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TRX 05-309 – HSR&D Study

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TRX 05-309
Patterns of Research Progression and Implementation within the VA Research and Development Program: Barriers, Facilitators and Policy Recommendations
Brian S. Mittman PhD MA
VA Greater Los Angeles Healthcare System, Sepulveda, CA
Sepulveda, CA
Funding Period: June 2005 - September 2005

BACKGROUND/RATIONALE:
VA’s Office of Research and Development (ORD) and other research funders have increasingly recognized the existence of barriers and gaps (labeled "translational roadblocks") in the nation’s health-related research-development-implementation pipeline. These barriers impede the translation of successful research findings into clinical treatments and, ultimately, into routine clinical practice.

OBJECTIVE(S):
This project aims to: (1) Understand whether, when, how, and why VA research activities are linked to comprise a continuous progression from basic science to clinical research to implementation, and from health services research to implementation, and (2) Identify "points of leverage" and opportunities to accelerate and strengthen these links and the transitions from one research effort to the next.

METHODS:
Two separate samples of research projects will be drawn to study research pipeline patterns, barriers and facilitators. A cross-sectional sample will include 50 projects selected (via stratified random sampling) from the full set of pipeline phases: basic/bench research, pre-clinical research, clinical trials (Phase I, II, III), basic health services research (e.g., development and evaluation of tools such as screening tools) and implementation research (Phase 1, 2, 3). Data collection will focus on tracking the proximal predecessor and successor projects (within and outside VA) and associated barriers and facilitators and "transition mechanisms" for each of the 50 sampled projects.
A second longitudinal sample will consist of approximately 15 case studies of specific lines of research, tracing the full set of predecessor activities and full set of successor activities (back to the original foundations, in terms of predecessor activities, and to the present day for successor activities), or distal predecessor and successor projects. The cross-sectional sample will permit the collection of data describing a broad range of factors and reasons for lack of follow-up (e.g., failed study with findings that do not warrant follow-up, successful study with insufficient interest or actions to stimulate rapid follow-up). The longitudinal sample will include data gathering across all of these phases, however, and will over-sample particularly "successful" examples of pipeline progressions to better understand the factors facilitating this success. Information regarding pipeline patterns (i.e., predecessor and successor projects) will be obtained from project proposals and reports, published journal articles, and interviews with (and surveys of) researchers. Interviews and surveys will also provide information on pipeline barriers and facilitators.

FINDINGS/RESULTS:
No results at this time.

IMPACT:
Translational roadblocks in ORD’s health-related research-development-implementation pipeline cause excessive delays (or outright failure) in the translation of successful research findings into clinical treatments and, ultimately, into routine clinical practice. The roadblocks limit the obtained benefits and impacts of health research and the nation’s considerable investment (in funding, time and effort) in such research. This project will produce data on common patterns and pathways of research activity or "flow" across the pipeline stages and add to ORD’s efforts to develop effective policies and mechanisms to accelerate pipeline processes.

PUBLICATIONS:

Conference Presentations

  1. Mittman BS. Implementation Research Within the Department of Veterans Affairs. Paper presented at: AcademyHealth Annual Research Meeting; 2005 Jun 1; Boston, MA.
  2. Mittman BS. A Leadership Role for VHA in Addressing the 'Clinical Research Enterprise Crisis'. Paper presented at: VA HSR&D National Meeting; 2005 Feb 1; Baltimore, MD.


DRA: none
DRE: none
Keywords: none
MeSH Terms: none

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