Implementation Science for Intervention Delivery in Healthcare Settings

描述(由申请人提供)：实施科学检查干预实施的效率，并将现有有效的干预模式转化为现实世界的服务。它可以潜在地增强行为的有效性和可持续性 干预项目。我于2009年在加州大学洛杉矶分校(UCLA)获得流行病学博士学位。通过参与几个大型艾滋病毒行为干预项目和我的博士论文研究，我意识到实施科学在干预提供中的重要性，并确定了长期的职业目标，成为一名实施科学研究人员，以弥合现有知识和服务提供之间的差距。为了填补我目前的技能与职业目标之间的差距，我将接受与实施科学相关的培训，包括卫生政策、干预适应和医疗保健管理。卫生政策培训将使我熟悉政策制定的过程及其对干预适应和实施的影响；干预适应课程将使我了解设计研究的一般概念和框架，以确保干预实施的所有方面得到解决；健康管理培训将为我提供分析工具，以模拟领导决策并评估医疗保健环境中的实施流程。导师团队成员李詈博士、Mary-Jane Rotheram-Borus博士、Thomas J.Coates博士和吴尊友博士都是行为干预实施和适应方面的国际重组专家。我的研究所，加州大学洛杉矶分校塞梅尔社区卫生中心(CCH)和加州大学洛杉矶分校艾滋病毒识别、预防和治疗服务中心(CHIPTS)，为我提供了一个由顶尖研究人员组成的多学科团队的支持。我将与国家艾滋病/性病预防控制中心中国合作，利用一项具有显著但不同结果的干预试验进行一项指导性研究，以调查影响干预实施和结果的多水平因素，并找到将干预模式整合到当前医疗保健环境中的最佳方法。研究将分三个阶段进行。第一阶段将是审查相关政策，并与医疗保健管理人员和医院主任进行深入访谈，目的是探索在适应干预模式方面的政策障碍和促进者。第二阶段将与医院主任进行联合分析，以模拟医疗设施中干预、适应和常规化的决策。阶段3将是定位结构的瓶颈分析 干预部分的合规性存在瓶颈。这一发现将为未来医疗保健领域的干预提供启示。一些分析工具在其他领域的应用，包括联合分析和瓶颈分析，可能有助于执行科学方法论的发展。基于从研究中获得的数据，我将准备在K获奖期的第四年在实现科学中应用R01。

DESCRIPTION (provided by applicant): Implementation science examines the efficiency of intervention implementation and to translate the existing efficacious intervention models to real world services. It could potentially enhance the effectiveness and sustainability of the behavioral intervention projects. I received my PhD in epidemiology from the University of California, Los Angeles (UCLA) in 2009. Through my involvement in several large-scale HIV behavioral intervention projects and my doctoral dissertation study, I realized the importance of implementation science in intervention delivery and determined long-term career goal to become an implementation science researcher to bridge the gap between existing knowledge and service delivery. To fill in the gap between my current skill set and the career goal, I will receive training in areas related to implementation science, including health policy, intervention adaptation, and healthcare management. The health policy training will familiarize me with the process of policy development and its influence on the intervention adaptation and implementation; the intervention adaptation courses will inform me with the general concept and framework to design the study ensuring all aspects of intervention implementation are addressed; and the health management training will provide me with analytical tools to model leadership decision making and to evaluate the implementation flow in healthcare settings. The mentor team members, Drs. Li Li, Mary-Jane Rotheram-Borus, Thomas J. Coates and Zunyou Wu, are all internationally reorganized experts in behavioral intervention implementation and adaptation. My institute, the UCLA Semel Center for Community Health (CCH) and the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), UCLA, provide me with support from a multidisciplinary team of top researchers. Collaborating with the National Center for AIDS/STD Control and Prevention (NCAIDS), China CDC, I will conduct a mentored research using an intervention trial with significant yet heterogeneous outcome to investigate multilevel factors influencing the intervention implementation and outcome, and to find the optimal approach to incorporate the intervention model into the current healthcare settings. The study will be conducted in three phases. Phase 1 will be review of related policies and in-depth interviews with healthcare administrators and hospital directors, with the aim to explore the policy barriers and facilitators in adaptation of the intervention model. Phase 2 will be conjoint analysis with hospital directors to model the decision-making in intervention adaptation and routinization in the healthcare facilities. Phase 3 will be bottleneck analysis to locate structure bottlenecks in compliance with the intervention component. The finding will provide implications for future intervention delivery in healthcare settings. Application of some analytical tools in other fields, including conjoint analysis and bottleneck analysis, will potentially contribute to te development of implementation science methodology. Based on the data achieved from the study, I will prepare for a R01 application in implementation science in Year 4 of the K award period.