This study aimed to review the literature describing and quantifying time lags in the health research translation process. Papers were included in the review if they quantified time lags in the development of health interventions. The study identified 23 papers. Few were comparable as different studies use different measures, of different things, at different time points. We concluded that the current state of knowledge of time lags is of limited use to those responsible for R&D and knowledge transfer who face difficulties in knowing what they should or can do to reduce time lags. This effectively ‘blindfolds’ investment decisions and risks wasting effort. The study concludes that understanding lags first requires agreeing models, definitions and measures, which can be applied in practice. A second task would be to develop a process by which to gather these data.

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The answer is 17 years, what is the question: understanding time lags in translational research:

The Answer Is 17 Years, What Is the Question

Legislators and their scientific beneficiaries express growing concerns that the fruits of their investment in health research are not reaching the public, policy makers, and practitioners with evidence-based practices. Practitioners and the public lament the lack of relevance and fit of evidence that reaches them and barriers to their implementation of it. Much has been written about this gap in medicine, much less in public health. We review the concepts that have guided or misguided public health in their attempts to bridge science and practice through dissemination and implementation. Beginning with diffusion theory, which inspired much of public health’s work on dissemination, we compare diffusion, dissemination, and implementation with related notions that have served other fields in bridging science and practice. Finally, we suggest ways to blend diffusion with other theory and evidence in guiding a more decentralized approach to dissemination and implementation in public health, including changes in the ways we produce the science itself.

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Diffusion Theory and Knowledge Dissemination, Utilization, and Integration in Public Health

Because translational research is not clearly defined, developers of translational research programs are struggling to articulate specific program objectives, delineate the knowledge and skills (competencies) that trainees are expected to develop, create an appropriate curriculum, and track outcomes to assess whether program objectives and competency requirements are being met. Members of the Evaluation Committee of the Association for Clinical Research Training (ACRT) reviewed current definitions of translational research and proposed an operational definition to use in the educational framework. In this article, the authors posit that translational research fosters the multidirectional and multidisciplinary integration of basic research, patient-oriented research, and population-based research, with the long-term aim of improving the health of the public. The authors argue that the approach to designing and evaluating the success of translational training programs must therefore be flexible enough to accommodate the needs of individual institutions and individual trainees within the institutions but that it must also be rigorous enough to document that the program is meeting its short-, intermediate-, and long-term objectives and that its trainees are meeting preestablished competency requirements. A logic model is proposed for the evaluation of translational research programs.

Defining translational research: implications for training.

This is a report on the research design and findings of a 23-year longitudinal study of the impact of intrafamilial sexual abuse on female development. The conceptual framework integrated concepts of psychological adjustment with theory regarding how psychobiological factors might impact development. Participants included 6- to 16-year-old females with substantiated sexual abuse and a demographically similar comparison group. A cross-sequential design wasused andsix assessments have takenplace,with participantsat medianage 11 at thefirst assessment andmedianage25 at thesixthassessment. Mothers of participants took part in the early assessments and offspring took part at the sixth assessment. Results of many analyses, both within circumscribed developmental stages and across development, indicated that sexually abused females (on average) showed deleterious sequelae across a host of biopsychosocial domains including: earlier onsets of puberty, cognitive deficits, depression, dissociative symptoms, maladaptive sexual development, hypothalamic‐pituitary‐adrenal attenuation, asymmetrical stress responses,high rates of obesity, more major illnesses and healthcare utilization, dropping out of high school, persistent posttraumatic stress disorder, self-mutilation, Diagnostic and Statistical Manual of Mental Disorders diagnoses, physical and sexual revictimization, premature deliveries, teen motherhood, drug and alcohol abuse, and domestic violence. Offspring born to abused mothers were at increased risk for child maltreatment and overall maldevelopment. There was also a pattern of considerable within group variability. Based on this complex network of findings, implications for optimal treatments are elucidated. Translational aspects of extending observational research into clinical practice are discussed in terms that will likely have a sustained impact on several major public health initiatives.

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The impact of sexual abuse on female development: lessons from a multigenerational, longitudinal research study.

Practice-based evaluation integrates research skills and techniques into the clinical process in order to correlate clinical interventions with treatment outcomes. Although most clinicians recognize the importance of some form of practice evaluation, barriers including lack of time, resources, expertise, and organizational support may deter such evaluation efforts. However, there are numerous advantages for clinicians and agencies to develop a culture that values and integrates practice evaluation into its daily work-life; these include opportunities for teamwork, collaboration, mentoring, and innovation. This paper defines practice evaluation research, identifies strategies for its implementation, and describes a framework for creating a “research friendly” culture. It further describes the implementation of such an innovative program in both a hospital and a mental health agency setting.

Practice-based research:changing the professional culture and language of social work.

As the United States experiences substantial growth in its population that is 65 years and older, development of safe housing and compassionate care for seniors is becoming a priority domestic issue. Assisted living is one of the fastest growing types of senior housing in the nation, attracting residents with a perceived combination of security, personal care services, less restrictive homelike environments and emphasis on independence, privacy and personal dignity. As there is limited reference to assisted living in the social work literature, this article selectively reviews the broader literature on the aging U.S. population and their need, assisted living as a senior housing and care option, the characteristics of this approach and the potential for social work practice in this evolving arena.

The coming of age for assisted living care: new options for senior housing and social work practice.

Though seemingly old-fashioned compared to modern methods of discerning professional development, process recordings offer many benefits for social work faculty, field instructors, and students ali...

https://www.jstor.org/stable/info/23043036

Process Recordings: Fine-Tuning an Old Instrument

The professional staff in five hospital social work departments participated in an exploratory study to assess the impact of organizational reengineering on job satisfaction, professional identity and other work related attitudes. A survey was used to explore how job functions had changed; whether or not staff felt adequately prepared to perform the new tasks; and whether the changes were consistent with their professional identities and academic preparation. Follow up focus group interviews were held to enrich the quantitative findings. The results of the study indicate that reengineering has a negative effect on job satisfaction and results in role changes that are experienced as inconsistent with the professional identity and academic preparation of social work staff. In addition to describing the results of the study, this paper provides a brief overview of reengineering, describes models of reengineering for hospital social work departments and suggests strategies for lessening the negative effect on staff.

The effect of organizational reengineering on job satisfaction for staff in hospital social work departments.

This study explored the perceptions of health care providers across the continuum of care as to how effective advance directive arrangements were in assuring compliance with the patients' wishes, as well as their overall satisfaction levels with the process. The health care providers who responded to the survey indicated high levels of overall satisfaction with advance directives, despite low patient completion rates and, most significantly, low confidence levels that surrogate decision making accurately reflected the patient's wishes. A secondary analysis compared the perceptions of health care providers with consumers' reasons for failing to complete advance directives. The need for further education was perceived as a primary need by the health care professionals but not by the consumers. Recommendations for policy initiatives and further research are then presented.

Karen Neuman

Papers

Practice-based research:changing the professional culture and language of social work.

The coming of age for assisted living care: new options for senior housing and social work practice.

Process Recordings: Fine-Tuning an Old Instrument

The effect of organizational reengineering on job satisfaction for staff in hospital social work departments.

Advance directives: the experience of health care professionals across the continuum of care.