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- Implementation Science Masterclass Training Program
Get Ready for Learning
Welcome to our Masterclass Implementation Science Programme, which will take users on a deep dive into specific implementation science topics.
The first Masterclass Programme focuses on the scale up of non-communicable disease programmes. It is free to access and includes preliminary reading, four modules of specially curated content, and the option for self-certification on completion.
It takes 6 hours and 30 minutes hours to complete the core content, plus additional time for further reading and reflection.
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Programme content
Module 1 Introduction to scale up
Lecture 1A Introduction to interventions at scale | Lisa Hirschhorn and Dike Ojji
Lecture 1B Key concepts, models, and issues | Brian Oldenburg
Lecture 1C Scaling up versus scaling out | Mark Huffman
Lecture 1D Case study: Implementation of an intervention at scale | Koku Awoonor
Recommend Reading:
- Beginning with the end in mind: planning pilot projects and other programmatic research for successful scaling up (WHO and ExpandNet, 2011)
- Nine steps for developing a scaling-up strategy (WHO and ExpandNet, 2010)
- Practical guidance for scaling up health service innovations (WHO, 2009)
Module 2 The people and politics of scale up
Lecture 2A Stakeholders – who should be involved in scaling up? | Aneth Dinis
Lecture 2B How to make policy changes and involve stakeholders in scaling up – From research to policies to politics | Adolfo Rubinstein
Recommended Reading
- See our Fundamentals Programme, Module 3 Stakeholder engagement and cultural adaptation
- GACD stakeholder engagement resource collection [website]
- A stakeholder-driven method for selecting implementation strategies: a case example of pediatric hypertension clinical practice guideline implementation (Knapp et al. 2022)
- Using a co-design process to develop an integrated model of care for delivering self-management intervention to multi-morbid COPD people in rural Nepal (Yadav et al. 2021)
Module 3 Frameworks for scale up
Lecture 3A Overview of theories, models, and frameworks for implementation science | Brian Oldenburg
Lecture 3B Developing an implementation research logic model for scale up | JD Smith
Lecture 3C Case study – the Kerala Diabetes Prevention Program| Kavumpurathu Thankappan
Lecture 3D Case study – Applying EPIS to scale up | Neo Tapela
Lecture 3E Case study – Applying RE-AIM to scale up | Lisa Hirschhorn
Lecture 3F Case study – Applying CFIR to scale up | Sarah Gimbel
Recommended Reading
- The Implementation Research Logic Model: a method for planning, executing, reporting, and synthesizing implementation projects (Smith et al. 2020)
- Development and application of the RE-AIM QuEST mixed methods framework for program evaluation (Forman et al. 2017)
- Evaluation of a systems analysis and improvement approach to optimize prevention of mother-to-child transmission of HIV using the Consolidated Framework for Implementation Research (Gimbel et al. 2016)
Module 4 Context and strategies for scale up
Lecture 4A Context for interventions at scale | Dike Ojji
Lecture 4B Strategies for scaling up and out | Lisa Hirschhorn
Lecture 4C Case study – Strategies for scale up in South East Asia | Brian Oldenburg
Lecture 4D A systems approach to upscaling – Findings from a GACD working group | Anusha Ramani Chander
Recommended Reading
- Factors influencing the scale-up of public health interventions in low- and middle-income countries: a qualitative systematic literature review (Bulthuis et al. 2020)
- The concept of scalability: increasing the scale and potential adoption of health promotion interventions into policy and practice (Milat et al. 2013)
- Implementation strategies: recommendations for specifying and reporting (Proctor et al. 2013)
- The FRAME-IS: a framework for documenting modifications to implementation strategies in healthcare (Miller et al. 2021)
- Applying systems thinking to identify enablers and challenges to scale-up interventions for hypertension and diabetes in low-income and middle-income countries: protocol for a longitudinal mixed-methods study (Ramani-Chander et al. 2022)
Further Reading
If you would like to extend your understanding of implementing interventions at scale, you may be interested in the following publications.
- A framework for scaling up health interventions: lessons from large-scale improvement initiatives in Africa (Barker et al 2015)
- Scaling Up: A Framework and Lessons for Development Effectiveness from Literature and Practice (Hartmann and Linn, 2008)
- Research for change: Using implementation research to strengthen HIV care and treatment scale-up in resource-limited settings (Hirschhorn et al. 2007)
- From scaling up to sustainability in HIV: potential lessons for moving forward (Hirschhorn et al. 2013)
- Should We Scale-Up? A Mixed Methods Process Evaluation of an Intervention Targeting Sedentary Office Workers Using the RE-AIM QuEST Framework (MacDonald et al. 2019)
You have now completed all four modules of core content in the Implementation Science Masterclass Programme
Congratulations!
To access your self-certification, please complete this feedback survey. You will be able to download your certificate at the end of the survey.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
All lecture videos at this website is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license.
- Regional Short Course Training on Implementation Research
The Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila (DHPA-CPH-UPM) invites you to:
Rationale
Implementation research (IR) must be a central component of policy and program implementation, as well as a part of the decision-making and problem-solving process. It identifies common implementation issues, determines factors that may obstruct or facilitate access to health interventions, develops and tests solutions, determines the best ways to introduce innovations into the health system, or promotes evidence uptake to scale up and sustain interventions. However, numerous significant individuals and organizations still have a misunderstanding of what IR is and what it can provide, resulting in inefficient use of vital resources. Furthermore, given the complexity of existing and growing public health concerns around the world that necessitate the development and adoption of creative solutions, it is critical to increasing the number of researchers who are familiar with and appreciate the application of implementation research. This short course will provide scholars and implementers with the chance to use IR to strengthen health systems, particularly in low- and middle-income countries.
Goals
The short course’s purpose is to improve participants’ knowledge and skills in developing and conducting implementation research to address needs and improve the quality and effectiveness of healthcare delivery in a specific setting or context. It will provide an in-depth grasp of how to address relevant implementation research questions using appropriate models, frameworks, designs, and techniques. During each session, participants will present an application of implementation science to their research topic. The short course training will culminate in a research protocol containing IR features that can be submitted for funding and implementation.
Objectives
This short course on implementation research training aims to:
- explain the field of implementation research and program evaluation;
- describe how to study and implement research findings into practice;
- differentiate the relevant theoretical models, research designs, and measurement used in implementation research;
- demonstrate various ways of collaborating and networking nationally and globally in implementation research; and
- showcase the range of applications of implementation research and the uptake of research findings into policy and practice.
Outcomes
After completing the implementation research short course, the participants will be able to:
- assess the relevance of implementation research in the delivery of quality and effective health care;
- formulate research questions in implementation research;
- evaluate common research methods, study designs, and data sources in implementation research;
- explain the different ethical considerations in conducting implementation research;
- determine various applications of research evidence in implementation research;
- present a customized implementation research proposal; and
- utilize an implementation research approach in addressing specific issues in their setting or context.
Activity details, mode of delivery, and duration
The implementation research short course is a 20-hour training course taught by local and international experts over four days (July 19-22, 2022). It will be conducted entirely online, with a half-day training session every morning. The short course will consist of a mix of online interactive didactics and debates, assignments with dedicated time to complete them, and workshops with break-out discussions and plenary presentations. Training participants can apply their new knowledge to their research topic or issue of interest through assignments and workshops. During the seminars, one to two faculty instructors will provide comments and support to each break-out group. There are 11 interactive lectures and four workshops in this course.
For further information, and to apply, please visit the application page.
Interactive Lectures
Lecture 1: Overview of implementation research – key concepts and issues
Speaker: Dr. Edward Mberu Kamau Technical Officer World Health Organization (WHO) Special Programme for Research and Training in Tropical Diseases (TDR) Geneva, Switzerland
Suggested readings:
- A guide to implementation research in the prevention and control of noncommunicable diseases (World Health Organization. (2016). A guide to implementation research in the prevention and control of noncommunicable diseases. Geneva: World Health Organization; 2016. Licence: CC BY-NC-SA 3.0 IGO.)
- Implementation research in health: a practical guide. (Peters, D. H., Tran, N. T., & Adam, T. (2013). Implementation research in health: a practical guide. World Health Organization.)
- Implementation research: what it is and how to do it. (Peters, D. H., Adam, T., Alonge, O., Agyepong, I. A., & Tran, N. (2013). Implementation research: what it is and how to do it. BMJ (Clinical research ed.), 347, f6753. https://doi.org/10.1136/bmj.f6753)
Lecture 2: Framing implementation research questions
Speaker: Dr. Yodi Mahendradhata, Vice Dean for Research and Development Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
Suggested readings:
- Recorded lecture: https://youtu.be/srC10_luRfw
- Frame your question: https://impsciuw.org/implementation-science/research/frame-your-question/
Lecture 3: Theories, Models and Frameworks
Speaker: Dr. Yodi Mahendradhata, Vice Dean for Research and Development Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada
Suggested readings:
- Recorded lecture: https://youtu.be/12DAJXj1u2E
- https://implementationscience.biomedcentral.com/articles/10.1186/s13012-015-0242-0
Lecture 4: Implementation strategies
Speaker: Prof Brian Oldenburg Professor of Public Health & Implementation Science Director, Academic Research Collaboration in Health (ARCH), Alfred Hospital Baker Heart & Diabetes Institute and LaTrobe University
Suggested readings:
- Recorded lecture: https://youtu.be/tJn9-so3ggw
- Identify implementation strategy: https://impsciuw.org/implementation-science/research/implementation-strategies/
- Implementation strategies: https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-8-139
Lecture 5: Research methods in implementation research
Speaker: Dr. Jason Alacapa Chief Executive Officer and Co-Founder Innovations for Community Health
Suggested readings:
- Research methods in Implementation Science: https://impsciuw.org/implementation-science/research/select-research-methods/
- Palinkas L, et al. (2011). Mixed Method Designs in Implementation Research. Administration and Policy in Mental Health, 38:44-53.
- Lewis A, Procotr EK, Brownson R. (2018). Measurement Issues in Dissemination and Implementation Research (Chapter 14).
- Rabin B, et al. (2016). Measurement resources for dissemination and implementation research in health. Implementation Science, 11:42.
Lecture 6: Study designs in implementation research
Speaker: Prof Brian Oldenburg, Professor of Public Health & Implementation Science Director, Academic Research Collaboration in Health (ARCH), Alfred Hospital Baker Heart & Diabetes Institute and LaTrobe University
Suggested readings:
- Brown, CH, et al. (2017). An overview of research and evaluation designs for dissemination and implementation. Annual Review of Public Health, 38:1-22.
- Creswell JW, Klassen AC, Plano Clark VL, and Smith KC for the Office of Behavioral and Social Sciences Research. Best practices for mixed methods research in the health sciences. (2011). National Institutes of Health.
- Curran G, et al. (2012). Effectiveness- implementation Hybrid Designs: Combining Elements of Clinical Effectives and Implementation Research to Enhance Public Health Impact. Medical Care, 50(3): 217-226.
Lecture 7: Measuring outcomes in implementation research
Speaker: Dr. Tilahun Haregu, Research Fellow, Baker Heart and Diabetes Institute, Australia
Suggested readings:
- Proctor, E., Silmere, H., Raghavan, R. et al. Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda. Adm Policy Ment Health 38, 65–76 (2011)
- Lewis, C.C., Fischer, S., Weiner, B.J. et al. Outcomes for implementation science: an enhanced systematic review of instruments using evidence-based rating criteria. Implementation Sci 10, 155 (2015). https://doi.org/10.1186/s13012-015-0342-x
Lecture 8: Stakeholder engagement in implementation research
Speaker 1: Dr. Tilahun Haregu, Research Fellow, Baker Heart and Diabetes Institute
Speaker 2: Dr. Eleanor Castillo, Professor Department of Health Promotion and Education College of Public Health, UP Manila
Suggested readings:
- Peters, D.H., Bhuiya, A. & Ghaffar, A. Engaging stakeholders in implementation research: lessons from the Future Health Systems Research Programme experience. Health Res Policy Sys 15, 104 (2017). https://doi.org/10.1186/s12961-017-0269-6
- Goodman MS, Sanders Thompson VL. The science of stakeholder engagement in research: classification, implementation, and evaluation. Transl Behav Med. 2017 Sep;7(3):486-491
Lecture 9: Getting funding: Global experience and challenges in implementation research and knowledge translation
Speaker 1: Prof Brian Oldenburg, Professor of Public Health & Implementation Science Director, Academic Research Collaboration in Health (ARCH), Alfred Hospital Baker Heart & Diabetes Institute and LaTrobe University
Speaker 2: Dr. Keiko Nakamura Professor Department of Global Health Entrepreneurship Tokyo Medical and Dental University
Lecture 10: Ethics in implementation research
Speaker: Dr. Olumide Ogundahunsi, Professor and Director Research, Innovation, and Development, University of medical State, Nigeria
Suggested readings:
- Luyckx VA, Reis A, Maher D, Vahedi M. Highlighting the ethics of implementation research. Lancet Glob Health. 2019 Sep;7(9):e1170-e1171.
- Gopichandran, V., Luyckx, V.A., Biller-Andorno, N. et al. Developing the ethics of implementation research in health. Implementation Sci 11, 161 (2016).
Lecture 11: Case studies of existing projects or research projects: applying implementation science in real-world projects
Speaker 1: Dr. Vicente Y. Belizario Jr. Former Dean and Professor College of Public Health University of the Philippines Manila SEAMEO TROPMED
Speaker 2: Dr. Carl Abelardo T. Antonio Associate Professor, Department of Health Policy and Administration College of Public Health, UP Manila
Speaker 3: Dr. Erlyn A. Sana Professor National Teacher Training Center for the Health Professions Chair Office of Research and Development University of the Philippines Manila
Facilitated group sessions for participants
Group session 1: Implementation research topic and research question
The aim of this workshop is for the participants to discuss within the break-out and plenary group their specific research topic of interest and research question that can be answered through the use of the concepts of implementation research.
Group session 2: Study design and research method
The aim of this workshop is for the participants to discuss within the break-out and plenary group the appropriate study design and research method that they would like to utilize in their implementation research plan.
Group session 3: Implementation research outcomes and relevant stakeholders
The aim of this workshop is for the participants to discuss within the break-out and plenary group the specific implementation research outcomes to be measured and the relevant stakeholders they would like to include in their implementation research plan.
Group session 4: Implementation research proposal
The aim of this workshop is for the participants to discuss within the break-out and plenary group their draft implementation research proposal.
Organisers: DHPA-CPH Training Team
GACD are delighted to be working alongside our colleagues in the field of implementation science to develop and deliver the regional short course:
- Dr. TJ Robinson T. Moncatar
- Dr. Carmelita S. Canila
- Dr. Fernando B. Garcia Jr.
- Dr. Emerito Jose A. Faraon
- Dr. Carl Abelardo T. Antonio
- Dr. Frederick S. Nieto
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
All lecture videos at this website is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license.
- e-Hub Newsletters Archive
Please find all of the e-Hub update newsletters listed below.
- CEBHA+/GACD Implementation Science Workshop
Addis Ababa, Ethiopia
8 September 2022
Venue: To be confirmed
Hosted by CEBHA+ partner – Armauer Hansen Research Institute, Addis Ababa, Ethiopia
Objectives
- To introduce the art & science of implementation science
- To introduce different theories, models, and frameworks
- To build the evidence base for implementation science in CEBHA+
- To discuss capacity building for implementation science in LMICs
Learning material
GACD Implementation Science e-Hub
Timetable
Session Time Topic Presenter 08:00-8:30 Coffee and arrival 1 08:30-08:45 Introduction to the workshop Peter 2 08:45-10:00 What is implementation Science? Brian 3 10:00-10:30 Theories, models, and frameworks (Part I) Nasreen 4 10:30-11:00 Theories, models, and frameworks (Part II) Peter 11:00-11:20 Tea break 5 11:20-11:50 CEBHA+ Case Study: IKT using EPIS (South Africa) Nasreen 6 11:50-12:20 CEBHA+ Case Study: CVD risk screening protocol (RE-AIM) Kufre 7 12:20-13:00 Q&A – panel discussion (?) 13:00-13:45 Lunch 8 13:45-14:30 Use of IS for intervention planning, implementation, and evaluation Brian 9 14:30-15:00 Building the evidence base in implementation science: A population / public health perspective Pre-recorded 10 15:00-16:00 Building capacity for IS in LMICs: The way forward?
Closing remarksTo be determined
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
All lecture videos at this website is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license.
- Workshop on Implementation Science
Max Healthcare in association with NIHR Global Health Research Unit and Network of Diabetes and Cardio Vascular Disease in South Asia cordially invites you to the:
Programme Overview
A key challenge faced by all countries is how to take proven interventions and strategies and to implement them “at scale” to improve health care delivery and public health outcomes. In India, many interventions and policy strategies have been widely and successfully implemented in the country to address its public health challenges over the last 20 years. Without having a good understanding on how best to deliver those interventions and programs at scale, and across the whole country, given the incredible diversity of settings and populations, it will be very challenging to achieve the best possible health outcomes for the country. Therefore, understanding implementation research and acquiring practical skills of program evaluation will be critically important for program implementers, clinicians and researchers in India.
This two-day workshop will overview the field of implementation science including basic concepts and methods in implementation research, applicable tools for program evaluation and quality improvement, as well as how to work with multidisciplinary teams involving researchers, program implementers and policy-makers. Through the workshop, participants will achieve a deeper understanding of the field of implementation research and will acquire practical skills that they can apply in their work.
Aims
- Introduce clinicians/program implementers/researchers to the field of implementation research and program evaluation.
- Inform, through health practitioners, policymakers and researchers, how to study and implement research findings into policy and practice.
- Overview relevant theoretical models, research designs and measurement.
- Illustrate ways of collaborating and networking more nationally and globally.
- Showcase examples of implementation research and the uptake of research findings into policy and practice.
Workshop Textbook: Fabrizio D’Esposito, Emma Thomas, and Brian Oldenburg. A practical guide for implementation research to improve the prevention and control of NCDs. World Health Organization, 2016.
Agenda
Day 1 Time/Venue Topic 8.00am – 9.00am Registration 9.00am – 9.20am Welcome and opening remarks : Dr. Sandeep Budhiraja 9.20am – 9.45am Introduction : Professor Brian Oldenburg and Dr.Vinitaa Jha
Participants to identify their workshop objectives to achieve by the end of the workshop
Introduction of faculty
Introduce the course textbook9.45am – 10.45am An overview of implementation science – Key concepts and issues (Lecture 1) – Professor Brian Oldenburg 10.45am – 11.00am Coffee break 11.00am – 12.00pm An overview of implementation science – Key concepts and issues (Lecture 1) – Professor Brian Oldenburg 12.30pm – 1.30pm Lunch 1.30pm – 3.00pm Group Activity: Development of an implementation research project (Small Group Session 1)
Each workshop participant will briefly present and discuss their project in the small group Brief reporting back from small groups of three key learnings Faculty members will facilitate the group discussion3.00pm – 3.30pm Coffee break 3.30pm – 5.00pm Panel: Translation between research, policy and practice
Faculty and invited speakers (senior researchers, policy makers, senior public health practitioners) will participate: Each panel member will briefly overview his/her approach to implementation research and knowledge translation The remainder of the time will be Q&A with workshop participants5.00pm-6.30pm Feedback, reception and networking
Day 2Time/Venue Topic 9.00am – 9.30am Review of day 1
Learnings and what the participants want to learn more about by the end of Day 29.30am – 10.30am Conceptual models and theoretical frameworks – What is useful? (Lecture 3) – Professor Brian Oldenburg 10.30am – 11.00am Coffee break 11.00am-12.30pm Case studies of existing projects or research projects: applying implementation science in real-world projects (Lecture 4)
Each case example will highlight how the issue of context has been conceptualised and addressed, how it was evaluated and what have been the major learnings for individual projects12.30pm – 1.30pm Lunch 1.30pm – 2.30pm Global experience and challenges in implementation research and knowledge translation (Lecture 5) – Professor John Chambers and Professor Brian Oldenburg 2.30pm -4.00pm Group activity: Development of future implementation research plan / program evaluation plan on participants’ own projects (Small Group Session 2)
Each workshop participant will discuss how to strengthen study design and measurement in their project Brief reporting back from small groups of three key learnings Faculty members will facilitate each of the groups4.00pm – 4.15pm Coffee break 4.15pm – 5.00pm Roundtable: Collaboration across disciplinary and plans for future capacity building and training
Discussion about collaboration across disciplinary, potential plan and strategy for capacity building across China, mentorship and networking5.00pm – 5.30pm Concluding remarks Feedback and evaluation 
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
All lecture videos at this website is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license.
- WHO Implementation Research Resources
WHO Implementation Research Resources
On this page you can find implementation science guides and toolkits produced by the World Health Organization.
The Special Programme for Research and Training in Tropical Diseases (TDR): Implementation Research Materials
The TDR is a global programme of scientific collaboration that helps facilitate, support and influence efforts to combat diseases of poverty.
The Alliance for Health Policy and Systems Research: Implementation research platform
The Alliance works to improve the health of those in low- and middle-income countries by supporting the generation and use of evidence that strengthens health systems.
Implementation Research Platform (IRP) is one of the key institutional capacity strengthening initiatives of AHPSR. From 2010 to 2012, the IRP program has supported a total of 36 projects in over 21 countries.
WHO Publications
The WHO publishes a range of resources to guide researchers and practitioners in implementation science.
Implementation Research in Health: A Practical Guide.
Peters, D. H., Tran, N. T., & Adam, T. (2013). Implementation research in health: a practical guide. World Health Organization.
A Guide to Implementation Research in the Prevention and Control of Noncommunicable Diseases.
World Health Organization. (2016). A guide to implementation research in the prevention and control of noncommunicable diseases. World Health Organization.
License: CC BY-NC-SA 3.0 IGO
Collaboration activities between WHO and the GACD e-Hub project team
- The e-Hub project lead Professor Brian Oldenburg was the director of the WHO Collaborating Centre on Implementation Research for Prevention and Control of NCDs.
- The e-Hub project team and members of the GACD Research Network provide technical assistance on implementation of programmes to WHO Western Pacific Regional Office.
- The e-Hub project team and members of the GACD Research Network have provided technical assistance on implementation research taking place in Kenya, Nepal, Mongolia, and many other countries.
- The e-Hub project team are working with the WHO African and European Regional Offices to develop training programmes on implementation science.
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
- Subscribe e-Hub for the latest resource in implementation science
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Welcome to WHO Regional Implementation Research Training Program
Here you will find many useful information about implementation science from basic knowledge to real word examples, as well as policy related resources. Please click the buttons below for relevant information.
A guide to Implementation Research
This WHO publication aims to provide guidance, tools and examples for implementation research that support the effective implementation of NCD policy options and cost-effective interventions as proposed in the Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020.
Implementation Research Overview
Here you will find a brief introduction of implementation research, including why it is important and how to conduct implementation research.
Implementation Research Toolkit
Interested to find more information? Check here to see tools and websites for implementation science practice, stakeholders engagement and grantsmanship.
Key Publications
Here you will find key publication in implementation research not only for research basics, but also for scale-up, strategies and dissemination.
Training Program
Explore GACD network and WHO regional training programs and many more!
Case Studies
Want to know real world examples of implementation research? Click here for more information!
Policy Resources
We are currently working on allocating policy related resources, and will publish it very soon!
Explore More…
- Implementation Research Workshop
Welcome to the IHSR & University of Malaya Implementation Research Workshop
This workshop aims to introduce participants to innovative scientific methods and tools of diverse disciplines to understand and overcome challenges to implementation and facilitate scale-up.
Workshop Date:
14, 15 & 22 October 2021
Agenda
Day 1 (14 October 2021)
9:00 – 9:05 am
Introduction to the course
9:05 – 9:10 am
Welcoming remarks from Director
9:15 – 10:15 am
Live lecture by Prof Brian Oldenburg
Lecture 1
- Introduction to implementation research
- Intervention vs. Implementation
- Implementation theories, models and frameworks
Recommended Readings
- An introduction to implementation science for the non-specialist (Bauer M. et al. (2015). An introduction to implementation science for the non-specialist. BMC Psychology. 16(3):32.)
- A guide to implementation research in the prevention and control of noncommunicable diseases (World Health Organization. (2016). A guide to implementation research in the prevention and control of noncommunicable diseases. Geneva: World Health Organization; 2016. Licence: CC BY-NC-SA 3.0 IGO.)
- National Institutes of Health Approaches to Dissemination and Implementation Science: Current and Future Directions (Glasgow R, et al. (2012). National Institutes of Health Approaches to Dissemination and Implementation Science: Current and Future Directions. American Journal of Public Health, 102(7): 1274-1281.)
- Evaluating the public health impact of health promotion interventions: the RE-AIM framework (Glasgow, R. E., Vogt, T. M., & Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions: the RE-AIM framework. American journal of public health, 89(9), 1322–1327.)
- Making sense of implementation theories, models and frameworks (Nilsen, P. (2020). Making sense of implementation theories, models, and frameworks. In Implementation Science 3.0 (pp. 53-79). Springer, Cham.)
- A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice (Feldstein, A. C., & Glasgow, R. E. (2008). A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. The Joint Commission Journal on Quality and Patient Safety, 34(4), 228-243.)
Recommended Videos to watch
- What is Implementation Science
- Key concepts, models and issues
- TMF For Program Design, Implementation and Evaluation
- TMF, A Practical Application
10:15 – 10:50 am
Group work: Choosing & describing the intervention to be studied
10:50 – 11:00 am
Break
11:00 am – 12:00
Live Lecture by Dr Tilahun
Lecture 2
- Needs assessment in implementation research and stakeholder analysis
Recommended Readings
- Lifestyle change in Kerala, India: needs assessment and planning for a community-based diabetes prevention trial (Daivadanam, M., Absetz, P., Sathish, T., Thankappan, K. R., Fisher, E. B., Philip, N. E., Mathews, E., & Oldenburg, B. (2013). Lifestyle change in Kerala, India: needs assessment and planning for a community-based diabetes prevention trial. BMC public health, 13, 95)
- Cultural adaptation of a peer-led lifestyle intervention program for diabetes prevention in India: the Kerala diabetes prevention program (K-DPP) (Mathews, E., Thomas, E., Absetz, P., D’Esposito, F., Aziz, Z., Balachandran, S., Daivadanam, M., Thankappan, K. R., & Oldenburg, B. (2018). Cultural adaptation of a peer-led lifestyle intervention program for diabetes prevention in India: the Kerala diabetes prevention program (K-DPP). BMC public health, 17(1), 974.)
- Cluster randomised controlled trial of a peer-led lifestyle intervention program: study protocol for the Kerala diabetes prevention program (Sathish, T., Williams, E. D., Pasricha, N., Absetz, P., Lorgelly, P., Wolfe, R., Mathews, E., Aziz, Z., Thankappan, K. R., Zimmet, P., Fisher, E., Tapp, R., Hollingsworth, B., Mahal, A., Shaw, J., Jolley, D., Daivadanam, M., & Oldenburg, B. (2013). Cluster randomised controlled trial of a peer-led lifestyle intervention program: study protocol for the Kerala diabetes prevention program. BMC public health, 13, 1035.)
- The science of stakeholder engagement in research: classification, implementation, and evaluation. (Goodman, M. S., & Sanders Thompson, V. L. (2017). The science of stakeholder engagement in research: classification, implementation, and evaluation. Translational behavioral medicine, 7(3), 486–491.)
- How to engage stakeholders in research: design principles to support improvement (Boaz, A., Hanney, S., Borst, R., O’Shea, A., & Kok, M. (2018). How to engage stakeholders in research: design principles to support improvement. Health research policy and systems, 16(1), 1-9.)
Recommended Toolkits
- NIH-Fogarty Toolkit for Engaging Diverse Stakeholder in Implementation Science
- Community-Based Participatory Action Research Toolkit
Recommended Videos to watch
- Cultural adaptation and context for program design, implementation and evaluation
- Stakeholder engagement
12:00 – 12:45 pm
Group work:
- Identifying implementation problem
- Formulating your research question and needs assessment
12:45 – 1:00 pm
Group feedback
Day 2 (15 October 2021)
9:00 – 9:05 am
Introduction of day 2 courses and recap first day course
9:05 – 10:05 am
Live Lecture by Prof Brian Oldenburg
Lecture 3
- Developing implementation research strategies part 1
Recommended readings
- Best Practices for Mixed Methods Research in the Health Sciences (NIH Office of Behavioral and Social Sciences. (2018). Best practices for mixed methods research in the health sciences (2nd ed). Bethesda: National Institutes of Health.)
- Writing Mixed Research Reports (Leech, N. L. (2012). Writing mixed research reports. American Behavioral Scientist, 56(6), 866-881.)
- Focusing on fidelity: narrative review and recommendations for improving intervention fidelity within trials of health behaviour change interventions (E. Toomey, W. Hardeman, N. Hankonen, M. Byrne, J. McSharry, K. Matvienko-Sikar & F. Lorencatto (2020) Focusing on fidelity: narrative review and recommendations for improving intervention fidelity within trials of health behaviour change interventions, Health Psychology and Behavioral Medicine, 8:1, 132-151)
Recommended Videos to watch
- Type of study questions and study designs
10:05 – 10:15 am
Break
10:15 – 11:15 am
Live Lecture by Prof Brian Oldenburg
Lecture 4
- Developing implementation research strategies part 2
11:15 am – 12:30 pm
Group work: Designing your implementation research strategy
12:30 – 1:00 pm
- Group feedback
- Homework for the week
Day 3 (22 October 2021)
9:00 – 9:05 am
- Introduction of day 3 courses and recap 2nd day course
- Reminder: Workshop assessment
9:05 – 10:05 am
Live Lecture by Dr Tilahun
Lecture 5
- Measuring outcomes in implementation research (+Q&A)
Recommended Readings
- Advances in EBI Development for Diverse Populations: Towards a Science of Intervention Adaptation (Castro, F. G., & Yasui, M. (2017). Advances in EBI Development for Diverse Populations: Towards a Science of Intervention Adaptation. Prevention science : the official journal of the Society for Prevention Research, 18(6), 623–629)
- Fidelity and Its Relationship to Implementation Effectiveness, Adaptation, and Dissemination (Allen, J. D., Linnan, L. A., Emmons, K. M., Brownson, R., Colditz, G., & Proctor, E. (2012). Fidelity and its relationship to implementation effectiveness, adaptation, and dissemination. Dissemination and implementation research in health: Translating science to practice, 281-304.)
Recommended Videos to watch
- Interventions and measurement at different levels (part A)
- Interventions and measurement at different levels (part B)
10:05 – 10:10 am
Break
10:10 – 11:10 am
Group work: Selecting outcomes to measure & methods to measure them
11:10 – 11:30 am
Group presentation (or record video of presentation) and Q&A
11:30 am – 12:30 pm
Live Lecture by Dr Tilahun
Lecture 6
- Ethics in implementation research (+ Q&A)
Recommended Readings
- Highlighting the ethics of implementation research (Luyckx, V. A., Reis, A., Maher, D., & Vahedi, M. (2019). Highlighting the ethics of implementation research. The Lancet Global Health, 7(9), e1170-e1171.)
- Developing the ethics of implementation research in health (Gopichandran, V., Luyckx, V. A., Biller-Andorno, N., Fairchild, A., Singh, J., Tran, N., … & Vahedi, M. (2016). Developing the ethics of implementation research in health. Implementation Science, 11(1), 1-13.)
- Ethical issues in implementation research: a discussion of the problems in achieving informed consent (Hutton, J. L., Eccles, M. P., & Grimshaw, J. M. (2008). Ethical issues in implementation research: a discussion of the problems in achieving informed consent. Implementation Science, 3(1), 1-8.)
- Ethical Challenges in Implementation Research (Macklin, R. (2014). Ethical challenges in implementation research. Public Health Ethics, 7(1), 86-93.)
- Addressing the tensions and complexities involved in commissioning and undertaking implementation research in low- and middle-income countries (Doherty, T., Lewin, S., Kinney, M., Sanders, D., Mathews, C., Daviaud, E., … & Leon, N. (2018). Addressing the tensions and complexities involved in commissioning and undertaking implementation research in low-and middle-income countries. BMJ global health, 3(4), e000741.)
12:30 – 12:45 pm
Next steps: Interactive session with participants about mentoring and other ongoing support
15 mins
Workshop assessment by participants
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
All lecture videos at this website is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license.
- WHPRO Implementation Research Workshop
Welcome to the WHPRO Implementation Research Workshop
This Implementation Research Module aims to strengthen the capacity health policy makers and managers in implementation research in the Western Pacific Region. The program is designed to help health policy makers and managers address the practical issues in the implementation of health policies and programs in the region.
Agenda
Pre-reading
Trainees are expected to go through the pre-reading materials and implementation e-hub before the first webinar session. The main pre-reading material for this workshop is WHO guide to implementation research in the prevention and control of noncommunicable diseases. This guide is available here.
Module 1: Introduction to implementation research
Lecture 1.1 Overview of implementation research
Learning objectives
The objective of this lecture is to introduce participants to implementation research by describing the definition and importance of implementation research.
Suggested videos to watch
Suggested readings
- A guide to implementation research in the prevention and control of noncommunicable diseases. Geneva: World Health Organization; 2016 available at https://apps.who.int/iris/bitstream/handle/10665/252626/9789241511803-eng.pdf
- Breda J, Wickramasinghe K, Peters DH, Rakovac I, Oldenburg B, Mikkelsen B, Shao R, Varghese C, Collins T, Wall K, Farrington J, Townsend N. One size does not fit all: implementation of interventions for non-communicable diseases. BMJ. 2019 Dec 6;367:l6434. Available at https://www.bmj.com/content/367/bmj.l6434.long
Lecture 1.2 Types of study questions and study designs for implementation research
Learning objectives
The objective of this lecture is to enable participants understand the types of research questions and the common study designs in implementation research.
Suggested videos to watch
Suggested readings
- Bauer, M.S., Damschroder, L., Hagedorn, H. et al. An introduction to implementation science for the non-specialist. BMC Psychol 3, 32 (2015). https://doi.org/10.1186/s40359-015-0089-9
Lecture 1.3 Theories, Models and Frameworks (TMFs) in implementation research
Learning objectives
The objective of this lecture is to enable participants select and apply relevant theories, models and frameworks in implementation research.
Suggested videos to watch
Suggested readings
- Nilsen, P. Making sense of implementation theories, models and frameworks. Implementation Sci 10, 53 (2015). https://doi.org/10.1186/s13012-015-0242-0
Assignment
Objective of the assignment
To familiarize participants with the practical steps in defining implementation research question.
As part of the assignment participants will:
- Assess and describe evidence gaps for implementation research
- Define an implementation research topic/question
- Formulate research hypothesis/objectives
- Identify an appropriate implementation research study design
- Identify other expertise (stakeholders) in their own country
Module 2: Practical aspects of implementation research in LMICs
Lecture 2.1: How to make sure that your research findings do not get lost in translation?
Learning objectives
The objective of this lecture is to discuss the importance of effective communication of implementation research findings to potential users.
Review the following article
- Oldenburg B, Absetz P. Lost in translation: overcoming the barriers to global implementation and exchange of behavioral medicine evidence. Transl Behav Med. 2011;1(2):252-255. doi:10.1007/s13142-011-0051-1
List the main barriers in implementation and exchange of behavioral medicine evidence.
Lecture 2.2. Stakeholder engagement in implementation research
Learning objectives
The objective of this lecture is to summarize key strategies for engaging stakeholders in implementation research.
Suggested videos to watch
Suggested readings
- Peters, D.H., Bhuiya, A. & Ghaffar, A. Engaging stakeholders in implementation research: lessons from the Future Health Systems Research Programme experience. Health Res Policy Sys 15, 104 (2017). https://doi.org/10.1186/s12961-017-0269-6
Implementation research in LMICs: Some exemplar case studies LMICs
Case study from China
Case study from Africa
Case study from India
IR resources for strengthening capacity in low- and middle-income countries
- A guide to implementation research in the prevention and control of noncommunicable diseases (WHO 2016)
- GACD supported Implementation science e-hub
- University of Washington Implementation Science Resource hub
- Implementation Science Journal
- Implementation Research in Health: A Practical Guide (Peters, D. et al 2013)
- Implementation research: what it is and how to do it (Peters, D. et al 2013)
- Writing implementation research grant proposals: ten key ingredients (Proctor, E. 2012)
- Dissemination and Implementation Research in Health: Translating Science to Practice (Brownson, R. et al 2012)
- Implementation research toolkit (WHO/TDR 2014)
- Nine steps for developing a scaling-up strategy (WHO 2010)
- RE-AIM Framework (Glasgow et al)
- An introduction to implementation science for the non-specialist (Bauer, M. et al 2015)
- Seven Approaches to Investing in Implementation Research in Low- and Middle-Income Countries
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
All lecture videos at this website is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license.
- Sitemap
- Other training programmes
Our implementation Research workshops that are tailored to the specific needs of healthcare workers, health managers and researchers aims to enhance the implementation research capacity through an appropriate mix of interactive lectures, group sessions and online discussion forums.
Malaysian Implementation Research Workshop
Dates:
Audience:
Collaborative partners: The Institute for Health Systems Research and University of Malaya
The Institute for Health Systems Research & University of Malaya Implementation Research Workshop introduces participants to implementation research methods and tools from diverse disciplines. It aimed to help participants to understand and overcome the challenges of implementation and to facilitate scale-up of programs. The workshop participants included researchers, health practitioners and policy makers. The program was delivered remotely over three days. Prof Brian Oldenburg and Dr Tilahun Haregu delivered the program. Small group sessions were supported by online discussions on Padlet and Whatsapp groups. As part of the program, participants developed six implementation research proposals. There will also be follow-up discussions to review progress in applying the knowledge from the workshop.
Collaborative partners:
WHO Western Pacific Regional Office Implementation Research Workshop
Dates:
Audience:
Collaborative partners: World Health Organisation Western Pacific Regional Office
This Implementation Research Module aims to strengthen the capacity health policy makers and managers in implementation research in the Western Pacific Region. The program is designed to help health policy makers and managers address the practical issues in the implementation of health policies and programs in the region.
The GACD holds a number of networking and collaboration events for implementation science researchers and capacity development training.
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
- Implementation Science Overview
What is Implementation Science?
Implementation science is the study of the methods and strategies that enable research uptake into practice and policy.
With the aim to improve population health, implementation science examines what works, for whom, and under what circumstances. It also looks at how effective interventions can be scaled up within and between countries, while maintaining equity of access, for example, across gender, age, and socioeconomic status.
Implementation science is the “application and integration of research evidence into practice and policy.”
Glasgow, Eckstein, and ElZarrad (2013)Gbenga Ogedegbe, Professor of Global Health, explains the importance of implementation science
Why Is Implementation Research Important?
Implementation research takes what we know and turns it into what we do.
Implementation research is needed to account for the complexities of the systems in which interventions are implemented since other approaches often fail to address these. Results of implementation research support evidence-based policymaking that can build robust programmes to improve public health.
The GACD has invested over $250 million USD in implementation science research for chronic non-communicable diseases, to see more of the GACD impact visit: https://www.gacd.org/our-impact/global-impact
How Is Implementation Research Conducted?
Figure: The Implementation Research Cycle Why is implementation science important for non-communicable diseases?
Non-communicable diseases (NCDs) are diseases that cannot be transmitted from person to person, are typically long term in nature, and where a complete cure is rarely achievable. They kill 41 million people each year, equivalent to 71% of all deaths globally.
While many proven interventions to prevent and manage NCDs exist, there can be significant challenges in implementing these effectively in diverse settings and different contexts. Implementation research can address such challenges.
Why is implementation science important in low- and middle-income settings?
Over three-quarters of all NCD deaths occur in low- and middle-income countries; however, many effective prevention and management interventions exist which could help alleviate this burden. Implementation science is critical in such settings to help ensure that limited resources are invested in cost-effective programmes that are relevant to the local context.
What next?
Read our implementation research for non-communicable diseases case studies
Explore our Resources and toolkit library
Take our Fundamentals of Implementation Science Programme
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
- How To: Implementation Science Research
Implementation science research is the investigation into methods and strategies to holistically embed and integrate evidence-based interventions in targeted settings relevant to population and global health. It can be difficult to navigate the process of implementation science research.
The core steps to succeeding in any implementation science efforts are listed below alongside useful tools to guide implementation research and studies.
Doing Implementation Science Research
Frame your research question
The first step is to define the implementation science research you wish to undertake. Some key considerations could be the discovery, evidence-gathering and incorporation of implementation science in different contexts, as well as how to de-implement in effective practices.
Pick a Theory, Model, or Framework
There are a variety of structures that can be used to guide research in the implementation science toolkit. It is important to understand what they are, how they can be used and the intended purposes to best align with your research question.
Identify Implementation Strategies
At the core of implementation science is the strategies to incorporate evidence-based interventions. As such the process of identifying effective strategies for your area of research is important. Additionally, the manner in which the strategies are published, explained and reported is important for others to understand and utilise in different settings.
Select Research Method
There are several research methods that can be chosen to achieve proximal implementation outcomes, intermediate service delivery outcomes or distal health outcomes. The main methods are: systems analysis and improvement approach, operations research, qualitative health systems research, organisational assessment, economic evaluation and stakeholder and policy analysis.
Select Study Design
The study design for implementation research is critical to ensure the data captured is relevant and appropriately addresses the aims of your research question. Common study designs used in implementation science are: randomised control trials, quasi-experimental designs, intervention optimisation and mixed methods.
Choose Measures
To garner relevant data, measures need to be used to detect aspects of ongoing implementation science strategies. It should be cautioned that there are an abundant list of potential measures, however, evaluation of the quality of the measure should be undertaken beforehand.
Get Funding
Implementation science research grant proposals can be difficult to articulate and demonstrate the impact of research outcomes. It has been proposed by Procter et al, that there are “ten key ingredients” to writing successful grants in implementation science research. The ingredients prompt researchers to consider their project from numerous standpoints including: access/quality gaps, evidence-based practices, conceptual model, stakeholder engagement, setting readiness, implementation strategy, team experience, feasibility of methods, measurement and analysis and alignment with current policy and funding procedures.
Report Results
Implementation science research grant proposals can be difficult to articulate and demonstrate the impact of research outcomes. It has been proposed by Procter et al, that there are “ten key ingredients” to writing successful grants in implementation science research. Now that you have framed your question, designed your study, secured funding and collected/analysed data, it is time to report your findings to the world. In order to ensure “transparent, accurate, reliable and replicable scientific research” (University of Washington 2022) is published, have a comprehensive understanding of relevant reporting guidelines is crucial.
NCI Implementation Science Tools
To facilitate effective implementation science research, the National Cancer Institute has collated and published useful tools and resources spanning from educational modules and workshops for upskilling to reports and workbooks showcasing successful models and case studies.
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
- How To: Implementation Science Research
- Resource Platform to Advance Knowledge and Practice
Welcome to the GACD Implementation Science e-Hub
The GACD e-Hub is a comprehensive online learning space for knowledge and skill development in implementation research, with particular focus on chronic and non-communicable diseases in low- and middle-income settings. It is an interactive online platform available to all, for free.
Watch the welcome video from Professor Brian Oldenburg, who introduces you to implementation science and the GACD e-Hub.
Where to start?
Our e-Hub is ideal for researchers, policymakers, and practitioners at any stage in their career, from anywhere in the world with an interest in implementation science as an essential aspect of bridging the evidence-to-practice gap.
Fundamentals
Explore our flagship online programme, Fundamentals of Implementation Science.
Overview
New to implementation science? Get a quick introduction to the field on our overview page.
Case Studies
Read state-of-the-art implementation research case studies from around the world.
Training Schools & Workshops
GACD has supported Implementation Science Schools for trainees all over the world since 2018. The syllabus for the Implementation Science Schools developed by international implementation experts forms the basis for the origins of this e-Hub.
GACD Implementation Science Training Schools Since 2018
Since 2014, GACD has been holding workshops around the world as part of its capacity-building mandate. Our e-Hub aims to build capacity amongst researchers by linking a broader range of community online.
GACD Implementation Science Workshops Since 2014
Latest Events
WHO Monograph Is Now Available in Chinese
We are keen to announce that the WHO monograph of “A guide to implementation research in the prevention and control of noncommunicable diseases” has been translated in Chinese for the first time with the joint efforts by experts and researchers from China Center for Disease Control and Prevention, Peking Union Medical College and the WHO Collaborating Centre on Implementation Research for Prevention and Control of NCDs.
Note: This work is available under the Creative Commons Attribution-Non Commercial-ShareAlike 3.0 IGO license, which allows you to copy, redistribute and adapt the work for non-commercial purposes. Any copying, redistribution or adaptation of the work for commercial purposes will require permission from the World Health Organization and Peking Union Medical College Press.
The 4th Implementation Science Training School
In November 2021, we held our second virtual training school over two weeks– the 4th Implementation Science Training School. Watch the video to find out more about the wonderful memories!
“The resources are amazing! Lots and lots of tools to help us in various aspects of implementation research.”
– Miriam Sequeira, IndiaWe are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
- Case Studies – early
On this page you will find case studies showcasing implementation research across a range of chronic and non-communicable diseases, countries, and target populations. Each case study provides practical, real-life examples of applying key implementation science principles.
A case study may focus on the whole project or may focus on one specific element of the project; for example, how a framework was selected and applied to a specific context or describing how a challenge with engaging stakeholders was addressed and overcome.
The case studies are all genuine implementation research projects from the real world. Many
Situational Analysis – Diabetes Prevention, India
Why this case study?
This illustrates how a situational analysis was carried out in the state of Kerala, India in order to assess the need to implement a diabetes prevention programme.
The situational analysis laid the foundation for the adaptation of diabetes prevention programmes from Europe, the USA and Australia to the local context.
Title
Carrying out a situational analysis for the implementation of NCD prevention and control policies and interventions
Source
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
Health issue
Type 2 diabetes mellitus
Setting
Trivandrum region in Kerala, India
Target population
Men and women at high risk of developing diabetes
Background
India has approximately 65 million individuals with type 2 diabetes mellitus (T2DM) – the second-largest number for a single country in the world. This number is expected to double by 2030.(1,2) Studies estimate that T2DM affects between 9% and 20% of the country’s adult population.(3,4)
Kerala has the highest prevalence of T2DM, with up to 20% of adults estimated to have the disease in parts of the state.(5,6)
Description of policy or intervention
The Kerala Diabetes Prevention Program (KDPP) is a lifestyle intervention aimed at individuals in rural areas of Kerala at high risk of developing diabetes. The programme is designed to reduce the risk of developing diabetes through a series of peer-led sessions held within local communities. Following training on diabetes prevention and group facilitation, peer leaders identified from within the community conduct small group sessions focused on increasing knowledge about diabetes and on prevention strategies. Sessions are supplemented with community-wide activities such as yoga, walking and gardening which help participants to put into practice the learning from the group sessions.
What took place?
A situational analysis was carried out prior to the development of the KDPP by triangulating evidence from:
- previous research on the prevalence and control of diabetes in India and elsewhere;
- policy and other programme documents relevant to diabetes prevention specific to Kerala or India and
- a collection of novel qualitative data in Kerala through engagement with local stakeholders (including consumers).(7)
Relevant published research was retrieved following PubMed searches using medical subject heading (MeSH) terms related to diet, physical activity, tobacco and health pro-motion interventions conducted in India.
The search engines of relevant government department websites (e.g. of the Ministry of Health & Family Welfare) were used to retrieve relevant policy and programme documents (including guidelines at both the state and national level on NCD prevention and control, diet, physical activity and tobacco and alcohol use).
The qualitative research component consisted of focus groups (with pre-diabetic individuals from rural areas of Kerala, identified from the database of an earlier survey(8) that explored perceptions and attitudes towards T2DM and its prevention). These group discussions helped to identify specific needs for cultural adaptation and for delivery of the programme to target communities.
What was learnt?
The National Programme for Prevention and Control of Diabetes Cardiovascular Dis- eases and Stroke (NPDCS) – with recommendations on diet and physical activity – only launched recently in India. This contrasts to the situation in high income countries (HICs), where most diabetes prevention programmes were implemented almost a decade ago.
Despite the large burden of NCDs in the state and across the country, the situational analysis revealed gaps in NCD research and policy in Kerala/India. A review of epidemiological studies revealed a higher prevalence of risk factors for T2DM in Kerala than in the rest of the country,(4) with some risk behaviours (such as smoking) higher than the national average. Adult physical inactivity during leisure time was also high (9).
The focus groups highlighted the important role of families and cultural norms in making lifestyle choices in India. This underpinned the importance of developing a more integrated approach to behaviour change interventions than used in HICs. Multiple strategies involving family and community empowerment were called for – as corroborated by other studies in India.(7, 10-11)
References:
- Shaw, J.E., R.A. Sicree, and P.Z. Zimmet, Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract, 2010. 87(1): p. 4-14.
- Ramachandran, A., R.C. Wan Ma, and C. Snehalatha, Diabetes in Asia. Lancet, 2009. 375(9712): p. 408-18.
- Thankappan, K.R., et al., Risk factor profile for chronic non-communicable diseases: Results of a community-based study in Kerala, India. Indian Journal of Medical Research, 2010. 131: p. 53-63.
- Menon, V.U., et al., Prevalence of known and undetected diabetes and associated risk factors in central Kerala – ADEPS. Diabetes Research and Clinical Practice, 2006. 74(3): p. 289-94.
- Raman, K.V., A. Joseph, and C.R. Soman, High prevalence of type 2 diabetes in an urban settlement in Kerala, India. Ethnicity and Health, 1999. 4(4): p. 231-9.
- Daivadanam, M., et al., Lifestyle change in Kerala, India: needs assessment and planning for a community-based diabetes prevention trial. BMC Public Health, 2013. 13: p. 95.
- Soman, C.R., et al., Cohort profile: the PROLIFE study in Kerala, India. Int J Epidemiol, 2011. 40(1): p. 10-4.
- Sugathan, T.N., C.R. Soman, and S. K, Behavioural risk factors for non communicable diseases among adults in Kerala, India. The Indian Journal of Medical Research, 2008. 127(6): p. 555- 63.
- Krishnan, A., et al., Evaluation of community-based interventions for non-communicable diseases: Experiences from India and Indonesia. Health Promotion International, 2011. 26(3): p. 276-89.
- Kumar, M.S., P.S. Sarma, and K.R. Thankappan, Community-based group intervention for tobacco cessation in rural Tamil Nadu, India: A cluster randomized trial. Journal of Substance Abuse Treatment, 2012. 43(1): p. 53-60.
- Mohan, V., et al., Community empowerment – A successful model for prevention of noncommunicable diseases in India – The Chennai Urban Population Study (CUPS-17). The Journal of the Association of Physicians of India, 2006. 54(858-62).
Knowledge Synthesis – Tobacco-related NCDs and plain packaging policies, India
Why this case study?
This showcases knowledge synthesis in preparation for the implementation of tobacco plain packaging policies and interventions in India.
The case study also illustrates that, although there may be evidence for a policy or intervention’s effectiveness, it is important to take account of local context.
Title
Knowledge synthesis on plain packaging to assess existing evidence to promote the selection of evidence-based policies and interventions for implementation in India
Source
Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia
Health issue
Respiratory diseases and other NCDs caused by tobacco
Setting
India
Target population
Individuals who use tobacco products
Background
Tobacco is responsible for 25% of deaths from respiratory diseases in India,(1) which is the world’s second largest consumer of tobacco (smoking and smokeless forms).(2) The prevalence of tobacco use is 48% in males and 20% in females, with many others exposed to second-hand smoke.(3,4) Tobacco attributable deaths in India are expected to rise to 1.5 million annually by 2020.(5) It has been suggested that the cost of respiratory diseases attributable to tobacco in India in 2011 was US$ 600 million(6)
In 2003 the Indian government, consistent with the WHO Framework Convention on Tobacco Control (FCTC),(7) passed The Cigarettes and Other Tobacco Products Act (COTPA). This prohibited tobacco-related advertising and sponsorship and specified health warnings on tobacco packs.(8) However, the impact of these measures was limited,(9) prompting the Indian Government to consider larger, more effective pictorial health warnings.(10-15) The next step would be plain packaging, for which there is growing international evidence.
Description of policy or intervention
Plain packaging entails the removal of all branding (colours, imagery, corporate logos and trademarks), with brand names mandated a uniform size and font and placed together with current or enhanced graphic health warnings on the tobacco packaging.
Plain packaging would apply to packaging of all forms of tobacco; in India this includes beedis and chewed forms of tobacco as well as conventional cigarettes.
The aim of plain packaging is to decrease the attractiveness of the package, enhance the effect of pictorial health warnings on the package, increase thoughts about quit- ting and promote negative attitudes towards tobacco use.
Plain packaging of tobacco products has a significant evidence base from a number of countries(13, 16-19) – especially from Australia where it was first introduced. However, evidence on such packaging in rapidly developing countries such as India is relatively scant.(20,21)
What took place?
A joint Indian and Australian taskforce was convened with support from a small grant from the Australia India Institute. Following a comprehensive knowledge synthesis project, the taskforce produced a report on the possibility of plain packaging in India.(19)
The report included evidence from other jurisdictions, local market research on plain packages(22) and results from a stakeholder analysis undertaken with legal experts, policy-makers and tobacco control experts. It summarized all the behavioural, political and legal evidence and provided graded recommendations as to the way forward.
The report was launched at a high level event attended by politicians from India, WHO representatives, leading tobacco control experts and legal experts. In response, a private members bill on plain packaging was introduced to the Indian parliament in 2013 and a follow up international conference was also held at which the Indian health minister and health secretary gave presentations.
However, a number of contextual barriers have slowed progress on plain packaging. These include a change of government and health ministers, a demand for local evidence and opposition from a significant tobacco farming industry in India. Further research is planned to respond to these concerns and produce additional local evidence.
What have we learnt?
While external (international) evidence and the input of international experts is a helpful start in formulating policies, it is not sufficient for successful policy change.
To increase the chances of the knowledge synthesis leading to a change in policy, the following points are useful:
- It is important to know the specific audience for whom the knowledge synthesis is being undertaken.
- Research needs to take account of the policy-making timetable – e.g. regulatory committee meetings or election cycles.
- A mechanism is needed to ensure the knowledge synthesis is fed to the appropriate groups to inform debate and policy. In particular, a clear communication strategy is needed to reach decision-makers.
- The knowledge synthesis team need to involve credible figures to maximize the likelihood of evidence reaching decision-makers. (In this example, two coinvestigators sat on government advisory committees).
- Contextual information can often result in a need to include and/or produce unique evidence in addition to that available from other jurisdictions. (For example, in this case the tobacco products and industries of Australia and India were very different, so further information was needed).
Finally, note that while the stages of knowledge synthesis outlined above will help to identify policies and interventions that may be pursued in the prevention and control of NCDs, they may not provide information about transferability of these to new and different contexts. Approaches to the assessment of suitability and adaptation of policies and interventions to new contexts are discussed later in the guide.
References:
- World Health Organization, WHO global report: mortality attributable to tobacco, W. Press, Editor. 2012: Geneva.
- Jhanjee, S., Tobacco Control in India – Where are we now? Delhi Psychiatry Journal, 2011. 14(1): p. 26.
- Ministry of Health and Family Welfare India, Tobacco use among students and teachers. Findings from the Global Youth Tobacco Survey and Global School Personnel Survey India. 2010: New Delhi.
- International Institute for Population Sciences & MoHFW India, Global Adult Tobacco Survey (GATS) India 2009-2010. New Delhi.
- ITC Project, TCP India National Report. Findings from the Wave 1 Survey (2010-2011). 2013, University of Waterloo, Canada; Healis-Sekhsaria Institute for Public Health, India.
- Ministry of Health and Family Welfare (Government of India), Economic Burden of Tobacco Related Diseases in India. Executive Summary. 2014, New Delhi: PHFI and WHO Country Office for India.
- World Health Organization, WHO Framework Convention on Tobacco Control. 2003: Geneva.
- Ministry of Health and Family Welfare India, The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003. 2009: New Delhi.
- Arora, M., Tewari A, Nazar PN, Gupta K, Shrivastav R,, Ineffective pictorial health warnings on tobacco products: lessons learnt from India. Indian Journal of Public Health, 2012. 56(1): p. 61-64.
- Yadav, A., India: New Warnings to Cover 85% of Packs. Tobacco Control, 2015. 24(1): p. 3.
- Moodie, C., et al., Plain tobacco packaging: A systematic review. UK Centre for Tobacco Control Studies, 2012.
- Wakefield, M.A., et al., Introduction effects of the Australian Plain Packaging policy on adult smokers: a cross-sectional study. BMJ open, 2013. 3(7): p. e003175.
- Lok Sabha Secretariat, Fourth Report on the Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003, C.o.S. Legislation, Editor. 2015, Government of India Press: New Delhi.
- White V, Australian Secondary Students’ Alcohol and Drug (ASSAD), Centre for Behavioural Research in Cancer (CBRC), Editor. 2015, Department of Health Canberra.
- Hammond D, Health warning messages on tobacco products: a review Tobacco Control, 2011. 20(327).
- Arora M, T.A., Grills N, Nazar GP, Sonrexa J, Gupta VK, Moodie R, Reddy KS., Exploring perception of Indians about Plain Packaging of tobacco products. Frontiers in Public Health, 2013. 1: p. 35.
- Dunlop, S., et al., Impact of Australia’s introduction of tobacco plain packs on adult smokers’ pack-related perceptions and responses. BMJ Open, 2014. 4: p. e005836.
- Hammond, D., Standardized packaging of tobacco products: evidence review. 2014, Irish Department of Health.
- Australia India Institute, Report of the AII Taskforce on Tobacco Control: Plain Packaging of tobacco products. 2012: Melbourne
- Hughes N, Grills N, and Aurora M, Effect of plain packaging of tobacco products in low and middle income settings: A systematic review of the literature. Currently under reviewed, 2015.
- Jann W and Werich K, Theories of policy change, in Handbook of Public Policy Analysis: Theory, Politics, and Methods, Fischer F and Miller GJ, Editors. 2007, Taylor and Francis group.
- Henggeler, S.W., et al., Transporting efficacious treatments to field settings: The link between supervisory practices and therapist fidelity in MST programs. Journal of Clinical Child & Adolescent Psychology, 2002. 31(2): p. 155-67.
Adapting Interventions – Hypertension, Mongolia
Why this case study?
This case illustrates the importance of adapting interventions to the local context and piloting them prior to scale up.
The case study also highlights some of the barriers and facilitators to the adaption and piloting process and proposes ways in which to address these.
Title
Adapting policies and interventions to new contexts
Source
The George Institute for Global Health, Sydney, Australia
Health issue
Hypertension and comorbidities
Setting
Mongolia
Target population
General population of Ulaanbaatar (Mongolia’s capital city)
Background
Population-wide salt reduction programmes are widely viewed as one of the most cost-effective interventions for the prevention of hypertension and associated NCDs.
The number of such national programmes has almost doubled between 2010 and 2014 and programmes are now being implemented in most regions of the world. However, to date, most of those that have demonstrated an impact are from HICs. There is some way to go to translate the lessons from these countries to low and medium income countries (LMICs).
Description of policy or intervention
Successful salt reduction programmes identify the main sources of salt in the diet and then develop a strategy to reduce them.
The Ministry of Health in Mongolia (MMoH) implemented a pilot intervention to reduce population salt intake in Ulaanbaatar during 2012–2013. The results of this pilot, combined with a series of other initiatives, informed the development of a National Salt Reduction Strategy.
What took place?
The MMoH established an intersectoral working party and organized a two-week national consultation and training programme on salt reduction. Actions arising included implementation of a pilot salt reduction intervention.
The main objective of the pilot intervention was to reduce salt intake of the employees of three factories, based on the notion that simply telling people what they should/should not eat does not work – the food environment also needs to change. Adapting this to the Mongolian context, implementation strategies included training employees on the negative health impact of salt and on consuming a healthy diet, as well as actually reducing salt levels in the food served in company canteens/kitchens.
Pre- and post-intervention monitoring showed that salt intake reduced between 2011 and 2013. The number of people that did not know which foods were high in salt also declined substantially during the same period.
These activities demonstrated the potential for action and helped to convince policy-makers to scale up the policy to national level, resulting in the Mongolian National Salt Reduction Strategy being endorsed by the government in 2015 – with the ultimate goal to reduce population salt intake in Mongolia by 30%.
What have we learnt?
Success of the pilot intervention and scaling up of the policy to national level was possible for a number of reasons:
- The importance of multisectoral action was recognized from the outset.
- The project emerged from consultation and training on salt reduction and raised awareness of the health impacts of salt.
- The approach started by trying to understand the main sources of salt in the diet and how best to reduce them (rather than simply replicating salt reduction initiatives from other countries).
Lessons for other countries:
- Do not just replicate other programmes. A good understanding of how consumption patterns are contributing to salt intake in the country of interest is also needed.
- Do ensure that your strategy is multifaceted, combining a change of the food environment together with programmes to change consumer behaviour.
- Do continue with advocacy programmes to ensure strong government support and adequate financing.
- Do establish effective multisectoral stakeholder engagement, community participation and training procedures from the outset.
- Do, where possible, implement pilot interventions.
- Do not leave evaluation until the end of the programme. Regular monitoring ensures programmes are on track to achieve targets.
Establishing Acceptability – Respiratory Diseases, Senegal
Why this case study?
This illustrates the negative consequences of implementing an effective intervention without first assessing acceptability in a new context.
Title
The importance of establishing acceptability
Source
Beltramo T, Levine DI. The effect of solar ovens on fuel use, emissions and health: Results from a randomised controlled trial.(1)
Health issue
Respiratory diseases
Setting
Senegal
Target population
Households where cooking is conducted using solid fuels
Background
Traditional stoves for cooking and heating in LMICs are frequently fuelled with dung, coal and wood. The smoke resulting from burning such solid fuels pollutes the air and has been linked to a range of respiratory and other diseases.
Improved stoves have the potential to reduce exposure to household air pollution and so improve health outcomes. One such improved stove is the solar oven. During laboratory testing in highly controlled contexts, solar ovens frequently show positive results and do not emit any emissions. However, studies in real-world contexts are far less promising.
Description of policy or intervention
A phased, randomized controlled trial to test the effects of a solar oven called ‘the HotPot’ was carried out in Senegal.
What took place?
The solar oven was provided to 465 households. After six months, the intervention group had just as high carbon monoxide exposure as the control group and there was no reduction in self-reported health symptoms.
In the laboratory these stoves were shown to be effective – so what went wrong?
The study showed poor levels of adoption of the HotPot, with households using the stove very infrequently. A major reason for this was that the solar oven was far too small for the majority of households in the study.
Other studies(2) indicated additional reasons for solar oven unacceptability to communities: cooking could take longer, the ovens could not be used for heating and light, and the oven might need be used outdoors during sunlight.
What have we learnt?
Adoption of new technologies is challenging and interventions must be tailored to the needs and preferences of communities in order to succeed.(3)
References:
- Beltramo, T. and D.I. Levine, The effect of solar ovens on fuel use, emissions and health: Results from a randomised controlled trial. Journal of Development Effectiveness, 2013. 5(2): p. 178-207.
- Otte, P.P., Solar cookers in developing countries-What is their key to success? Energy Policy, 2013. 63: p. 375-381.
- Thomas, E., et al., Improved stove interventions to reduce household air pollution in low and middle income countries: a descriptive systematic review. BMC Public Health, 2015. 15: p. 650.
Considering Reach – Diabetic Foot, India
Why this case study?
This illustrates the importance of assessing reach to ensure that populations with the greatest health need are reached by a new policy or intervention.
Title
Why do we need to assess reach as well as effectiveness?
Source
Christian Medical College, Vellore, Tamil Nadu, India
Health issue
Diabetic foot
Setting
Integrated Diabetes Foot Clinic, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
Target population
Type 2 diabetes mellitus patients affected with diabetic foot problems
Background
Diabetic foot problems are the most common reason for hospitalization of diabetic patients and absorb some 20% of the total healthcare costs of the disease, more than all other diabetic complications put together. Treatment involves footwear modification and offloading (i.e. reducing pressure on affected areas of the foot).
Description of policy or intervention
An Integrated Diabetes Foot Clinic was set up in 2008 at the Christian Medical College in Vellore, India, with a core team of endocrinologists, diabetes nurse educators, vascular surgeons, physiotherapists and orthotists.
The clinic was equipped with tools for the diagnosis and treatment of diabetic foot, and radiological investigations were completed and reviewed within the same day. Meanwhile, patient-specific footwear was developed at the Prosthetics and Orthotics Centre.
In 2015, a retrospective study was carried out on 138 patients to assess the utility of low-cost footwear modifications (such as anterior rocker modifications) in reducing ulcer healing time.
What took place?
Over half of the group of patients using the anterior rocker modification had healed fully within 8–12 weeks; those noncompliant with or without anterior rocker foot- wear had a prolonged healing time of 4–6 months.
What have we learnt?
Adequate foot care and offloading techniques remain inaccessible for a significant proportion of diabetic patients due to socioeconomic factors and lack of awareness, leading to amputations and healthcare expenditure. So, although treatments may be effective their reach may be limited.
The care provided at the clinic had a greater reach. The study indicates that use of simple diagnostic criteria and development of cost-effective modifications such as the anterior rocker significantly reduced healing time and hence reduced economic burden.
Scaling Up – Physical Activity Interventions, Brazil
Why this case study?
This illustrates the importance of engaging different sectors for the scale up of effective interventions.
It also highlights challenges to scale up – such as changes in policies and funding mechanisms.
Title
Scaling up of physical activity interventions at the national level in Brazil: An effective solution to increase physical activity at the population level
Source
Washington University in St. Louis, St Louis, Missouri, United States of America
Health issue
Inadequate levels of physical activity and the need to address health disparities in the population of Brazil
Setting
Community (Brazil)
Target population
Brazil (adults and older adults from the general community)
Background
In Brazil, guidelines on physical activity suggest a minimum of 150 minutes of moderate or vigorous physical activity per week. However, the most recent national survey showed that nearly half the adult population did not reach this level of activity, with approximately 15% being completely inactive. The most commonly cited barriers to engaging in physical activity include lack of time and work/family responsibilities.
Project GUIA (Guide for Useful Interventions for Physical Activity in Brazil and Latin America)(3) is a cross-national collaboration funded by the Prevention Research Centers programme (run by the Centers for Disease Control and Prevention (CDC)); it sets out to evaluate a programme taking place in Brazil for over a decade.(4)
Description of policy or intervention
The programme ‘Academia da Cidade’ or ‘City Gym’ started in Recife, Pernambuco in the north-east of Brazil, and was institutionalized in 2002. It is carried out at a number of points of intervention or so called polos – new spaces or re-engineered and beautified public spaces.
Physical and cultural activities are provided by professional instructors and include: dancing, aerobics, strength training, flexibility and other health enhancing activities.
What took place?
In 2008, Project GUIA evaluated the Academia da Cidade programme using a combination of qualitative and quantitative methods including a phone survey, systematic direct observation, historical evaluation, logic models and qualitative interviews of coordinators, staff and users.(5-9)
Results from the evaluation showed that the programme was effective in increasing and maintaining physical activity levels of the population and helped meet the guide- lines for physical activity.
The evaluation also assessed reach, showing that women, older adults, and lower in- come people were the segments of the population that benefited the most from the programme.(10)
What have we learnt?
Two significant events took place after results from the evaluation were shared with Project GUIA stakeholders:
- In early 2011, the government of the state of Pernambuco created the Academias das Cidades de Pernambuco (ACP), a programme that aimed to expand the basic offering of Academia da Cidade.(11)
- Later in 2011, the ministry of health created the Academia da Saude (AS), a national programme with added nutritional and social development components.(11) Changes in the supportive policies and in the funding mechanisms have represented challenges for implementation at a large scale and for sustainability.
The experience and lessons learned in Brazil show the challenge of scaling up physical activity interventions and the need to consider long-term political and financial support.(11)
References
- Hoehner, C.M., et al., Physical activity interventions in Latin America: a systematic review. Am J Prev Med, 2008. 34(3): p. 224-233.
- Hoehner, C.M., et al., Physical activity interventions in Latin America: expanding and classifying the evidence. Am J Prev Med, 2013. 44(3): p. e31-40.
- Paez, D.C., et al., Bridging the gap between research and practice: an assessment of external validity of community-based physical activity programs in Bogota, Colombia, and Recife, Brazil. Transl Behav Med, 2015. 5(1): p. 1-11.
- Pratt, M., et al., Project GUIA: A model for understanding and promoting physical activity in Brazil and Latin America. J Phys Act Health, 2010. 7 Suppl 2: p. S131-4.
- Parra, D.C., et al., Assessing physical activity in public parks in Brazil using systematic observation. Am J Public Health, 2010. 100(8): p. 1420-6.
- Simoes, E.J., et al., Effects of a community-based, professionally supervised intervention on physical activity levels among residents of Recife, Brazil. Am J Public Health, 2009. 99(1): p. 68-75.
- Hallal, P.C., et al., Association between perceived environmental attributes and physical activity among adults in Recife, Brazil. J Phys Act Health, 2010. 7 Suppl 2: p. S213-22.
- Hallal, P.C., et al., Evaluation of the Academia da Cidade program to promote physical activity in Recife, Pernambuco State, Brazil: perceptions of users and non-users. Cad Saude Publica, 2010. 26(1): p. 70-8.
- Soares, J., et al., Cross-sectional associations of health-related quality of life measures with selected factors: a population-based sample in recife, Brazil. J Phys Act Health, 2010. 7 Suppl 2: p. S229-41.
- Reis, R.S., et al., Assessing participation in community-based physical activity programs in Brazil. Med Sci Sports Exerc, 2014. 46(1): p. 92-8.
- Parra, D.C., et al., Scaling up of physical activity interventions in Brazil: how partnerships and research evidence contributed to policy action. Glob Health Promot, 2013. 20(4): p. 5-12.
Want to know more about Implementation Science in real world? Check out the videos below!
Program Design and Implementation – Kerala Diabetes Prevention Program, India
What is it?
The Kerala Diabetes Prevention Program (K-DPP) is a group-based peer-support lifestyle intervention aimed at reducing the risk of Type 2 Diabetes in high-risk individuals. The details of the K-DPP intervention program included increasing the consumption of fruit, vegetables and fibre; reducing the intake of carbohydrates with high glycaemic index and total and saturated fats; increasing physical activity; reducing tobacco use; reducing alcohol consumption; and setting realistic goals for weight loss and other lifestyle risks.
The K-DPP intervention program consisted of the following four core components: (1) a group-based peer-support program consisting of 15 sessions for high-risk individuals, (2) peer-leader training and ongoing support for intervention delivery, (3) diabetes education resource materials and (4) strategies to stimulate broader community engagement.
The findings of this unique community-based intervention model using low technology and local expertise for reducing diabetes incidence are also relevant and have been applied to other LMICs as well as resource-poor settings in high-income countries. The program findings have been used to inform the future development, adaptation and implementation of diabetes prevention programs to reduce long-term diabetes risk in India and other LMICs. Lessons from this study will also be relevant and have applicability to other rapidly developing low- and middle-income countries with high burdens of type 2 diabetes.
Reference
- Kerala Diabetes Prevention Program 2020 [cited 2021 25 February 2021]. Available from: https://mspgh.unimelb.edu.au/research-groups/nossal-institute-for-global-health/non-communicable-disease-unit/the-kerala-diabetes-prevention-program-kdpp.
Cultural Adaptation – StopDiabetes, Somalia/Finland
What is it?
As part of the StopDia project and supported by the European CHRODIS PLUS project, an operating model aimed at identifying the risk of diabetes in people with an Somali immigrant background living in Finland and preventing diabetes has been developed in 2019. The intervention was organized in the mosque by a Somali researcher and volunteer health care students and comprised of T2D risk detection with FINDRISC risk score followed by group and digital lifestyle counselling.
Findings from this pilot study have suggested moderate positive changes in some health measurements, diet and physical activity. The pilot is a good example of cultural adaptation in implementation research in the real world. It also may be also a feasible model to provide prevention interventions to be transferred to other Somali communities and other immigrant groups in Finland and other countries, but would require close collaboration with the target population as well as training of the local implementers.
Reference
- Somaliväestölle mukautettu StopDia -toimintamalli [cited 2021 26 February 2021]. Available from: https://sites.uef.fi/stopdia/2021/01/26/somalivaestolle-mukautettu-stopdia-toimintamalli/.
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
- About Us
We are a group of implementation science experts specialising in the prevention and control of non-communicable diseases. We have created this e-Hub to provide resources and support for researchers who want to learn more about the field of implementation science, particularly in relation to chronic, non-communicable diseases.
Resource Platform to Advance Knowledge and Practice
It is a free resource platform to advance knowledge and practice in implementation science in relation to chronic, non-communicable diseases.
The e-Hub is supported by the Global Alliance for Chronic Diseases (GACD) and the WHO Collaborating Centre on Implementation Research for Prevention and Control of NCDs.
The e-Hub development is continually advised by a group implementation science experts from across the world. Together the aim is to ensure that the e-Hub delivers a leading platform for young researchers and health professionals to develop their careers in the fields that implementation science may be applied.
People
Prof. Brian Oldenburg
BSc, MPsychol, PhD
Professor of Public Health & Implementation Science
Director, NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes
Director, Academic Research Collaboration in Health (ARCH), Alfred Hospital
Baker Heart & Diabetes Institute and LaTrobe UniversityUntil early 2021, Brian Oldenburg was a Professor of Public Health and Head of the Noncommunicable Diseases Unit in the Melbourne School of Population and Global Health at the University of Melbourne. Brian and his NCD Unit team re-located to the Baker Heart and Diabetes Institute in early 2021. Brian has a joint position as Professor of Public Health and Implementation Science at the Baker Heart & Diabetes Institute and La Trobe University. He has also just been appointed as the Director of the Academic Research Collaboration in Health (ARCH) at The Alfred Hospital. Brian is a chronic disease epidemiologist and implementation scientist and a global expert in the prevention and control of chronic diseases – in particular, cardiovascular disease and Type 2 diabetes – in both high-income and low and middle-income countries.
Dr. Morven Roberts
CEO, Global Alliance for Chronic Diseases
Dr Roberts started her research career with a PhD from the London School of Hygiene and Tropical Medicine and thereafter worked as a researcher focussed on tropical infectious diseases in Africa, India, and South America for more than 15 years. On returning to the UK, she joined the UK MRC funding agency, where she was responsible initially for the extensive clinical trials portfolio and then latterly the global health activities of that organisation. It was during this time that she became more aware of the changes in global health burden with increasing rise in chronic non-communicable diseases. She joined the GACD as CEO in October 2019.
Ms. Isobel Bandurek
Research Capacity Manager, Global Alliance for Chronic Diseases
Izzy is GACD’s Research Capacity Manager and leads on networking, capacity, and capability strengthening activities across GACD Research Programmes and cross-cutting working groups. Izzy is a UK-registered dietitian with a special interest in public health nutrition. Previously, she has worked for the World Cancer Research Fund in evidence interpretation and synthesis, with homeless young people at Centrepoint UK in food insecurity, and various clinical roles in the UK National Health Service. Izzy has an undergraduate degree in biological sciences from the University of Oxford and postgraduate degrees in nutrition and dietetics from King’s College London.
Dr. Zahra Aziz
Senior e-Hub Advisor and Senior Training Program Coordinator
Dr. Zahra Aziz (MPH, PhD) is a Lecturer at the School of Psychological Sciences, Monash University. She leads the online education innovation program for the fully online Graduate Diploma of Psychology Advanced (GDPA) course and is a leader of its associated online education research program. She is an implementation scientist and a research fellow at the University of Melbourne and the WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs.
Adjunct Prof. Pilvikki Absetz
Senior e-Hub Advisor
Dr. Pilvikki Absetz (PhD) is an Adjunct Professor of Health Promotion at the Tampere University, visiting researcher at the University of Eastern Finland, the Head of Research and Development at Provention Ltd, and the CEO and sole owner of Collaborative Care Systems Finland. She has over 20 years of experience in designing, implementing and evaluating behavioral interventions for prevention and self-management of chronic non-communicable diseases through lifestyle changes. The theory- and evidence-based interventions have utilized different delivery platforms and technologies and they have been implemented in different “real world” settings in both high-income and low- and middle-income countries. Her specialty area is the application of theories, models and frameworks in implementation research.
Ms. Allissa Desloge
e-Hub Advisor
Allissa Desloge (MPH) is a graduate of the Yale School of Public Health where she received her Master’s of Public Health in Health Policy with a concentration in Global Health. She has various experiences with the Women’s Rights and Empowerment Network of South Carolina, the Connecticut Commission on Women, Children & Seniors, and the World Health Organization. She worked on various projects for the WHO Collaborating Center with University of Melbourne, including developing implementation science website for University of Melbourne.
Dr. Yingting (Tina) Cao
e-Hub developer and project manager
Dr. Tina (MBBS, MMSc, PhD) is a postdoc fellow at Noncommunicable disease unit within the Nossal Institute for Global Health, the University of Melbourne. Her research interest focuses on lifestyle factors related to noncommunicable diseases, including diabetes and cultural adaptations in populations from low- and middle- income countries living in high-income countries. Tina is also involved in implementation science e-Hub project development, as well as project management.
Mr Kevin Mao
Research Assistant and e-Hub Project Manager
Kevin is an aspiring public health focused clinician-scientist working to integrate bench-to-bedside discoveries into the global community utilising population health measures. In 2021, he joined Professor Brian Oldenburg’s group to apply his theoretical training, work together with passionate students and public health practitioners. Kevin is both a Bachelor of Biomedicine graduate, and currently a Doctor of Medicine (MD) candidate with the University of Melbourne.
Ms. Yu Wen
e-Hub project officer
Yu Wen (B.A.) is a current Master of Public Health student at the University of Melbourne. She is experienced in planning and marketing online education products. She also has experiences in copywriting for many global consumer brands in China. Yu is involved in assisting implementation science e-Hub project.
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
- Feedback
We are very keen to receive your feedback on the e-Hub in order to improve it further for you and others in the future. We would really appreciate you going through the questions and comment box below, which will take 5-10 min.
Thank you!
- Frequently Asked Questions
Looking for additional help? Check out the Frequently Asked Questions below.
What is the Global Alliance for Chronic Diseases (GACD) / University of Melbourne Implementation Science e-Hub?
Advancing knowledge and practice, improving global health.
Our e-Hub is a comprehensive online learning space for knowledge and skill development in implementation research, particularly in relation to chronic and non-communicable diseases.
Our e-Hub is ideal for researchers, policymakers, and practitioners at any stage in their career, from anywhere in the world with an interest in implementation science as an essential aspect of bridging the evidence-to-practice gap. It is an interactive online platform available to all, for free.
Researchers from diverse disciplines can learn, share experience and self-manage their career development, accessing international lectures and relevant case studies.
Free resources and learning aids include:
- Self-directed training programmes
- Evidence summaries
- Interactive learning tools
- Specially curated index of international resources
Who should use the e-Hub?
- Anyone interested in improving their knowledge of implementation research, especially those working in the prevention and management of non-communicable diseases, or in low-resource settings
- Researchers at any stage of their career, from any part of the world
- Healthcare professionals
- Public health professionals
- Policymakers
- Policy change and healthcare advocates
- Students and graduates of public health, global health, or other related subjects
- Alumni of the Global Alliance for Chronic Diseases Implementation Science Schools or Workshops
Who created the e-Hub and who writes the content?
The need for the e-Hub was identified through discussions between Global Alliance for Chronic Diseases (GACD) staff and faculty members of our Implementation Science Schools.
Development and improvement of our e-Hub is continuous, with updates added as the field of implementation science evolves and is overseen by a group of global implementation science experts.
Who funds the e-Hub?
The e-Hub is supported by the Global Alliance for Chronic Diseases (GACD) through a funding agreement with the University of Melbourne and the World Health Organization Collaborating Centre on Implementation Research for Prevention and Control of Non-Communicable Diseases.
What is the purpose of the e-Hub?
It is a free resource platform to advance knowledge and practice in implementation science in relation to chronic, non-communicable diseases.
The e-Hub provides an interactive interface for users to learn, communicate and self-manage their career development in the field of implementation science, including:
- Training program: We provide a free training program for researchers at different stages of their career, relevant to implementation science in many different contexts
- Case studies: We select good evidence and case studies that showcase examples of the implementation of interventions including NCDs prevention and control policies.
- Links to international resources: We help researchers connect with specially curated resources across the breadth of the implementation science field.
Who is running the e-Hub?
The e-Hub is supported by the Global Alliance for Chronic Diseases (GACD) through a funding agreement with The University of Melbourne and the WHO Collaborating Centre on Implementation Research for Prevention and Control of NCDs.
Why a e-Hub?
Regardless of your career stage, you will find a lot of helpful information on this e-Hub relevant to the field of implementation science. This includes international resources, information about training programs and workshops, interactive learning quizzes and much more. Our team is continuously improving the functionality, the contents and the quality of this e-Hub to suit your goals and requirements.
If you want to use a video recording/image/lecture notes/audio recording, what are the rules?
The content of the e-Hub is free to access but we kindly request that you attribute any use of the e-Hub in your work (presentations, academic articles, blogs, etc).
We suggest that you use the following citation:
Global Alliance for Chronic Diseases / University of Melbourne/ Baker Heart and Diabetes Institute. Implementation Science e-Hub [website]. Available at implementationscience-gacd.org. Accessed ADD DATE.Information published on this e-Hub is subject to copyright. Whilst much of the information is published under Creative Commons licenses or is in the public domain, it is your responsibility to check the copyright status of those materials that you might like to use.
Lecture videos on the e-Hub is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license. Click here to learn more information about Privacy Policy.
If you are unsure about using any resources from the e-Hub, please contact us at contact@implementationscience-gacd.org.
- Contact Us
You can contact us via contact.ehub@implementationscience-gacd.org, or submit the form below. We will endeavour to respond to any queries as quickly as possible..
We want your feedback! We welcome all feedbacks and comments that can help us build a better e-Hub!
- International Advisory Board
The role of the International Advisory Board is firstly, to advise and support the future development of the e-Hub, and secondly, to advise on target audiences for the e-Hub and future training opportunities.
Dr. Kremlin Wickramasinghe
Technical Officer – Noncommunicable Diseases WHO European Office for Prevention and Control of Noncommunicable Diseases (NCD Office) Moscow, Russian Federation
Karin Geffert, MD
Consultant, WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office)
Dr. Pilvikki Absetz
Professor of Public Health, Faculty of Social Sciences, Tampere University
Dr. Zahra Aziz
Lecturer and Researcher, Monash University and Honorary Fellow, University of Melbourne
Dr. Gregg, Edward W
Chair in Diabetes and Cardiovascular Disease Epidemiology, Imperial College London
Dr. Vilma Irazola
Director of the Department of Chronic Diseases, Institute for Clinical Effectiveness and Health Policy (IECS)
Dr. Catherine Kyobutungi
Executive Director, African Population and Health Research Center (APHRC)
Dr. Rachel Sturke
Deputy Director and Senior Scientist, Fogarty International Center, National Institutes of Health (NIH)
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
- Feedback
- 4th Implementation Science School
Welcome to the 4th Implementation Science School
This page will prepare you for the program that runs from 29 November to 10 December. Across the whole program, each trainee will engage with:
- 19 lectures via asynchronous online learning
- Background reading
- 7x Plenary sessions
- 6x Group Sessions (A or B)
Welcome message from Dr Morven Roberts
Useful resources recommend during the School
There are very useful links and resources recommended during the plenary sessions at ISS4, which you can find here. Some of them are already in our e-Hub at “tookit page”. Also please check out other important publications.
- Theory at a Glance, A guide for for health promotion practice, National Cancer Institute
- Human-centered implementation research: a new approach to develop and evaluate implementation strategies for strengthening referral networks for hypertension in western Kenya
- Implementation mapping: using intervention mapping to develop implementation strategies
- Understanding the implementation of evidence-informed policies and practices from a policy perspective: a critical interpretive synthesis
- Agendas, alternatives, and public policy: lessons from the U.S. foreign policy arena
- Leverage points: places to intervene in a system
- Kingdon’s “Streams” model at thirty : still relevant in the 21st century?
- Net-Map- a toolkit to understand and visualise stakeholder influence
- The role of power in health policy dialogues: lessons from African countries
Preparatory work before the start date
We have pre-recorded lectures on many topics related to implementation science. These topics will be the key ones discussed during the live sessions during the program, so we encourage you to watch the relevant videos before each similarly named session. You can watch the videos here. In addition, you will find related publications/resources here.
Prepare a short presentation (less than 5 minutes) to introduce your project/abstract to your team members. The presentations will be delivered in Group Session 1 (A or B). This can be oral only or with slides.
Reading List
An introduction to implementation science for the non-specialist (Bauer M. et al. (2015). An introduction to implementation science for the non-specialist. BMC Psychology. 16(3):32.)
National Institutes of Health Approaches to Dissemination and Implementation Science: Current and Future Directions (Glasgow R, et al. (2012). National Institutes of Health Approaches to Dissemination and Implementation Science: Current and Future Directions. American Journal of Public Health, 102(7): 1274-1281.)
A guide to implementation research in the prevention and control of noncommunicable diseases (World Health Organization. (2016). A guide to implementation research in the prevention and control of noncommunicable
diseases. Geneva: World Health Organization; 2016. Licence: CC BY-NC-SA 3.0 IGO.)
Programme Summary
Program schedule
3rd Implementation Science School Highlights
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- Training Program (中国用户界面)
Get Ready for Learning
On this page you will find the Implementation Science e-Hub Training Program. This includes preliminary reading, and 12 sessions of specially curated content in the form of lectures and further reading.
We recommend it takes 30-40 hours to complete the whole Training Program.
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中文读物
实施性研究在慢性病防控中的应用指导
Preliminary Reading
A guide to implementation research in the prevention and control of noncommunicable diseases (World Health Organization. (2016). A guide to implementation research in the prevention and control of noncommunicable
diseases. Geneva: World Health Organization; 2016. Licence: CC BY-NC-SA 3.0 IGO.)Implementation research in Health: a practical guide. (Peters, D. H., Tran, N. T., & Adam, T. (2013). Implementation research in health: a practical guide. World Health Organization.)
ImImplementation research: what it is and how to do it. (Peters, D. H., Adam, T., Alonge, O., Agyepong, I. A., & Tran, N. (2013). Implementation research: what it is and how to do it. BMJ (Clinical research ed.), 347, f6753. https://doi.org/10.1136/bmj.f6753)
Sessions
Session 1 An Overview of Implementation Science
By Dr. Brian Oldenburg
A. What is Implementation Science
B. Key concepts, models and issues
Session 2 Study Questions and Study Design
By Dr. Vilma Irazola
Types of study questions, study designs and evidence for implementation science
Related Articles
Recommend Reading:
- Identifying the Implementation Problem, Aims & Questions: A guide to implementation research in the prevention and control of noncommunicable diseases Chapter 3.1
- Relevant materials from other Hubs/platforms:
Session 3 Models, Frameworks and Theory for Program Design, Implementation and Evaluation
By Dr. Pilvikki Absetz
Dr. Rajesh Vedanthan
A. TMF For Program Design, Implementation and Evaluation
B. TMF, A Practical Application
Recommended Monograph:
Articles of TMF mentioned in Lecture 3A
Recommended Reading
Models, Theories and Frameworks: Design and Implementation
Models, Theories and Frameworks: Evaluation
Models, Theories and Frameworks: materials from other Hubs/platforms
Session 4 Career Development
By Dr. Brian Oldenburg
By Dr. Kavita Singh
A. Developing a career in a global world
B. Career development plan/research experience
By Dr. Dawn Duke
C. Progressing your career
Session 5 Implementation Science in LMICs – Case Studies from China, Africa and India
By Dr. Lijing Yan
By Dr. Catherine Kyobutungi
By Dr. Zahra Aziz
A. Case study from China
B. Case study from Africa
C. Case study from India
Recommended Reading
Study Design
Study Measure
Grant Writing/Funding
Relevant materials from other Hubs/platforms:
Session 6 Building the Evidence Base
By Dr. Edward Gregg
Building the evidence base for D & I: A Population and Public Health Perspective
> Quiz
Session7 Interventions and Measurement at Different Levels
By Dr. Pilvikki Absetz
By Dr. Vilma Irazola
A.
B.
> Quiz Coming Soon…
Session 8 Implementation Research in the Real World
By Dr. Rajesh Vedanthan
Implementation research in the real world: how to propose a good topic and get funded
> Quiz Coming Soon…
Session 9 Cultural Adaptation and Context for Program Design, Implementation and Evaluation
By Dr. Pilvikki Absetz
Recommended Reading
Cultural Adaptation
> Quiz Coming Soon…
Session10 From Surveillance to Natural Experiments and Population Monitoring
By Dr. Edward Gregg
> Quiz Coming Soon…
Session 11 Stakeholder Engagement and Community-based Participatory Approaches
By Dr. Rachel Sturke
Recommended Reading
Stakeholder Engagement & Community Participation
> Quiz Coming Soon…
Session 12 Building Capacity for Implementation Science in LMIC – Training and Funding
By Dr. Rajesh Vedanthan
By Dr. Brian Oldenburg
A.
B.
> Quiz Coming Soon…
Now you have finished all 12 sessions in the training program
Congratulations!
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
All lecture videos at this website is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license.
- Join our e-Hub community!
- Members page
- 3rd Implementation Science School Highlights
We held our first virtual Implementation School program towards the end of 2020 (3rd ISS). This was the first time that all of the faculty, facilitators, and participants were involved in such an online program. We are continuing to grow and improve this program over time. The highlights of the 3rd ISS are presented on this page.
Reunion Year
The GACD staff team has been in touch with alumni of GACD Implementation Schools since 2014. Since the 3rd ISS, the GACD has been piloting a ‘Reunion Year’ with the school alumni. This involves engaging the alumni in activities with each other, and more widely, for 12 months after the end of the training. Such activities included online reunion events and a closed LinkedIn group to facilitate ongoing networking and learning.
The ‘Reunion Year’ content and activities are being adapted in real-time in response to alumni feedback and requests.
69.5%
of all alumnus signed up
11
e-newsletters
1
Specialist LinkedIn private group
6 hours
of live engagement including lectures
- 5 lectures from 5 expert speakers (topics voted for by the alumni) were delivered. One final event to take place in late 2021.
- 1 asynchronous online journal club was delivered over 5 consecutive days.
Watch the Recording of the “Reunion Year”:
Group Presentations from the 3rd Implementation Science School Trainees
A Mixed Method Approach to Evaluate the HIV Urban Board (“HUB”): A Novel digital intervention for Adolescents and Youth living with HIV to prevent multimorbidities in Low and Middle Income Countries
Community co-designed and led sharing circles: An intervention to prevent and address depression and anxiety in Chiapas, Mexico
Adaptation and Integration of the PEACE (PTSD Effectiveness, Assessment and Care Component) in the Friendship Bench program in Zimbabwe.
Integrating physical activity for the prevention and management of common mental disorders in people with type 2 diabetes in South Africa
Improving Physical Activity and Reducing Sedentary Behaviour Among Adolescents in Mumbai, India
Community health worker assisted, mobile app based, healthcare programme for people with cardiometabolic diseases.
Reducing Salt intake To Optimum Requirement
Multilevel intervention package for Prevention and Early detection of Tobacco related Cancers in Meghalaya, India (MiPE-ToC)
Adherence to Diabetes and Hypertension Medication in Odisha, India (ADHmed)
Trainees and Facilitators
We are keen to receive your feedback on the e-Hub to improve it further. We would appreciate you completing a short survey, available here.
If you would like to provide more detailed feedback, please contact us at contact.ehub@implementationscience-gacd.org.
- Fundamentals of Implementation Science Programme
Get Ready for Learning
Welcome to our Fundamentals of Implementation Science Programme, which will introduce users to the science of implementation in the context of non-communicable disease programmes for low- and middle-income settings and vulnerable populations in high-income settings.
The programme is free to access and includes preliminary reading, seven modules of specially curated content, and the option for self-certification on completion.
It takes nine hours to complete the core content, plus additional time to complete quizzes, further reading, and reflection.
>> For our users in China who cannot access YouTube, please click here to enter…
Preliminary Reading
A guide to implementation research in the prevention and control of noncommunicable diseases (World Health Organization. (2016). A guide to implementation research in the prevention and control of noncommunicable diseases. Geneva: World Health Organization; 2016. Licence: CC BY-NC-SA 3.0 IGO.)
Implementation research in health: a practical guide. (Peters, D. H., Tran, N. T., & Adam, T. (2013). Implementation research in health: a practical guide. World Health Organization.)
Implementation research: what it is and how to do it. (Peters, D. H., Adam, T., Alonge, O., Agyepong, I. A., & Tran, N. (2013). Implementation research: what it is and how to do it. BMJ (Clinical research ed.), 347, f6753. https://doi.org/10.1136/bmj.f6753)
Programme content
Module 1: Introduction to implementation science
Dr. Brian Oldenburg
Dr. Vilma Irazola
Lecture 1A What is Implementation science | Brian Oldenburg
Lecture 1B Key concepts, models, and issues | Brian Oldenburg
