An $11.5 million grant from NIH launches Implementation Science for Equity Center at KU Medical Center
The new center, funded as part of a prestigious program at the National Institutes of Health, will bridge the gap between research knowledge and clinical practice and reduce health inequities.
Every day, researchers work to find the best treatments and prevention methods for myriad diseases and conditions of the human body. They publish their research findings in academic journals and present them at conferences and meetings, all with the goal of these discoveries being used in clinics and hospitals to deliver evidence-based health care to patients.
Unfortunately, the translation of knowledge into practice is far from simple, and the chasm from (laboratory) bench to (hospital) bedside is famously wide. One frequently cited study estimated that it takes an average of 17 years for research knowledge to make its way out of the lab and into the clinic.
“There are a lot of barriers to change in medicine and in health care in general,” said Kimber Richter, Ph.D., MPH, professor of population health at the University of Kansas Medical Center. “There’s a big learning curve that comes with new medical practices. Old workflows that deliver those old practices make it hard to change because busy clinicians must re-imagine new team connections and handoffs,” she said, noting that there are numerous obstacles in the path. “Sometimes change requires practitioners with new skills, but budgets may limit hiring them, and reimbursement might not happen uniformly for new treatments. Practice change also requires changes in electronic health records. There also may be resistance because of cultural mindsets around certain health issues or treatment innovations.”
For rural, minority and other underserved populations, the lag from bench to bedside is often even longer. And even for the treatment and prevention of such common health problems as asthma, hypertension and cardiovascular disease, evidence-based guidelines often are not used, even though they are known to be effective.
“About 40% of patients do not receive care consistent with current evidence-based practice,” said Christie Befort, Ph.D., professor of population health at KU Medical Center. “What’s more, the gap between research and clinical practice tends to be even more pronounced in disadvantaged communities.”
Last month, KU Medical Center was awarded a 11.5 million, five-year grant from the National Institutes of Health (NIH) to identify and develop ways to implement evidence-based practices into clinical care and ensure equitable care for rural, minority and underserved populations. The project is led by Richter and Befort.
The grant funds the creation of a new center at KU Medical Center that will be part of the NIH’s prestigious Centers of Biomedical Research Excellence (COBRE) program, which supports the establishment and development of innovative biomedical and behavioral research centers at institutions in IDeA-eligible states through awards for three sequential five-year phases.
"About 40% of patients do not receive care consistent with current evidence-based practice. What’s more, the gap between research and clinical practice tends to be even more pronounced in disadvantaged communities."- Christie Befort, Ph.D., professor of population health
KU Medical Center has two other COBRE centers: the Kansas Center for Precision Medicine COBRE and the Kansas Center for Metabolism and Obesity Research COBRE. The new center will be the Implementation Science for Equity COBRE.
Implementation science is a burgeoning new field concerned with moving evidence-based research into clinical practice and improving delivery processes, including shortening the time it takes for patients to receive diagnosis and treatment. The center will provide mentoring and support for implementation science-based research. KU Medical Center has strong relationships with rural and urban health systems that can serve as settings for studying and testing innovations in health care delivery.
And like all Centers of Biomedical Research Excellence, KU Medical Center’s Implementation Science for Equity Center will provide support and mentoring for early-career investigators to put them in a good position to apply for independent funding. The new center’s long-term goal is to produce a critical mass of researchers who work to bridge the gap between research and practice in a way that increases health equity.
“The field of implementation science is about managing change, and equity is critical,” said Richter. “We want to make sure we don't continue to leave vulnerable and at-risk populations behind in the implementation of research innovations.”
The first four researchers supported by the new center are:
Heather Gibbs, Ph.D., associate professor of dietetics and nutrition at KU School of Health Professions. Gibbs partnered with KU Medical Center’s JUNTOS Center for Advancing Latino Health to create a Spanish version of Nutricity, a program accessible via mobile devices that delivers instructional videos, interactive quizzes, games and text messages to support healthy eating for families with small children. Her project will test Nutricity in pediatric primary care and safety net clinics serving Latino families.
Jaime Perales-Puchalt, Ph.D., assistant professor at the University of Kansas Alzheimer's Disease Research Center. Perales-Puchalt will test the feasibility of an intervention, delivered by community health workers, for Latino caregivers of people with dementia at two primary care clinics in the Kansas City area. That intervention, called ¡Unidos Podemos!, provides support for caregivers of people with dementia and has been shown to reduce depressive symptoms among Latino caregivers.
Taneisha Scheuermann, Ph.D., associate professor of population health at KU School of Medicine. Scheuermann will determine the preliminary effectiveness of an incentive-enhanced text messaging program for smoking cessation, facilitated by an implementation toolkit, for low-income pregnant smokers.
Sharla A. Smith, Ph.D., MPH, associate professor of population health at KU School of Medicine. Smith will test an intervention and implementation strategy to prevent preeclampsia. The intervention, Centering HER (Health, Empowerment, and Reproduction), includes in-person individual and telehealth sessions to address the pregnancy and birth process, self-care, blood pressure monitoring and aspirin adherence. The project will be conducted at two sites that provide prenatal care to most Black women in the Kansas City area.