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Syllabus

Translating Evidence Into Practice EPI245

Date/Time Activity Topic/Content Faculty Locations
Thurs 9/24/2009
8:45 AM-10:15 AM		Lecture

Overview; Building the Case for Your Study/Intervention

Introduce students to Donabedian’s structure-process-outcome paradigm of healthcare quality; to Wennberg’s studies of practice variation; and to IOM’s report on the Quality Chasm and Quality Gap. We will also review databases and resource that are readily available for examining practice patterns of interest.

Required Reading:

  1. How is science used in HIV prevention?
  2. IOM Report Brief
  3. The “3T’s” Road Map to Transform US Health Care

Optional Reading:

  1. Auerbach
  2. Berwick

Note/Slide Files: Lecture_1.ppt (5061 KB) Overview_Specs.doc (67 KB)

Assignment Files: EPI_245_HOMEWORK_1_revised.doc (37 KB)

R GonzalesCB 6704
Thurs 10/1/2009
8:45 AM-10:15 AM		Lecture

Sifting Through the Translational Toolbox

To become familiar with intervention tools that have been employed in health intervention strategies to influence organizational, clinician, patient and public behaviors.

Required Reading:

  1. Patient-Centered Tool
  2. Community Engaged Public Health Tool
  3. Physician-Centered Tool

Optional Reading:

  1. IMPAACT Project
  2. OEMs
  3. Jamtvedt
  4. Kawamoto
  5. O’Connor

Note/Slide Files: Translational Toolbox.2009.ppt (4263 KB)

Assignment Files: EPI 245 HOMEWORK #2.doc (28 KB)

R GonzalesCB 6704
Thurs 10/8/2009
8:45 AM-10:15 AM		Lecture

Organizational and Delivery System Approaches to Improving Healthcare Quality

Review theoretical approaches to changing organizational behavior within the health cae delivery system; review specific types of intervention modalities (CQI; six-sigma; P4P); and provide a framework for students to consider delivery system approaches for their intervention projects.

Required Reading:

  1. Assessment of high performing medical groups

Optional Reading:

  1. Microsystem
  2. Lindenauer
  3. Shekelle SR Public Reporting
  4. Teamwork training RCT

Note/Slide Files: Lecture_3.pdf (2454 KB)

Assignment Files: Auerbach homework Epi245 Fall 09.doc (28 KB)

A AuerbachCB 6704
Thurs 10/15/2009
8:45 AM-10:15 AM		Lecture

Understanding and changing public and patient behavior: Theory, Evidence, Planning

Review of explanatory theoretical approaches to understanding public and patient behavior (focus on health belief model, theory of planned behavior primarily); review evidence supporting these theories in selected areas related to preventive behavior, diet/lifestyle behavior, and medication adherence; discussion of using these theories to develop a framework for students' explanatory model of public/patient behavior as it relates to their own projects.

Required Reading:

  1. Behavioral Intervention to Improve Obstetric Care
  2. Racial/Ethnic Barriers to Flu Vaccination
  3. Theory at a Glance

Optional Reading:

  1. Social Marketing in Public Health
  2. Facilitators & Barriers to Adopting Evidence-Based Perinatal Care in Latin America
  3. Health Beliefs, Disease Severity and Patient Adherence
  4. Transtheoretical Modle

Note/Slide Files: Lecture_4.ppt (22650 KB)

Assignment Files: HW#4.doc (24 KB)

M HandleyCB 6704
Thurs 10/22/2009
8:45 AM-10:15 AM		Lecture

Understanding and changing physician behavior: Theory, Evidence, Planning

Review theoretical approaches to understanding clinician behavior; review seminal evidence supporting these approaches; and provide a framework for students to develop interventions to modify clinician behavior as it relates to their own projects.

Required Reading:

  1. Hospital Nurse Staffing and Mortality
  2. Adopting Health Behavior Change Theory Throughout the Clinical Practice Guideline Process
  3. An Analysis of Factors Influencing Patient and Physician

Optional Reading:

  1. Informed Decision Making in Surgery
  2. Why Physicians do not Follow Practice Guidelines
  3. Theory-Based Promotion of Research Findings
  4. Changing Physician Behavior--Eisenberg
  5. Medical Heuristics

Note/Slide Files: Clinician Behavior Change.2009.ppt (1155 KB)

Assignment Files: Homework.5.doc (32 KB)

R GonzalesCB 6704
Thurs 10/29/2009
8:45 AM-10:15 AM		Lecture

Case Studies in Implementation Research by invited faculty: D. Frosch, Palo Alto Medical Foundation Reserve Institute; A. Stewart, UCSF

‘Real life’ implementation research projects, presented by investigators in the field. 1. Dominick Frosch, PhD. The Next Frontier in Quality Improvement. A Randomized Trial of Patient Decision Support for Prostate Cancer Screening. 2. Anita Stewart, PhD. Translational Research: Experiences Implementing a Lifestyle Program to Reduce Disparities in Diabetes Risk.

NO HOMEWORK THIS WEEK... HAPPY HALLOWEEN!!!

Required Reading:

  1. Internet Patient Decision Support

Optional Reading:

  1. Shared Decision Making Review

Note/Slide Files: Frosch UCSF 10-29-09.pdf (844 KB)

D Frosch
A Stewart		CB 6704
CB 6704
Thurs 11/5/2009
8:45 AM-10:15 AM		Lecture

Community Engagement

Community Engagement. Review significance, relevance and approaches to community-engaged research and practice.

Required Reading:

  1. Translating Practice into Evidence
  2. Participatory Research and Practice-Based Research Networks
  3. Community Engagement Standards and Principles

Note/Slide Files: TICR Ralph course lecture 11 03 09.ppt (231 KB)

Assignment Files: Epi 245 HOMEWORK.#6.doc (26 KB)

E Goldstein
K Grumbach		CB 6704
CB 6704
Thurs 11/12/2009
8:45 AM-10:15 AM		Lecture

Program Evaluation: J. Ovretveit, Visiting Professor of Health Innovation, Implementation, and Evaluation, Karolinska Institute, Stockholm

Provide an understanding of programmatic evaluation models. Review basic principles of process and outcome evaluations.

GUEST SPEAKER: Dr Ovretveit from Karolinska Institute, Sweden, will review quasi-experimental Study Designs and other approaches to outcome measurement of interventions during 2nd half of seminar.

Ovretreit Tools and Publications: http://homepage.mac.com/johnovr/FileSharing2.html

Required Reading:

  1. Hulscher
  2. RE-AIM
  3. Ovretreit Chapter

Optional Reading:

  1. CDC Program Evaluation in Public Health

Note/Slide Files: Ovretveit_UCSFNov09.ppt (5175 KB) Program Evaluation.Tebb11.12.09.ppt (841 KB)

Assignment Files: Homework #7.doc (27 KB)

J Ovretveit
K Tebb		CB 6704
CB 6704
Thurs 11/19/2009
8:45 AM-10:15 AM		Lecture

Analytical Design Issues

Provide an introduction to analytical issues that are particularly relevant to healthcare intervention studies, including interrupted time series analysis, cluster randomized trials, and hierarchical models.

Required Reading:

  1. CRT - Courting Real Trouble
  2. Interrupted Time Series
  3. Example: QIDS in the Phillippines

Note/Slide Files: Translational Research Analytical and Design Issues 2009 HOs.pdf (257 KB) Translational Research Analytical and Design Issues 2009 HOs.ppt (239 KB)

Tool Files: ITS ar1 n=3 variance calc.xls (32 KB) ITS ar1 n=5 variance calc.xls (40 KB)

C McCullochCB 6704
Thurs 12/3/2009
8:45 AM-10:15 AM		Lecture

Final Protocol Presentations

Selected protocols will be reviewed by a mock study section, and their critiques presented to the class.

Note/Slide Files: Bryant.EXAMPLE.ppt (285 KB) Davis.EXAMPLE.ppt (2535 KB)

Assignment Files: INSTRUCTIONS for Epi 245 Final Presentations.2009.doc (32 KB)

R GonzalesCB 6704