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Supporting Evidence-based Practice : Center of Excellence for Training and Research Translation
SIP 10-04 Cooperative Agreement Number U48-DP000059Centers for Disease Control and Prevention
Division for Heart Disease and Stroke PreventionDivision of Nutrition, Physical Activity and Obesity
Center TRT – Promoting Evidence-based Practice
Brief Overview and HistoryTraining practitioners
◦Obesity Prevention Course◦Web-based Training
Translation and Dissemination ProductsTranslation and Dissemination MethodsQuestions and Discussion
Center TRT LeadershipPrincipal 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
Center TRT Staff
Nancy AycockAvia MainorKelly NorbySusanne SchmalJanice SommersMay May Leung (not pictured)
National Advisory Board
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)
2005-06 Website: designed, tested, launched
2004 Infrastructure takes root: Staff, Coordinating Committee,National Board
2005 Formative work: surveys and focused discussion with state staff, literature reviews, web searches, lots of meetings
2005-09 Training Courses: Nutrition and Public Health, Obesity Prevention, WW Short Courses
2005-06 Methods Developed: criteria, review tools, processes for review, methods for literature reviews
2008-09 Disseminate Evidence: web-based training, contributing factors, strategies, interventions
Growing the Center-TRT
2007-09 Interventions reviewed and templates developed
Center TRT TRAINING
Primary Audience is State-level Program staff
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
Training
Training
Obesity Prevention in Public Health2005: Program Coordinators (29)2006: Nutrition Coordinators (44)2007: Physical Activity Coordinators (35)2008: Open to new state staff (31)
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
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)
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)
Physical Activity Module
Required ReadingsLesson 1: Terms and Definitions Lesson 2: Recommendations & RationaleLesson 3: Barriers Lesson 4: Science to PracticeSupplemental Materials
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
Nutrition and Health Demonstration
Intervention-Specific Implementation Trainings
NAPSACC
Online LifestyleAssessments
www.center-trt.org
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)
Phase 1: Evidence Identification and
Review
Phase 2: Intervention Abstraction
Phase 3: Dissemination
Phase 4: Research – Practice Integration
Center TRT Translation and Dissemination Framework
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
www.center-trt.orgwww.center-trt.org
www.center-trt.org
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
Center-TRT.org Center-TRT.org DownloadsDownloadsThe 2008 NumbersThe 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!
Center TRT Translation Methods
A Model for Balancing Evidence of Effectiveness with Other Practice-
relevant Evidence
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
Criteria for Review of Interventions
Potential public health impactDissemination readinessEvidence in support of its
effectiveness
Review Criteria: Potential Public Health ImpactREACH 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
Review Criteria: Dissemination ReadinessIntervention/policy described sufficiently
to allow replication
Materials/supporting documents are available for download and of useable quality
A knowledgeable contact person is available
Review Criteria: Evidence for its Effectiveness
Research-Tested Interventions
Assess strength of reported methods for
Sampling
Design
Measurement
Analysis
Interpretation of Results
Review Criteria: Evidence for its EffectivenessPractice-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
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.
Review ProcessApplication from Developer
Stop
NO
Review ProcessReview ProcessExpert PanelExpert Panel
NO
Stop
In the pipeline…In the pipeline…
Food Access
Food Pricing Policy
Play Space
Afterschool policy
Worksite Wellness Incentives
Questions, Counterpoints, Discussion….
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