CTRI Community Engagement Dissemination and Implementation Research Pilot Grants

The next application period is anticipated in 2018 for 2019 grants.

Background

UC San Diego Clinical and Translational Research Institute (ACTRI) Community Engagement Unit now offers funding for “Dissemination Research” or “Implementation Research” projects. The mission of the ACTRI Community Engagement Unit is to advance health care through enhancing interactions between basic scientists, clinical investigators, services researchers, community clinicians, and patients. The purpose of this RFA is to support pilot projects to increase the adoption, implementation, and sustainment of evidence‐based clinical practices by local health care organizations, providers, and systems. Funded projects will address barriers that inhibit rapid translation of evidence-based therapies to patients served by UCSD and other health agencies and community providers. Projects that promote the participation of community‐based organizations and clinicians in their projects are encouraged.

Pilot funds are to be used for the development of new projects which will serve as a basis for future NIH (or other funding source) grant proposals. The funds are not intended to support extensions of prior work. Awards will range from $15,000 to $30,000 each, which is to be spent within the designated 12-month period. The funding period for the 2017 grants is April 1, 2017 - March 31, 2018.

Faculty at UC San Diego and other ACTRI partner institutions (SDSU, Salk Institute, Sanford Burnham, La Jolla Institute for Allergy and Immunology, J Craig Venter Institute) who are eligible to become ACTRI members are encouraged to apply. Research Scientists and all Professor Series Faculty, including Adjuncts are eligible to apply as principal investigators (PI). Although Project Scientists, Postdoctoral Fellows and other Academics are not PI eligible, they are encouraged to participate as Co-Investigators. To become a member of ACTRI, and learn about the many benefits of ACTRI membership, click here.

Description

ACTRI’s aims of this funding opportunity are to:

  1. Support research that reflects the priorities of local clinicians and their respective health service agencies;
  2. Stimulate dissemination and implementation research in San Diego County and Imperial County
  3. Encourage local clinicians, health administrators, and health science scholars to adopt dissemination and implementation research as an important part of their careers;
  4. Generate new publications on dissemination and implementation research in peer‐reviewed health journals; and,
  5. Generate data that will lead to research funding from: Agency for Healthcare Research Quality (AHRQ), National Institutes of Health (NIH), Patient Centered Outcomes Research Institute (PCORI) or other agencies or foundations that fund research in this field.

For the purpose of this RFA Dissemination Research and Implementation Research are defined as follows:

Dissemination Research is an active approach of spreading new interventions to specifically targeted audiences using systematically-planned strategies. Interventions may include: the targeted distribution of information and intervention materials to an audience of clinicians and/or health plan administrators through various means; the use of policies and procedures to encourage uptake; reimbursement strategies that encourage uptake, and many others. The scientific goal is an understanding of the mechanisms that can successfully be used to increase the spread of knowledge, and greater use of the evidence‐based intervention. Outcomes are generally about the reach and timeframe for adoption of new evidence‐based practices.

Implementation Research is the systematic study of how a specific set of activities and designed strategies are used to successfully integrate and sustain an evidence‐based intervention within specific settings [e.g., primary care practices, Independent Practice Associations (IPAs), medical groups, federally qualified health centers (FQHCs)]. Factors associated with implementation success might be individual (e.g., provider practice), organizational (e.g., characteristics of the organization seeking adoption), community (e.g., characteristics of the population intended to benefit from the intervention, i.e. age, SES, access to care, transportation etc.) or environmental or system factors (e.g., availability of funding, policies, etc.). This type of research can involve both organizational or provider outcomes (e.g., reach, adoption, adaptation, fidelity) and also population level outcomes (e.g., reach, adoption, adaptation, fidelity).

Note that the purpose of this type of research is not to demonstrate that a specific intervention is efficacious or effective, but to examine the factors that are associated with the successful spread, implementation, and sustainment of an evidence‐based practice in a given setting.

Other Terms used in Dissemination, and Implementation Research

  • Adoption refers to the uptake of the desired intervention into the target population or uptake by the implementers.
  • Adaptation or tailoring refers to the modifications of the intervention itself or the necessary alterations in the supporting infrastructure (e.g., system or organization) to ensure clinical intervention implementation without losing fidelity to core elements of the intervention.
  • Evidence-based interventions: Evidence‐based means that the intervention has already undergone sufficient scientific evaluation demonstrating that it is efficacious or effective (e.g., the intervention is considered valid or “proven” because it has scientifically linked to a desirable outcome). Thus, it is important to adequately define and describe the characteristics of the evidence‐based intervention for which you are studying its dissemination or implementation (e.g. a hypertension treatment algorithm, psychosocial intervention for depression, etc.).
  • Fidelity refers to “the adherence of actual treatment delivery to the protocol originally developed” or “the degree program developers implement programs as intended by the developers.”
  • Outcomes and impacts are the end results of public health interventions which include effects that people experience and care about, such as change in the ability to function, improved health, quality of life, satisfaction, or cost.
  • Scalability describes the adoption of an intervention resulting in wider usage that retains or improves its effectiveness, affordability, and sustainability.
  • Sustainment is achieved when the evidence‐based intervention is routinely utilized over time in a given setting. Long‐term sustainment can be dependent upon funding availability and policies which support a functional infrastructure that maintains fidelity of the evidence‐based intervention (e.g., training, laws, and reimbursement for services, leader commitment to the evidence-based intervention).

Examples of Dissemination and Implementation Research

Example 1 – Different, but comparable, health plans, medical groups or IPAs in San Diego County have adopted various strategies in order to increase utilization of evidence‐based practices by clinicians. We encourage studies that compare different strategies implemented in terms of their ability to reach the target audience of providers and encourage adoption and sustained implementation. What are the factors associated with reach, implementation and sustainability? Are there cost‐benefits of one strategy over another?

Example 2 - Within any one medical group, there have been significant differences in the extent to which an evidence‐based practice has been successfully applied to different patient populations (e.g., cultural groups, males vs females, old vs. young, affluent vs. poor communities, etc.). Do strategies need to be adapted or tailored such that health care providers can reach specific types of patients? If so, what are the factors associated with successful reach, implementation, and sustainability for these patients?

Example 3 - It has been suggested that tying physician medical license “Maintenance of Certification” projects to an evidence‐based practice can increase adherence to using that evidence‐based practice. We would encourage prospective studies to determine whether this strategy is effective in terms of reach, implementation and sustainability of evidence‐based practice.

Application Guidelines/Project Requirements

  • Eligibility - ACTRI members with PI eligibility (described above). Become a member: http://ctri.ucsd.edu/about/membership/Pages/membership-application.aspx
  • Inclusion of co‐investigators from health service agencies other than ACTRI partner agencies is strongly encouraged.
  • Although all eligible investigators are encouraged to apply, in instances of evenly scored proposals, funding preference will be given to investigators and research teams from divisions that have not previously engaged in dissemination and implementation research.
  • The proposed research project cannot overlap with, or be a logical extension of, ongoing funded research.
  • For purposes of this application as well as for any data reporting after the award, the identity of health plans, medical groups, or IPAs to be studied may remain completely anonymous.
  • The principal investigator(s) selected to receive funding will be required to submit a six‐month progress report and a one‐year final progress report at the end of the funded project. An additional report one year later will also be required. This report will consist of a detailed description of progress to date and a listing of all submitted publications and grant applications (pending or funded), meeting abstracts, and seminars relating to the pilot project.
  • Awardees are expected to publish their findings in a scholarly peer‐reviewed journal and present this research at professional research and clinical meetings.
  • All publications, grants, and presentations resulting from research funded by the ACTRI or using ACTRI resources must cite the ACTRI as a contributing source of support and indicate the NIH CTSA grant title and number: University of California, San Diego, NIH CTSA grant # UL1TR0001442.
  • Investigators are responsible for submitting any peer‐reviewed journal articles resulting from research funded by this award to PubMed Central, the NIH digital archive of biomedical and life sciences journal literature. See publicaccess.nih.gov.
  • It is not expected that findings from these awards will be ready for presentation during the funding period.

Budget Guidelines

  • Funds must be spent within one year of being awarded. All funds not spent by the end date will be returned to the ACTRI. Investigators must have IRB approval in place before the beginning of the funding cycle.
  • Please note that all guidelines pertaining to allowable expenses on federal grants are applicable to these awards. No funding will be provided for travel, clerical help, office supplies, books and subscriptions, graduate student support, tuition remission or publication expenses. If equipment is budgeted, it will need a thorough justification.
  • Indirect costs will not be awarded to UC San Diego investigators. Awarded funds that transfer to sub­contracted agencies outside of UC San Diego may be eligible for indirect or overhead costs. In those circumstances where indirect costs are required by subcontracting agencies or institutions, a maximum of 10% overhead will be provided. Requests for overhead must be included in the initial budget request.
  • If any funds in the budget are designated for an institution or agency outside of UCSD, provide a letter from that institution or agency, on their letterhead, that describes: (a) the agency’s support for the proposed project, (b) agency’s role in the project, (c) the name, address, and contact information (e‐mail and telephone) of the agency representative who has primary responsibility for that portion of the project.

How to Apply

  1. Provide a maximum 4‐page application describing the project. Proposed projects will be scored using NIH scoring guidelines and criteria (i.e. Significance, innovation, approach, investigator(s), and environment). Applications must include the following sections: a) Specific Aims, b) Background and Significance, c) Preliminary Studies or Data Collection / Analysis (if applicable), d) Research Design and Methods, e) Literature Cited (need not be included in 4‐page limit). ACTRI uses WebGrants as a tool to apply for the Pilot grants. Click here to register for WebGrants. You will receive an e-mail from WebGrants with a User Name and Password upon registering.
  2. Provide a maximum two‐page NIH biosketch (brief curriculum vita) for each of the following: the principal investigator, all co‐investigators, and any postdoctoral fellows, residents, graduate or medical students you know will be involved in the proposed project.
  3. Budget — Provide a detailed budget (using NIH Budget Form “page 4” only) along with a brief budget justification.
  4. Submit an IRB application at the same time the pilot application is submitted to ACTRI.
  5. Applications should adhere to the following formatting specifications:
    • 11‐point Arial font
    • Single‐spaced
    • 0.5 inch margins on all sides
    • 8 ½” x 11” (i.e., standard size) paper
    • Numbering of all pages

Take Note of UC San Diego’s IRB Policy - UCSD Institution Review Board (IRB) approval must be secured by April 1, in order to receive funds on that date. As all funds must be spent by March 31 of the following year and cannot be extended. The requirement of IRB and NCATS approval prior to start-up and the inability to carry funds over are why applicants are strongly advised to submit an IRB application at the same time their pilot proposal is submitted to ACTRI.

Take Note of UC San Diego’s Conflict of Interest Policy - Before UC San Diego can issue a sub-award or subcontract to a community agency partner, compliance with PHS Financial Conflict of Interest (FCOI) requirements must be demonstrated. If a community agency receives funds, it will be required to either certify that it has its own PHS FCOI compliant policy or that it follows the UC San Diego HS FCOI policy by meeting all of our requirements. This can be demonstrated by submitting the FCOI Sub-recipient Commitment Form to the Business Contracts Office and COI Office. Feel free to contact the UC San Diego Conflict of Interest Office for detailed information.

Deadline for Future Applications: TBS

Preliminary Notice of Award & Scheduling of Meetings with ACTRI: TBS

Final funding contingent on successful completion of IRB and NCATS requirements.

Final Approval and Notice of Award:  TBS

Funding Period: TBS

Submit an application Once you register as an applicant you will be sent an e-mail notifying you of your username and password. Please refer procedural questions to Kathy Kennedy (Administrative Assistant) at (858) 822-0268. All other questions can be directed to both Kathy Kennedy and Dr. Shelia L. Broyles at slbroyles@ucsd.edu or (858) 822-4117.