Implementation Science

Dr. Mari-Lynn Drainoni of the Section of ID is the co-director of the Evans Center for Implementation and Improvement Sciences (CIIS).  In partnership with CIIS, trainees have the opportunity to learn implementation science research methods that will provide them with the opportunity to engage in a variety of scholarly activities that are closely linked to clinical practice.  Implementation science is the study of how to integrate research into practice and CIIS serves as a methodological hub for the scientific evaluation of efforts to improve health care delivery.   CIIS frequently partners with Boston Medical Center clinicians to integrate what is learned from research into practice and to study the process and members of our Section actively engage with CIIS across different areas of interest such as the opioid use and infectious diseases pandemic or infection control and antimicrobial stewardship.  To our knowledge, CIIS is the only implementation science center nationally that has an explicit sole focus on the conduct of implementation research in safety net settings.  Much implementation research uses mixed methods, both collecting and analyzing quantitative data to examine effectiveness or “what works” and qualitative data to understand “how” or “why” something does or does not work.  Through our relationship with CIIS, ID fellows can obtain basic implementation research training with a strong focus on evaluating innovative clinical practice interventions and learning how to study their new ideas.  Fellows can also take advantage of implementation science and mixed methods training activities and seminars available through CIIS.

Objectives:

  • Provide practical training in implementation research methods and study designs for evaluating clinical interventions
  • Learn the basics of how to plan and evaluate an intervention, including identification of outcomes and analysis
  • Learn the basics of mixed methods research
  • Provide research mentorship for individuals interested in careers in implementation science or program evaluation

Training

CIIS offers regular educational sessions covering a range of implementation science topics.  CIIS also has a 10-module training curriculum that is available to ID fellows free of charge.   The 10 modules include:

  1. Principles and Key Issues in Implementation Science
  2. Types of Implementation Science Studies and Study Goals – When and Why
  3. Implementation Science Models and Frameworks
  4. Implementation Science Study Designs
  5. Implementation Strategies
  6. Implementation Science Outcomes and Measures
  7. Quantitative Methods in Implementation Science
  8. Qualitative Methods
  9. Mixed Methods
  10. Intervention Fidelity and Adaptations

Junior faculty also have the opportunity for additional training through the two-year CIIS Fellowship, a competitive program that covers 50% of time for qualified junior faculty to receive advanced training in implementation science and to receive mentorship to conduct their own implementation research studies, as well as to partner with others on campus in implementation research . https://sites.bu.edu/ciis/ciis-fellowship/

 

Research Opportunities

Fellows have rich opportunities to not only learn about implementation science, but to participate in implementation research studies available at BMC and at partnering institutions.  Fellows are welcome to engage in funded ongoing investigations that fellows can join.   Numerous implementation research projects exist on campus and fellows can also propose their own research idea and obtain support.   The BU faculty profiles summarize individual research interests and publications.   Both ID and non-ID faculty are actively engaged in implementation science work; core ID faculty involved in implementation science research and who can serve as mentors include:

Mari-Lynn Drainoni, PhD, MEd –Research Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine; Research Professor of Health Policy and Management, Boston University School of Public Health; Co-Director, Evans Center for Implementation and Improvement Sciences, Boston University

Tamar Barlam, MD, MSc – Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine; Chief, Section of Infectious Diseases; Director, Antimicrobial Stewardship Program and Hospital Epidemiology, BMC

Shana AB Burrowes, PhD – Assistant Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine

Rebecca Rudel, DrPH – Assistant Professor of Medicine, Boston University Chobanian & Avedisian School of Medicine

Sampling of Recent ID-focused Implementation Science Publications

  1. Nelson A, Steiner J, Barlam TF, Drainoni M, Burrowes SAB, Pierre C. Revitalizing the Infection Prevention Workforce with a Fellowship Program for Underrepresented Groups, Infect Control Hosp Epidemiol; 2023 Jul 3;1-2. doi: 10.1017/ice.2023.38.  
  1. Chen S, Walt G, Aldrich A, McAlearney AS, Linas B, Amuchi B, Freedman D, Goddard-Eckrich DA, Gibson E, Hartman J, Bosak JS, Lunze K, Jones L, Christopher M, Salsberry P, Jackson R, Back S, Drainoni M, Walker DM. A Qualitative Study of Health Equity’s Role in Community Coalition Development, Health Education and Behavior, 2023 Jun 28;1.doi: 10.1177/10901981231179755.
  1. Drainoni M, Walt G, Sprague Martinez L, Santarpio S, Munoz-Lopez R, McClay C, Keisling L, Harris A, Gillen F, El-Alfi V, Crable EL, Cogan A, Carpenter JF, Barkowski L, Battaglia TA. Coalition building: What happens when external facilitators put the CBPR principles in practice? Ethnographic Examples from the Massachusetts HEALing Communities Study, Journal of Community Engagement and Scholarship, 2023; 16(1): July 3. DOI: 10.54656/jces.v16i1.457
  2. Tjilos M, Tamlyn AL, Ragan EJ, Assoumou SA, Gergen Barnett K, Martin P, Perkins RB, Linas BP, Drainoni M. Community members have more impact on their neighbors than celebrities”: Leveraging community partnerships to build COVID-19 vaccine confidence. BMC Public Health, 23, 350 (2023) February 16. https://doi.org/10.1186/s12889-023-15198-6
  3. Tamlyn AL, Tjilos M, Bosch NA, Gergen Barnett K, Perkins RB, Walkey A, Assoumou SA, Linas BP, Drainoni M. At the intersection of trust and mistrust: A qualitative analysis of motivators and barriers to research participation at a safety-net hospital. Health Expectations, March 2023; 1– 9. doi:10.1111/hex.13726
  1. Silver S, Redmond S, Jones KC, George E, Zornes S, Barwise A, Leppin A, Dong Y, Harmon LA, Kumar V, Kordik C, Drainoni M, Walkey AJ. A Multisite Exploration of the Association between Critical Care Implementation Factors and Clinical Outcomes during the COVID-19 Pandemic, Journal of Translational and Clinical Science, (1), E72. doi:10.1017/cts.2023.22
  1. Silver S, Jones KC, Redmond S, George E, Zornes S, Barwise A, Leppin A, Dong Y, Harmon LA, Kumar VK, Kordik C, Walkey AJ, Drainoni M. Facilitators and barriers to the implementation of new critical care practices during COVID-19: A multicenter qualitative study using the Consolidated Framework for Implementation Research (CFIR), BMC Health Services Research, 23, 272 (2023). https://doi.org/10.1186/s12913-023-09209-w

  2. Tjilos M, Drainoni M, Burrowes SAB, Butler JM, Damschroder LM, Goetz MB, Madaras-Kelley K, Reardon CM, Samore MH, Shen J, Stenehjem EA, Zhang Y, Barlam TF. A qualitative evaluation of frontline clinician perspectives towards antibiotic stewardship programs (ASPs), Infection Control and Hospital Epidemiology,  Infect Control Hosp Epidemiol. 2023 Mar 29:1-7. doi: 10.1017/ice.2023.35. Epub ahead of print. PMID: 36987859.
  3. Fletcher L, Burrowes SAB, Khan GK, Sabin L, Johnson S, Kimmel SD, Ruize-Mercado G, Pierre C, Drainoni M. Perspectives on Long-Acting Injectable HIV Antiretroviral Therapy at an Alternative Care Site: A Qualitative Study of People with HIV Experiencing Substance Use and/or Housing Instability, Harm Reduction Journal, 10 January 2023, online ahead of print. 20:4 https://doi.org/10.1186/s12954-023-00730-z
  4. Freibott CE, Sprague Martinez LS, Rajabiun S, Drainoni M. Health literacy, health outcomes and community health worker utilization: a cohort study in HIV primary care. BMC Health Services Research. 2022;22(1):1254. doi:10.1186/s12913-022-08634-7
  5. Khan GK, Harvey L, Johnson S, Kimmel S, Pierre C, Drainoni M. Integration of a community-based harm reduction program into a safety net hospital: a qualitative study, Harm Reduction Journal, (2022 April 12) 19:35. https://doi.org/10.1186/s12954-022-00622-8
  6. Burrowes SAB, Drainoni M, Tjilos M, Butler JM, Damschroder LJ, Goetz MB, Madaras-Kelly K, Reardon CM, Samore MH, Shen J, Stenehjem E, Zhang Y, Barlam TF. Survey of physician and pharmacist stewards perceptions of their antibiotic stewardship programs, Antimicrobial Stewardship & Healthcare Epidemiology, 1(1), E48. doi:10.1017/ash.2021.219

  7. Burrowes SAB, Barlam TF, Skinner A, Berger R, Ni P, Drainoni M. Provider views on rapid diagnostic tests and antibiotic prescribing for respiratory tract infections: A mixed methods study, PLOS ONE 16(11): e0260598. https://doi.org/10.1371/journal.pone.0260598
  8. Livorsi D, Drainoni M, Reisinger HS, Nanda N, McGregor JC, Barlam TF, Morris AM, Szymczak JE, Leveraging Implementation Science to Advance Antibiotic Stewardship Practice and Research, Infection Control and Hospital Epidemiology, 1-8. doi:10.1017/ice.2021.480.

  9. Davoust M, Drainoni M, Baughman A, Campos MR, Estes T, Rajabiun S, Ross-Davis K, McCann K, Sullivan M, Todd L, Wolfe HL, Sprague Martinez L. “He gave me spirit and hope”: Client experiences with community health workers in HIV care, AIDS Patient Care and STDs.Aug 2021.318-326. http://doi.org/10.1089/apc.2021.0085
  10. Drainoni M, Biancarelli DL, Jansen E, Bernstein J, Joseph N, Eun T, Fenton A, Hanchate AM, Legler A, Schuch T, Leschly K, Perkins RB. Clinician and practice experience integrating a multilevel intervention into clinical practice, Journal of Continuing Education in the Health Professions, 2021 Jul 1;41(3):195-201. doi: 10.1097/CEH.0000000000000363.PMID: 33973928
  11. Metsch LR, Feaster DJ, Gooden LK, Masson C, Perlman DC, Jain MK, Matheson T, Nelson CM, Jacobs P, Tross S, Haynes L, Lucas GM, Colasanti JA, Rodriguez A, Drainoni ML, Osorio G, Nijhawan AE, Jacobson JM, Sullivan M, Metzger D, Vergara-Rodriguez P, Lubelchek R, Duan R, Batycki JN, Matthews AG, Munoz F, Jelstrom E, Mandler R, Del Rio C. Care Facilitation Advances Movement Along the Hepatitis C Care Continuum for Persons With Human Immunodeficiency Virus, Hepatitis C, and Substance Use: A Randomized Clinical Trial (CTN-0064). Open Forum Infect Dis. 2021 Aug; 8(8):ofab334. PMID: 34377726. https:://doi.org/10.1186/s12913-020-06055-y.

  12. Davoust M, Grim V, Hunter A, Jones DK, Rosenbloom D, Stein MD, Drainoni M. Examining the implementation of police-assisted referral programs for substance use disorder services in Massachusetts, International Journal of Drug Policy, 2021 Feb 2;103142.  doi: 10.1016/j.drugpo.2021.103142. Online ahead of print.
  1. Kimmel AL, Messersmith LJ, Bazzi AR, Sullivan MM, Boudreau J, Drainoni M. Implementation of HIV Pre-Exposure Prophylaxis for Women of Color: Perspectives from Healthcare Providers and Staff from Three Clinical Settings, Journal of HIV/AIDS and Social Services, DOI: 10.1080/15381501.2021.1887038
  1. Wolfe HL, Baughman A, Davoust M, Sprague Martinez LS, Rajabiun S, Drainoni M. Client Satisfaction with Community Health Workers in HIV Care Teams. J Community Health. Published online March 26, 2021. doi:10.1007/s10900-021-00978-1
  1. Sprague Martinez L, Davoust M, Rajabiun S, Baughman A, Bachman SS, Bowers Sword R, Campos Rojo M, Sullivan M, Drainoni M. “Part of getting to where we are is because we have been open to change” Integrating community health workers on care teams at ten Ryan White HIV/AIDS Program recipient sites, BMC Public Health, 2021 May 14;21(1):922. doi: 10.1186/s12889-021-10943-1.