Selecting, adapting, and sustaining programs in health care systems.
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2015-01
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Abstract
Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA) Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities.
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Zullig, Leah L, and Hayden B Bosworth (2015). Selecting, adapting, and sustaining programs in health care systems. Journal of multidisciplinary healthcare, 8. pp. 199–203. 10.2147/jmdh.s80037 Retrieved from https://hdl.handle.net/10161/29981.
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Leah L Zullig
Leah L. Zullig, PhD, MPH is a health services researcher and implementation scientist whose work focuses on accelerating the adoption of evidence-based practices to improve healthcare delivery and population health. She is a Professor in the Duke University Department of Population Health Sciences and an investigator with the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham Veterans Affairs Health Care System.
Dr. Zullig is a recognized leader in implementation science. She directs INTERACT, the Implementation Science Research Collaborative, which fosters interdisciplinary collaborations across Duke University and with external partners to accelerate the translation of research into practice. She also leads the Dissemination and Implementation Catalyst within Duke's Clinical and Translational Science Award (CTSA) program and serves as Co-Leader of the Duke Cancer Institute's Cancer Prevention and Control Research Program.
Dr. Zullig's research spans three interconnected areas: improving the quality and delivery of cancer care; advancing cancer survivorship and chronic disease management; and enhancing medication adherence. Across these domains, she applies implementation science methods to develop, evaluate, and scale evidence-based interventions that promote equitable, high-quality care across diverse healthcare settings. Her research is characterized by strong partnerships with healthcare systems, ensuring that findings extend beyond publication to inform clinical practice, health system transformation, and policy.
Dr. Zullig has authored more than 200 peer-reviewed publications and has established a national reputation for leading pragmatic, health system-embedded research that improves patient outcomes and advances the science of implementation.
Dr. Zullig earned her Bachelor of Science in Health Promotion, Master of Public Health in Public Health Administration, and PhD in Health Policy.
Hayden Barry Bosworth
Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities.
Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.
Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy
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