Fundamentals of Implementation Science

Course dates:
Apr 02, 2018 to Jun 17, 2018

Faculty: 

Course hours:
11 weeks, 6-9 hours per week

Syllabus

Learning Objectives

After completing this course, you will be able to 

  • Identify the major factors that limit the translation of efficacy trials to effective health programs, and describe the role of complementary implementation science research methods in the development of evidence-based health programs and policies.
  • Explain appropriate research and evaluation methods to overcome impediments to implementation and facilitate timely scale-up of proven interventions with high levels of fidelity and effectiveness.
  • Contextualize and explain real-world examples where sound interventions failed or succeeded.
  • Describe at least one framework for designing successful implementation strategies and apply the framework to a real world health problem.

Topics

Week 1:

Introduction to Implementation Science and Surveillance to Measure Impact and Inform Strategies (Judy Wasserheit, MD, MPH and Kenneth Sherr, PhD, MPH)

  • Describe why implementation science is important to global health.
  • Summarize a framework for using implementation science to facilitate the translation of knowledge to successful program implementation.

Surveillance to measure impact and inform strategies (David Fleming, MD)

  • Recognize the value of core systems of information collection to monitor disease and health programs in developing countries.
  • Identify barriers to implementing these systems and applications of these concepts in developed countries as well.

Week 2:

Overview of Impact Evaluation and Study Design (Emmanuela Gakidou, PhD, MSc)

  • Describe the dominant impact evaluation and study design methods used to evaluate the effects of programs at scale.
  • Differentiate between randomized designs that are RCTs conducted for specific interventions and treatments, versus randomized designs for large-scale programs.
  • Identify the types of health metrics and sources of data for health metrics
  • Recognize the importance of impact evaluations in the design of sound health policies

Case Study: HPV Vaccine Introduction and Scale-up (Lauri Markowitz, MD)

  • Recognize current knowledge about efficacy, immunogenicity and safety of available prophylactic HPV vaccines.
  • Describe policy and programmatic issues related to implementation of HPV vaccination.
  • Identify data on impact of HPV vaccination programs.

Week 3:

Economic Analysis and Cost Effectiveness Analysis (Hidecki Higashi, PhD, MPH)

  • Provide an overview of economic analysis methods
  • Provide an overview of the application of cost effectiveness analysis

Case Study: Male Circumcision (Peter Cherutich, PhD, MD)

  • Explain the evidence base for the association between male circumcision and reduced risk for acquisition of HIV infection.
  • Recall the issues involved in planning, implementing and evaluating programs to scale up male circumcision services in Africa.

Week 4:
Qualitative Health System Research (James Pheiffer, PhD, MPH, MA)

  • Identify qualitative data gathering methods and sampling approaches, and describe their implications for analysis and interpretation of data in operations research studies.
  • Identify how qualitative research design and methods can be developed to maximize rigor, validity, and reliability of findings in OR studies.
  • Describe the benefits and limitations of mixing qualitative and quantitative methods in OR designs.

Case Study: Ebola Prevention and Control (Gabrielle Fitzgerald, MPA)

  • Recognize the global impact of the current Ebola outbreak, and the policy and programmatic issues that must be addressed in order to get to zero cases
  • State the role new stakeholders played in combating the outbreak, with a focus on the philanthropic sector

Week 5:
Operations Research as a Contributing Discipline (Joseph Heim, PhD)

  • Identify basic lean implementation and it’s application to healthcare settings: waste and time, value steam mapping, process improvement/Kaizen
  • Recognize the use of simulation modeling (model development, model verification and validation, what-if analysis)

Case Study: Road Traffic Injury Prevention and Control (Charles Mock, MD, PhD, MPH)

  • Understand that injury can be addressed scientifically, as with any other health problem, and that affordable and sustainable measures can be enacted in both injury prevention and trauma care, which really do result in lowered rates of injury-related mortality and disability.
  • Understand the various technical factors that go into injury prevention, along with the on the ground realities and policy issues that must be addressed.

Week 6:
Quality Improvement as a Management Tool (Edward Wagner, MD, MPH)

  • Define how quality improvement can be used to identify and test innovations in the health care setting.
  • Demonstrate how quality improvement has facilitated broad scale-up of health programs.

Case Study: CVD in Cambodia (Jim LoGerfo, MD, MPH)

  • Recognize the current global burden of CVD and effectiveness of interventions for CVD control
  • Explain policy and programmatic dimensions of a public health perspective for CVD control, using Cambodia as a case study

Week 7:
Stakeholder and Policy Analysis (Jeff Lane, JD, MPH)

  • Describe the stages of policy development and how empirical information can be used at each stage.
  • Identify and map key stakeholders in a policy issue.

Case Study: Polio Eradication (Walter Orenstein, MD)

  • Explain the components of the current strategy to eradicate polio and the scientific basis underpinning the strategy.
  • Describe progress in eradicating polio to date and the remaining challenges to success.

Week 8:
Dissemination Research (Jeffery Harris, MD, MBA, MPH)

  • Describe and use the Health Promotion Research Center framework for dissemination of evidence-based health promotion practices.
  • Discuss the need for dissemination research and describe the roles that researchers play in dissemination.

Case Study: Evolving an African National Malaria Control Program to Scale Up for Elimination (Rick Steketee, MD, MPH)

  • To become familiar with the epidemiology and burden of malaria in the Africa region.
  • To learn about the approaches to program scale up in Africa with an explicit commitment to achieving health impact.
  • To learn about progress in the 2005-2010 as national malaria control programs have scaled-up intervention coverage.
  • To understand the challenges to sustaining and extending progress to date for elimination.

Week 9:
Social Marketing (Mark Forehand, PhD)

  • Identify the process of developing an effective marketing strategy
  • Assess the incremental value of the marketing approach in health intervention development and execution

Case Study: Family Planning (Baker Maggwa, MD, MS)

  • Identify progress in expanding access to, and use of, family planning methods, and identify best practices and continued challenges.
  • Describe issues involved in planning, implementing and evaluating programs to scale up family planning programs.

Week 10:
Course Synthesis and Final Presentation

  • Justify the need for an implementation science framework and summarize its main attributes.
  • Apply appropriate public health methods and strategies to develop and implement successful, large-scale public health programs.

*outline subject to change