrition and Public Health, Obesity Prevention, WW Short Courses 2005 Formative work: surveys and focused discussion with state staff, literature reviews, web searches, lots of meetings 2004 Infrastructure takes root: Staff, Coordinating Committee, National Board

  8. Center TRT TRAINING Primary Audience is State-level Program staff

  9. Training • Develop training competencies • Conduct training needs assessments • Develop a training plan • Provide training for state-level WISEWOMAN and Obesity Prevention Program staff • Evaluate impact of trainings on practice

  10. Training Obesity Prevention in Public Health • 2005: Program Coordinators (29) • 2006: Nutrition Coordinators (44) • 2007: Physical Activity Coordinators (35) • 2008: Open to new state staff (31)

  11. Obesity Prevention in Public Health Course: 2009 DATES: August 23 – 28 at the Rizzo Center in Chapel Hill, NC NEW Curriculum focused on leadership development for NPAO State Coordinators APPLICATIONS are being accepted; we have a number of scholarships available for unfunded states www.center-trt.org

  12. Cover the basics to allow more advanced material during in-person trainings • Extends the reach of Center TRT • Easily accessed at any time (great staff orientation) • Interactive and self-paced • Low cost to participant (time only; no travel, no registration fee)

  13. Nutrition, Physical Activity, and Chronic Disease Series • Nutrition and Health • Physical Activity and Health • Nutrition, Physical Activity and Cardiovascular Health (April 2009) • Obesity Prevention in Children (Summer 2009)

  14. Physical Activity Module Required Readings Lesson 1: Terms and Definitions Lesson 2: Recommendations & Rationale Lesson 3: Barriers Lesson 4: Science to Practice Supplemental Materials

  15. RE-AIM Online! Reach, Effectiveness, Adoption, Implementation and Maintenance Required Readings Lesson 1: Introduction to RE-AIM Lesson 2: RE-AIM for Behavior Change Lesson 3: RE-AIM for Policy/Environmental Change Lesson 4: Putting it All Together Available Summer 2009

  16. Nutrition and Health Demonstration

  17. Intervention-Specific Implementation Trainings NAPSACC

  18. Online Lifestyle Assessments www.center-trt.org

  19. Web-based TrainingThe 2008 Numbers • 595 users registered for the modules • 305 completed the post tests • 82 – NAPSACC (4/08) • 97 – Physical Activity and Health (6/08) • 126 – Nutrition and Health (6/08)

  20. Center TRT Translation and Dissemination Framework Phase 1: Evidence Identification and Review Phase 4: Research – Practice Integration Phase 2: Intervention Abstraction Phase 3: Dissemination

  21. Phase 3: DisseminationIntervention Resources • Evidence to support development of interventions • Contributing Factors (target areas) • Intervention Strategies (approaches) • Interventions that can be adapted • Research-tested • Practice-based • Emerging

  22. www.center-trt.org www.center-trt.org

  23. Center-TRT.org UsersThe 2008 Numbers • Users in every state and the District of Columbia. Visitors from North Carolina were among the most frequent users. • People from 79 different countries with users in the US, Canada, United Kingdom and Australia, the most frequent visitors • 5,725 NEW users, defined as first-time-ever visitors and an additional 6,000 unique but not new visitors

  24. Center-TRT.org DownloadsThe 2008 Numbers • 7,926 documents were downloaded from the website. • New Leaf, Choices for Healthy Living and the Nutrition and Physical Activity Self-Assessment for Childcare (NAPSACC) are UNC developed and tested interventions and were the most frequently downloaded interventions from the site!

  25. Center TRT Translation Methods A Model for Balancing Evidence of Effectiveness with Other Practice-relevant Evidence

  26. Phase 1: Evidence Identification and Review Evidence Contributing Factors Intervention Strategies Research-Tested Interventions Practice-Based Interventions Source Systematic Reviews Systematic Reviews and Other Consensus Documents Research Studies Evaluation in real-life conditions

  27. Criteria for Review of Interventions • Potential public health impact • Dissemination readiness • Evidence in support of its effectiveness

  28. Review Criteria: Potential Public Health Impact • REACH and representation • EFFECTIVENESS, especially in groups disproportionately affected • Evidence of and Potential for ADOPTION, IMPLEMENTATION, and MAINTENANCE in public health practice. Glasgow et al., 2003

  29. Review Criteria: Dissemination Readiness • Intervention/policy described sufficiently to allow replication • Materials/supporting documents are available for download and of useable quality • A knowledgeable contact person is available

  30. Review Criteria: Evidence for its Effectiveness Research-Tested Interventions Assess strength of reported methods for Sampling Design Measurement Analysis Interpretation of Results

  31. Review Criteria: Evidence for its Effectiveness Practice-Based Interventions Use of an evidence-based intervention strategy Formative work with stakeholder groups & intended audience Logic and theory Methods for evaluating processes and outcomes

  32. Review Criteria: Evidence for its Effectiveness Practice-Based Interventions illustrate how practitioners working within the constraints of a real world setting implemented an evidence-based strategy in practice.

  33. Review ProcessApplication from Developer NO Stop

  34. Review ProcessExpert Panel NO Stop

  35. In the pipeline… Food Access Afterschool policy Play Space Worksite Wellness Incentives Food Pricing Policy

  36. Questions, Counterpoints, Discussion….

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