Dissemination & Implementation Curriculum and Competencies

Our training program is innovative on several levels. While the program is the first of its kind to focus on training for D&I research in cancer prevention and control, we are also working to develop and refine a set of core D&I competencies and a model curriculum specific to D&I research on cancer disparities, neither of which currently exist. Importantly, we are developing competencies for D&I research in cancer not only based on formative input from researchers but also from cancer control practitioners who are addressing disparities. While our training program focuses on D&I research in cancer, our methods and approaches are applicable to numerous other public health issues.

The first Aim of this program is to “Develop and refine a set of competencies and model curriculum in D&I research, including those specific to D&I research on cancer disparities”. Competency-based education is rapidly becoming a norm in all levels of education in the United States. Formally, a competency is defined as a cluster of related knowledge, attitudes, and skills that affects the major part of one’s job and can be measured against well-accepted standards and improved through training. Competency sets are used both to guide credentialing processes, and for this program, curriculum development.

In the Spring of 2014, we started to outline a list of competencies that has been used in building the curriculum and agenda of our Summer Institutes. We employed an online card-sort to engage the expertise and opinions of current leaders in D&I research to help sort these competencies into learning levels and categorical domains. The results of that card-sort can be found below. A paper was published on this work at Implementation Science on August 12th 2015. A downloadable PDF of the paper can be accessed from the link below:

Padek_2015_Developing educational competenices for disseminaiton and implementation reserach training programs

Information about this Card-sort process was also presented at the 7th Annual Conference on the Science of Dissemination and Implementation: Transforming Health Systems to Optimize Individual and Population Health. You can find a link to the slides for this presentation below.

http://www.academyhealth.org/files/2014/Padek_presentation.pdf

In the Spring of 2015, additional work was started to fill in the gaps in D&I training programs that the previous competency list does not address. Results of that project were presented in a poster at the 8th Annual Conference on the Science of Dissemination and Implementation. The abstract can be found here:

http://implementationscience.biomedcentral.com/articles/10.1186/s13012-016-0452-0

D&I Competencies by Domain

*Expertise levels: B = Beginner; I = Intermediate; A = Advanced.

Number	Competency	Expertise*
	Section A: Definitions, Background and Rational
A1	Define and communicate D&I research terminology.	B
A2	Define what is and what is not D&I research.	B
A3	Differentiate between D&I research and other related areas, such as efficacy research and effectiveness research.	B
A4	Identify the potential impact of disseminating, implementing and sustaining effective interventions.	B
A5	Describe the range of expertise needed to conduct D&I research (e.g., mixed method experience, economic, organizational, policy, clinical).	B
A6	Determine which evidence-based interventions are worth disseminating and implementing.	I
A7	Assess, describe, and quantify (where possible) the context for effective D&I (setting characteristics, culture, capacity & readiness).	I
A8	Identify existing gaps in D&I research.	I
A9	Identify the potential impact of scaling down (aka de-implementing) an ineffective but often used intervention.	I
A10	Formulate methods to address barriers of D&I research.	I

 

Number	Competency	Expertise*
	Section B: Theory and Approaches
B1	Describe a range of D&I strategies, models and frameworks.	B
B2	Identify appropriate conceptual models, frameworks, or program logic for D&I change.	I
B3	Identify core elements (effective ingredients) of effective interventions and recognize the risks of making modifications to these.	I
B4	Describe a process for designing and dissemination (planning for adoption, implementation, and sustainability during the intervention development stage).	I
B5	Describe the relationships between various organizational dimensions (e.g., climate, culture) and D&I research.	I
B6	Explain how knowledge from discipline outside health (e.g. business, marketing, and engineering) can help inform further trans-disciplinary efforts in D&I research.	I
B7	Identify and articulate the interplay between policy and organizational processes in D&I.	I

 

Number	Competency	Expertise*
	Section C: Design & Analysis
C1	Describe the core components of external validity and their relevance to D&I research.	B
C2	Identify common D&I measures & analytic strategies relevant for your research questions(s).	B
C3	Identify and measure outcomes that matter to stakeholders, adopters and implementors.	I
C4	Describe the applications and integration of mixed-methods (quantitative and qualitative) approaches in D&I research.	I
C5	Apply common D&I measures & analytic strategies relevant for your research question(s) within your model/framework.	I
C6	Identify possible methods to address external validity in study design reporting and implementation.	I
C7	List the potential roles of mediators and moderators in a D&I study.	I
C8	Identify and articulate the trade-offs between a variety of different study designs for D&I research.	I
C9	Describe how to frame and analyze the context of D&I as a complex system with interacting parts.	I
C10	Effectively integrate the concepts of sustainability/sustainment and the rationale behind them in D&I study design.	I
C11	Describe gaps in D&I measurement and critically evaluate how to fill them.	I
C12	Effectively explain and incorporate concepts of de-adoption and de-implementation into D&I study design.	I
C13	Incorporate methods of economic evaluation (e.g., implementation costs, cost-effectiveness) in D&I study design.	I
C14	Evaluate and refine innovative scale-up and spread methods (e.g., technical assistance, interactive systems, novel incentives and ‘pull’ strategies).	I

 

 

Number	Competency	Expertise*
	Section D: Practice-Based Consideration
D1	Describe the importance of incorporating the perspectives of different stakeholder groups (e.g., patient/family; employers, payers, healthcare settings, public organizations, community and policy makers).	B
D2	Describe the concept and measurement of fidelity.	B
D3	Articulate the strengths and weaknesses of participatory research in D&I research.	B
D4	Determine when engagement in participatory research is appropriate with D&I research.	I
D5	Describe the appropriate process for eliciting input from community-based practitioners for adapting an intervention.	I
D6	Identify and apply techniques for stakeholder analysis and engagement when implementing evidence-based practices.	I
D7	Identify a process for adapting an intervention and how the process is relevant to D&I research.	I
D8	Explain how to maintain fidelity of original interventions during the adaption process.	I
D9	Identify sites to participate in D&I studies and negotiate or provide incentives to secure their involvement.	I
D10	Identify and develop sustainable partnerships for D&I research.	I
D11	Describe how to measure successful partnerships for D&I research.	I
D12	Use evidence to evaluate and adapt D&I strategies for specific populations, settings, contexts, resources and/or capacities.	A