Moving Research to Practice for Child Health

描述(由申请者提供)：自2001年医学研究所的开创性出版物《跨越质量鸿沟》以来，许多人都写到了“研究-实践鸿沟”--即有效的健康创新始终未能在现实世界的实践环境中被采用。消除这一差距在妇幼保健领域尤为重要，在这一领域，实施循证做法比在其他领域更加难以捉摸。这一K24职业中期奖的目的是将传播和实施科学的原则应用于以家庭为基础的心理健康，并促进采用和传播针对产妇抑郁的循证干预措施。在过去的九年里，西尔弗斯坦博士开发并证明了问题解决教育(PSE)作为一种针对低收入母亲的抑郁症预防策略的有效性。这份K24概述了一个五年计划，其中Silverstein博士将学习传播和实施科学的理论和实践；进行新的研究，将早期实施研究嵌入一系列正在进行的、由R01资助的PSE试验中；并扩大他的指导能力的覆盖范围和范围。Silverstein博士的K24职业发展活动包括与传播和实施科学、应用医疗服务研究和儿童发展领域的专家团队举行有组织的会议；与医疗保健改进研究所建立为期两年的“奖学金”；以及参加专注于组织行为和创新传播的教学课程。这份职业发展计划是在西尔弗斯坦博士研究过程中的关键时刻发布的。在拟议的K24的时间框架内，他将在不同的社区和医院环境中完成三项抑郁症预防试验。这提供了一个独特的机会来比较每个环境的能力，以支持PSE实施和可持续发展所必需的基本计划过程。拟议的K24研究计划包括1)失败模式和影响分析，以确定跨研究环境实施PSE的绩效差距；2)对每种环境中的利益相关者进行一系列定性访谈，以洞察PSE实施的障碍和促进者；以及3)在新生儿重症监护病房对促进PSE模式忠诚度的实施战略进行试点测试-最近NICHD资助的PSE多点试验的地点。最后，西尔弗斯坦博士将利用他的K24研究计划来扩大他的指导能力的范围和覆盖范围。他的具体指导目标是与波士顿大学校园内的其他研究人员组建跨学科指导团队，指导初级调查人员开展工作；扩大他的指导内容的范围，包括传播和实施研究；扩大他的指导的范围，以容纳更多的博士后和初级教师指导对象。西尔弗斯坦博士的最终目标是开展--并指导初级调查人员开展--研究，从而为儿童和家庭可持续地实施有效的、可推广的项目。

DESCRIPTION (provided by applicant): Since the Institute of Medicine's seminal 2001 publication, Crossing the Quality Chasm, many have written about the 'research-practice gap' - whereby efficacious health innovations consistently fail to be adopted within real world practice settings. Addressing this gap is particularly important in the realm of maternal-child health, where implementing evidence-based practice has been more elusive than in other fields. The purpose of this K24 mid-career award is to apply the principles of dissemination and implementation science to family-based mental health, and to promote the adoption and spread of evidence-based interventions for maternal depression. Over the past nine years, Dr. Silverstein has developed and demonstrated the efficacy of Problem Solving Education (PSE) as a depression prevention strategy for low-income mothers. This K24 outlines a five year plan, whereby Dr. Silverstein will learn the theory and practice of dissemination and implementation science; conduct new research that embeds early implementation studies within a series of ongoing, R01- funded trials of PSE; and expand the reach and scope of his mentoring capacity. Dr. Silverstein's K24 career development activities include structured meetings with a team of experts in the fields of dissemination and implementation science, applied health services research, and child development; a two-year 'fellowship' with the Institute for Healthcare Improvement; and participation in didactic courses focusing on organizational behavior and innovation spread. This career development plan comes at a critical time in the course of Dr. Silverstein's research trajectory. Within the timeframe of the proposed K24, he will complete three depression prevention trials in diverse community-based and hospital settings. This presents a unique opportunity to compare the capacity of each setting to support essential program processes necessary for PSE's implementation and sustainability. The proposed K24 research plan includes 1) a Failure Modes and Effects Analysis to identify performance gaps in PSE's implementation across study settings; 2) a series of qualitative interviews with stakeholders in each setting to provide insight into barriers and facilitators to PSE's implementation; and 3) a pilot test of an implementation strategy to promote fidelity to the PSE model in the neonatal intensive care unit - the site of a recently NICHD-funded multisite trial of PSE. Lastly, Dr. Silverstein will leverage his K24 research plans to expand the scope and reach of his mentoring capacity. His specific mentoring objectives are to assemble interdisciplinary mentoring teams with other researchers across the Boston University campus to guide junior investigators in conducting their work; expand the scope of his mentoring content to encompass dissemination and implementation research; and expand the reach of his mentoring to accommodate additional postdoctoral and junior faculty mentees. Dr. Silverstein's ultimate goal is to conduct - and to guide junior investigators in conducting - research that leads to the sustainable implementation of effective, generalizable programs for children and families.