The Road From Research to Practice - Issues in Translation and Synthesis

1. The RoadFrom Research to Practice - Issues in Translation and Synthesis Alice Gandelman, MPH, Director CA STD/HIV Prevention Training Center

2. Implicit Assumptions • Goal of HIV researchers and practitioners: • Improve the quality of interventions implemented in clinic/community settings • Reduce acquisition and/or transmission of HIV

3. Summary of Key Issues • Identify gaps along the research-to practice road • Core elements and adaptation • Agency capacity vs. intervention complexity • Quality assurance issues (is intervention occurring as intended?) • Recommend strategies to help bridge these gaps • Research Efficacy  Program Effectiveness • Technology Transfer  Technology Exchange

4. Evolution of Prevention Research to Practice • Studies rigorously evaluated • Study Design (methodological preferences) • random assignment • no apparent assignment bias • pre/post data • statistically significant (positive) behavioral results • Intervention criteria • clearly defined audience, goals, objectives • based on sound behavioral theory • focused on reducing specific HR behaviors

5. Current Efforts in Technology Transfer • Compendium of Effective Behavioral Interventions • Diffusion of Effective Behavioral Intervention (DEBI) Project • Research replication packages (researcher) • Training curriculum development (contractor) • Training dissemination to LHJs and CBOs (PTCs) • Technical Assistance/Consultation (CBAs)

6. Implicit Assumptions about the Technology Transfer Process • Intervention studies “worked” in research settings, therefore will “work” in program settings • Can be successfully replicated in program settings • Funding is available or will be re-directed from existing, to more effective interventions • LHJs and CBOs have the capacity to implement • QA guidelines protocols are in place to ensure that interventions are being implemented as intended • Agencies posses adequate skills to conduct intervention

7. Replication/Translation Issues • Base-Line Skill Prerequisites • ILI: basic counseling skills • GLI: group facilitation skills • CLI: outreach, community organizing, etc Many agency staff lack above skills • Every-day messiness of real-world program implementation • True cost of implementation • Adequate staffing, staff turnover • Staff-Buy-In • Training/staff development

8. Recommended Strategies • Increase Program Involvement During Formative Research Stages • Is intervention feasible to implement? • What would you need to modify? • core element • adaptation • How costly will the intervention be for your agency? • What would be the easiest part to implement? • Most difficult part to implement? • What are the training needs of staff to successfully implement?

9. Conclusion • Health Depts., CBOs, and CPGs: • Allocate needed resources for staff training • Become active participants for program effectiveness • Researchers: • Understand the adaptations that are going to occur (despite best intentions) in programs • Funders: • Ensure adequate funding required for quality implementation of replicated interventions • Recognize importance of training and staff development as a core element of translation