Implementation Science studies

In implementation research, we identify why certain evidence-based practices are not adopted into standard medical practice, and evaluate ways to promote their use. Our researchers work to ensure that the best practices are implemented, and reduce or eliminate the use of unnecessary or low-value practices. Our Care Improvement Research Team has identified unnecessary tests for prostate and breast cancer patients and unneeded antibiotic prescriptions for sinusitis, and identified strategies to reduce readmission for patients with chronic obstructive pulmonary disease.

A Non-Inferiority Comparative Effectiveness Trial of Home-Based Palliative Care in Older Adults (HomePal)

The aim of this pragmatic trial is to compare the effects of a standard home-based palliative care (HBPC) model to a more efficient tech-supported model that includes remote physician supervision/consultation on patient symptom burden and days spent at home in the last 6 months of life and family caregiving preparedness.

Principal Investigator:

Huong Q. Nguyen, PhD, RN

Funding Source:

Patient-Centered Outcomes Research Institute (PCORI)

Funding Years:

2021 - 2018

An Evaluation of the National Zero Suicide Model across Learning Healthcare Systems

Our project seeks to develop metrics to measure fidelity and outcomes for the National Zero Suicide Model components implemented in each system using electronic health records and insurance claims data sources that are easily extractable and generalizable to other systems. Then, we propose to use these metrics to conduct fidelity and outcome evaluation of the various Zero Suicide Initiative approaches in each system using Interrupted Time Series Designs, which are among the strongest, pragmatic designs appropriate for evaluating care system intervention and policy changes in ‘Learning Healthcare Systems.’ We hypothesize that the implementation of various National Zero Suicide Model components will significantly reduce suicidal behavior within and across the participating systems. We seek to accomplish the following aims: 1) Collaborate with health system leaders to develop EHR metrics to measure specific quality improvement targets and care processes tailored to local Zero Suicide Initiative implementation; 2) examine the fidelity of the specific Zero Suicide Initiative care processes implemented in each system; and 3) investigate suicide attempt and mortality outcomes within and across Zero Suicide Initiative healthcare system models.

Site Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

National Institute of Mental Health (NIMH)

Funding Years:

2017 - 2022

Breast cancer screening decisions in younger women: a hybrid effectiveness-implementation study

The major goals of the project are to evaluate the effectiveness of a web-based decision aid on improving knowledge about breast cancer screening in women age 40 to 49 and reducing decisional conflict about breast cancer screening, and to explore the acceptability and feasibility of large-scale implementation.

Principal Investigator:

Erin E. Hahn, PhD, MPH

Funding Source:

Natl Cancer Inst

Funding Years:

2017

Research Categories:

,

Developing tailored de-implementation strategies to reduce use of low-value cancer care services

The goal of this mixed methods study is to develop and test interventions to reduce use of surveillance biomarkers for early stage breast cancer patients.

Principal Investigator:

Erin E. Hahn, PhD, MPH

Funding Source:

Kaiser Permanente, Southern California

Funding Years:

2014 - 2015

Digital Mindfulness Based Cognitive Therapy for Perinatal Depression

Mindfulness Based Cognitive Therapy (MBCT) an 8-session in-person intervention using mindfulness meditation and cognitive-behavioral strategies, has shown effectiveness in reducing residual depressive symptoms and risk for recurrence among pregnant women with histories of depression. A digital adaptation of MBCT for pregnant women, Mindful Mood Balance for Moms (MMBFM), was recently developed to overcome access barriers to in-person groups and increase potential for scale-up in OB care settings. We will address the following aims for this study: 1) Compare the clinical effectiveness (i.e. engagement and symptom reduction) of MMBFM supported by clinician vs. peer coaches among women with a history of prior depressive episodes; 2) examine specific mechanisms of action for MMBFM participants receiving clinician vs. peer coaching; 3) examine the effects of specific implementation strategies on reach of the MMBFM program; and 4) estimate the cost-effectiveness of MMBFM supported by clinician vs. peer coaches. We hypothesize that MMBFM will be more cost-effective when supported by peer vs. clinician coaches.

Site Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

National Institute of Mental Health (NIMH)

Funding Years:

2019 - 2024

Implementing systematic distress screening in breast cancer

This project focuses on implementation and effectiveness of an evidence-based guideline recommendation for systematic distress screening for breast cancer patients.

Principal Investigator:

Erin E. Hahn, PhD, MPH

Funding Source:

Not Applicable

Funding Years:

2016

Research Categories:

,

Translation of a Lung Cancer Palliative Care Intervention for Clinical Practice

The purpose of this study is to test the dissemination of a Palliative Care Intervention (PCI) for patients with non-small cell lung cancer (NSCLC) and their primary family caregivers (FCG)

Principal Investigator:

Huong Q. Nguyen, PhD, RN

Funding Source:

National Institutes of Health (NIH)

Funding Years:

2014 - 2018