Thursday, August 1, 2024

Research in CTS (formerly CROW) Meeting: August 1, 2024

Present: Amanda Kennedy, Jerry Landau, Ben Littenberg, Gail Rose, Connie van Eeghen (6)

 1.                   Warm Up:

a.       Dissertation committee planning – sooner is better than later

2.                   D&I and Equity – Jerry Landau: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7977499/

                                                   i.      Jerry has come to D&I gradually, as he has worked with the Comprehensive Pain Program, and trying to grapple with “feasibility”

1.       Summer independent study on Brownson text, Dissemination and Implementation Research in Health: Translating Science to Practice 3rd Edition, see https://www.amazon.com/Dissemination-Implementation-Research-Health-Translating/dp/019766069X/ref=asc_df_019766069X/?tag=hyprod-20&linkCode=df0&hvadid=692875362841&hvpos=&hvnetw=g&hvrand=1656788153007457778&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9002887&hvtargid=pla-2281435181698&psc=1&mcid=5260f94c155b361391fa87c8c2960f9b&hvocijid=1656788153007457778-019766069X-&hvexpln=73&gad_source=1

2.       With all the shortcomings of integrating equity into science, how do we do that in a balanced way, with all the other important things included as well?

                                                 ii.      Ben started in Technology Assessment (the better mousetrap model, some degree true with the asthma study, and helpful to marginalized people). Does a rising tide raise all boats equally or are the rich person’s boat raised more than others?

1.       HPV vaccination is taken up by the rich world, not so much by the poorer world

2.       Innovations are difficult, including de-implementation of a past innovation; it takes 30 years to reflect a new innovation in text books (beta blockers for heart attacks)

3.       We wondered if the scientific method can be applied to implementation; a little better but still doesn’t work unless you have access to resources/opportunities

4.       Are the structural issues outside of health care: education, life style… ? Is equity about solving social problems.

a.       Can we even tackle these problems?

b.       Phil Aides could set up cardiac rehab but could not get people of low income to come

c.       Is the behavioral bar misrepresenting factors that are really outside the choice of the individual, e.g. living in a food desert? Our urbanized environment?

                                               iii.      Social medicine has been around for ~100 years.  Who is in charge?

1.       Brownson suggests that Implementation Science can fix these problems.

                                               iv.      This article was written when COVID was raging and social unrest was rolling through the US.

1.       The buzz on this issue has dwindled; what parts of this topic should we grab and retain

2.       Ben knew Debra Haire-Joshu; she was good at knowing were the focus of research is currently pointed

                                                 v.      Should we be doing anything differently

1.       Collaborate with those who can help us see and understand differently: leaders, team members, stakeholders

2.       How do we do research on policy as a pre-test – it either gets implemented or it doesn’t

a.       Is VT the perfect experimental sandbox?

3.       Could we use Enola Proctor’s implementation outcomes (acceptable, appropriate, affordable, feasible…) might be measures we can use as resarchers

4.       We tend to study highly compliant participants; compliance may not be consistent with equity

a.       Efficacy: compliance is essential

b.       Effectiveness: compliance is a goal but not a requirement; the question is what are the factors affecting compliance

5.       Where do we want to be on the CTS spectrum?

3.                   Next meeting: August 8, 2024

 

Recorded by: CvE