DISC

What is Implementation Science?

Implementation Science is the study of methods to promote the integration of research findings into healthcare policy and practice. Dissemination and implementation (D&I) research aims to accelerate the timely translation of evidence-based research findings to practice and policy by designing studies to better understand how interventions, practices and innovations are launched and executed in specific settings. While dissemination studies focus on the targeted distribution of information and materials to advance the spread of evidence about interventions and innovations, implementation studies focus on understanding implementation processes and outcomes, and identifying effective strategies for integrating new evidence-based practices/innovations within a specific setting.

Examples of D&I research studies:

1. Evaluating the natural spread of an innovation in a specific setting
2. Understanding the mechanisms underlying an intervention’s success or failure
3. Characterizing key barriers / facilitators to intervention uptake
4. Developing and testing strategies to optimize adoption, uptake or sustainability of an evidence-based practiceIdentifying needed adaptations for scaling an intervention to a new setting or population

Citations:
• NIH PAR 19-274
• Brownson RC, Colditz GA, Proctor EK. Dissemination and Implementation Research in Health. New York: Oxford University Press; 2012.

For more information on understanding the basics of implementation science, check out the following references.

Introduction to Implementation Science Reference List (.doc)

DISC provides educational and consultative services in the areas listed below to investigators and study teams interested in conducting D&I research.

• D&I Presentations and Group Lectures
• D&I Methods and Models
• D&I Metrics and Measures

Visit SPARCRequest to submit a request.

SC Safer Together: A dissemination & implementation study of a COVID-19 exposure notification app in a national public university

Clemson University and the Medical University of South Carolina have partnered on an innovative new project to implement and evaluate the South Carolina Safer Together App. This is an exposure notification system disseminated by Google and Apple and developed jointly by MUSC’s Biomedical Informatics Center and Clemson Computing and Information Technology (CCIT) with the permission of the SC Department of Health and Environmental Control (DHEC). The app enables Clemson students and employees to join a community of App users to promote confidential exposure tracking in those who download and activate the application. If positive test results are entered by a user, the app contacts other App users potentially exposed to facilitate testing steps. The goal of the app is to enable earlier testing, treatment and quarantine processes.

Dr. Ron Gimbel has assembled an inter-disciplinary research group including a technology design team (co-led by Les Lenert, MD and James Pepin, PhD), a dissemination and implementation team (co-led by Cathy Melvin, PhD, Katie Sterba, PhD, and Kathleen Cartmell, PhD) and a data analysis team (co-led by Lior Rennert, PhD and Corey Kalbaugh, PhD) to conduct an implementation research study to monitor the process of disseminating the app in the Clemson community to guide potential future state-wide deployment of the app. The research teams have adopted the RE-AIM framework, an implementation science framework, to guide study data collection and measures. The study will characterize app development steps, identify implementation challenges encountered, and evaluate student and employee attitudes about and experiences using the app. To carry out this research, the research team is using multiple data collection strategies including surveys, focus groups, user data and an implementation tracking log to gather feedback from key stakeholders (students, employees, leaders, healthcare providers, community members).

Early study results have provided useful information showing that the process of downloading and activating the app is simple. The study has also identified additional information that may be needed by users about how to share information about COVID-19 exposure and what an exposure notification looks like and about strategies to more broadly market the app on campus and to add additional “value added” functionality to the app for users, such as clickable links to set up an appointment for COVID-19 testing or to access the Clemson dashboard that shows recent COVID-19 statistics on campus.

The SC Safer Together app is part of an ecosystem at Clemson that links test ordering, test result reporting, case referral and management with exposure notification. Overall, this system may have an important impact on reducing the spread of COVID- 19 at Clemson. The implementation study will provide valuable data to understand the complexities of deploying such a system to guide future efforts.

Making the most of a limited resource to help patients with severe COVID-19 across the state

In May 2020, as COVID-19 cases surged in South Carolina and other hot spots around the country, demand grew for remdesivir, one of the only medications that had shown benefit in patients with severe disease by speeding recovery of patients with severe COVID-19 and reducing the average hospital stay. At that time, Gilead, the manufacturer, had limited supplies of remdesivir on hand, so federal authorities had to allocate the available treatment courses to states based on their numbers of hospitalized COVID-19 patients. The process resulted in hospitals in some states having more remdesivir than needed, while leaving others in hard-hit areas without enough to offer to all patients who could benefit.  Key principles of implementation science were used to guide the identification of appropriate strategies to disseminate remdesivir, leading to the successful adoption of an evidence-based treatment into practice in an equitable and patient-centered manner.

South Carolina officials recognized early that an equitable and transparent process was needed to ensure that its initial allotment of 74 treatment courses would go to those patients who would benefit most. The South Carolina Department of Health and Environmental Control (DHEC) and the South Carolina Hospital Association (SCHA), charged with coming up with such a plan, turned to South Carolina’s leading health systems and ethics experts to establish a remdesivir advisory committee. MUSC Health critical care expert Dee Ford, M.D., was a key contributor. 

“I think it's very much to the credit of DHEC and SCHA that they really wanted an ethical framework to inform how South Carolinians received the medication,” said Ford. “The key ethical principles were that the process should be patient-centered, equitable, transparent and clinically informed.”

One of the key decisions made was to base the distribution on designated clinical criteria. Desperately needed, however, was a tool for gathering the necessary clinical data for COVID-19 patients to determine their eligibility.  Ford immediately thought of REDCap, a Vanderbilt-developed research survey tool that is made available at MUSC through the South Carolina Clinical & Translational Research (SCTR) Institute. She had often used the tool herself as a clinical researcher and director of the Dissemination and Implementation Science Collaborative (DISC) for SCTR and knew how simple it was to use.  A link to a REDCap survey could be shared easily by email to obtain the necessary data, and the collected information could then be exported and analyzed. 

This approach would turn out to be exactly what was needed to gather the information critical to remdesivir allocation. Ford reached out to Royce Sampson, M.S.N., R.N., CRA, SCTR primary administrator, for help. Sampson championed the project and helped to identify SCTR resources to support it.  With assistance from Stephanie Oppenheimer, M.S., a REDCap administrator and DISC Program Manager, the advisory committee developed a REDCap survey to collect clinical data about COVID-19 patients that could be sent to health care institutions statewide. 

 “Less than forty-eight hours from when SCTR first heard about it, we were deploying this query out to providers –it was quick,” said Ford. 

In the end, using this clinically informed, patient-centered system, DHEC distributed 2,100 treatment courses of remdesivir between May 15 and July 12: 599 to the Upstate, 388 to the Midlands, 655 to the Pee Dee and 458 to the Lowcountry. Having an equitable, transparent and clinically informed system in place helped to speed the administration of this potentially lifesaving drug to patients who needed it most and could continue to be important as new treatments and vaccines are rolled out. 

Adapted from an article written by Kimberly McGhee.

CTSA Compendium of D&I Catalogs

The CTSA Compendium of D&I Catalogs provides a curated list of resource catalogs relevant to the conduct of Dissemination & Implementation (D&I) science. The resource catalogs gathered here include frameworks/theories/models, methods/measures, funding resources, practice resources, training, and health equity resources. Included resource catalogs are curated/sponsored by academic and non-profit organizations with expertise in D&I; contain multiple resources that are systematically organized; and are (in almost all cases) both open-access and actively maintained/updated.

How to use the D&I Catalogs tool: Use the Sort and Filter functions below to view resources in categories of interest, or to view “featured resources.” Use this D&I Resource Suggestion Form to suggest a new catalog for inclusion.

This resource was developed by the Clinical & Translational Science Awards (CTSA) Program’s “Advancing Dissemination and Implementation Sciences in CTSAs” working group. This group focuses on meeting both the conceptual as well as practical challenges to advancing the utilization of D&I across the translational science spectrum. In particular, this group focuses on the “how” of D&I integration within CTSA hubs nationally, and on creating and disseminating practical tools, resources, and insights that CTSAs can use to fully realize the potential of D&I to enhance CTSAs’ mission.

Dissemination & Implementation Research Interest Group

The D & I Research Interest Group brings together researchers interested in learning more about implementation science. Participation is open to those new to the field, as well as those who may already be engaged in implementation research. The group is fortunate to have outstanding members, several of whom are outside of MUSC. All meetings are held via Zoom. If you are interested in participating and/or would like to learn more about upcoming meetings, please email Rochelle Hanson at hansonrf@musc.edu.

Dissemination & Implementation Toolkits

Washington University D&I Toolkits

PCORI’s Implementation and Dissemination Toolkit

Dissemination Toolkit

Dissemination Planning Tool

Implementation Toolkits

Implementation Science Research Development Tool

ADP Implementation Research Toolkit

QUERI Implementation Guide

Global Alliance for Chronic Diseases – Implementation Science Toolkit

Implementation Science Centers in Cancer Control (ISC3) Program Resources

Implementation Science Trainings

Global Alliance for Chronic Diseases – Implementation Science e-Hub Training Program

Global Alliance for Chronic Diseases Training School & Workshops

Training in Implementation: Actionable Research Approaches (TIARA) 

Below is a list of sources of funding opportunities that are either specific to or include sources of support for D&I research. If you would like additional assistance with finding the types of funding resources specific to your study, please feel free to enter a SPARC Request for a consultation. Once on the SPARCRequest page you will find the D&I services under the green SCTR services button on the left.

NIH: National Cancer Institute

Division of Cancer Control & Population Sciences
[Dissemination and Implementation Research in Health (DIRH) Notice of Reissuance (PAR-22-105, PAR-22-106, PAR-22-109)]

The Agency for Healthcare Research and Quality (AHRQ)

This website is a portal for a variety of grants, and we recommend visiting it frequently for updated D&I opportunities.
Grant Mechanisms and Descriptions | Agency for Healthcare Research and Quality (ahrq.gov).

The Patient-Centered Outcomes Research Institute (PCORI)

The PCORI site is also one we suggest visiting frequently for D&I funding opportunities.

MUSC Funding Portal

Search for funding opportunities matching specific keywords using databases. You can also set up funding alerts.

MUSC Library

Need help? Colleges and programs have a designated liaison librarian. Liaisons are subject specialists who provide support for students, staff and faculty in the areas of education, research, clinical work, and scholarly communication. You can contact your Library Liaison or “Ask A Librarian” at the MUSC library. 

MUSC Office of Research Development (ORD)

ORD identifies extramural funding opportunities and assists faculty members in writing competitive grant proposals, emphasizing strategic research areas. You can access their MUSC Funding Portal here and through that page sign up for their Funding Focus newsletter and/or access a variety of funding databases where you can create profiles unique to your specific area of research.

The South Carolina Clinical & Translational Research (SCTR) Institute

SCTR Institute facilitates the sharing of resources and expertise and streamlines research-related processes to bring about large-scale change in the state’s clinical and translational research efforts. SCTR’s partners include the Medical University of South Carolina (MUSC), Clemson University, Health Sciences South Carolina, and South Carolina State University. Its innovative research resources, funding opportunities, training programs, and other activities foster the growth of clinical and translational research across the state. Subscribe to the SCTR newsletter here: SCTR weekly eNews

SCTR Funding - Telehealth Pilots

Through the South Carolina Telehealth Alliance (SCTA), telehealth pilot grants support South Carolina clinicians and researchers in their efforts to develop innovative, scientifically meritorious telehealth projects with an overarching objective of collecting preliminary data for subsequent submission of extramural grant applications as well as publication and dissemination of their research findings. We place a premium on interdisciplinary and/or interprofessional (ID/IP) team science, and cross-institutional and/or organizational collaborations. Applicants are strongly encouraged to review the SCTA strategic priorities. (Budget $25,000; 12 months)