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

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

Summary of Key Issues Identify gaps along the research-to practice road 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 Recommend strategies to help bridge these gaps  Research Efficacy  Program Effectiveness  Technology Transfer  Technology Exchange

Evolution of Prevention Research to Practice Studies rigorously evaluated 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

Current Efforts in Technology Transfer Compendium of Effective Behavioral Interventions 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)

Implicit Assumptions about the Technology Transfer Process Intervention studies “worked” in research settings, therefore will “work” in program settings 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 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

Replication/Translation Issues Base-Line Skill Prerequisites 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 Every-day messiness of real-world program implementation  True cost of implementation  Adequate staffing, staff turnover  Staff-Buy-In  Training/staff development

Recommended Strategies Increase Program Involvement During Formative Research Stages 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?

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