Overview of Translational Research in Long Term Care
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1 Overview of Translational Research in Long Term Care Linda S. Noelker, Ph.D Benjamin Rose Institute on Aging Cleveland, Ohio Presented at the preconference workshop, Key Topics in Long Term Care: Person Centered Care and Translational Research at the annual meeting of the Gerontological Society of America, Boston, Massachusetts, November 18, PLEASE DO NOT CITE, QUOTE, DUPLICATE, OR DISTRIBUTE THIS DOCUMENT WITHOUT THE AUTHOR S PERMISSION
2 Defining Translational Research Activity that translates new knowledge, mechanisms, and techniques generated from scientific research into new devices, interventions, programs, and services designed to improve the long term care of older adults Multidisciplinary in nature Integrates scientific discovery with application in long term care settings
3 History of Translational Research First cited in PubMed in 1988 NIH Clinical and Translational Science Award Program (CETA) in 2006 Journal of Translational Medicine, American Journal of Translational Research, and Translational Medicine NIH Bench to Bedside Awards
4 Types of Translational Research T1 (Translational Block 1): transfer of new knowledge from basic research in the laboratory into the development of new methods, drugs, devices to diagnose, treat, and/or prevent disease Biomedical research (interface between science and clinical medicine) Focus of NIH and the Clinical and Translational Science Award Program (CETA)
5 Types of Translational Research T2 (Translational Block 2): translation of research (efficacy and effectiveness studies) into the application of the device, program, service, or intervention in long term care settings Requires an understanding of implementation science Very little funding committed to T2 relative to T1 Still evolving; no satisfactory term and definition
6 Types of Translational Research Proposed T3 (Translational Block 3): practice-based research to produce systematic reviews and practice guidelines Production of training manuals, program protocols, designation of essential components for fidelity to intervention, and components that can be changed (reinvention)
7 Barriers to T2 and T3 Research Quirkiness, unpredictability of human behavior Changing and unpredictable conditions of the real world Organizational inertia Resistance to change by humans and organizations Resource constraints
8 What makes for successful translation into LTC settings? Device or intervention has demonstrated efficacy and effectiveness across a wide range of research studies in diverse types of LTC settings with diverse populations Essential components are clearly identified Opportunities for reinvention (changed or adapted to make it work better in a given setting) Trainer and program manual Cost analysis/resources needed Network for dissemination and implementation
9 Dissemination & Implementation in LTC Settings Target motivated LTC settings Identify effective marketing strategies Find novel delivery mechanisms that make adoption easier/less costly Investigate recruitment and program attrition Allow for reinvention Plan for sustainability Establish ongoing communication between providers/practitioners and researchers (study innovations arising from practice community)
10 Research Agenda for Innovation & Improvement in LTC Settings Efforts at culture change & effects on residents, families and staff Workforce innovations for improved job outcomes Interventions for better care transitions Best practices for end-of-life and mental health care Structures & operation of LTC settings that foster and sustain innovation Special populations delivering & receiving care New and emerging types of residential care
11 Conclusions New area of endeavor Limited funding Changing environment Advocacy & education Special Interest Group, journal or journal section
12 References Marincola, F. M. (2003) Translational Medicine: A Two-Way Road, Journal of Translational Medicine, 1 (1), Prohaska, T. Translating Research to Practice: Issues and Strategies to Maximize the Impact of Evidence-based Best Practices in Aging, presentation to Grantmakers in Aging, October 22, Prohaska, T. & Glasgow, R.E. (forthcoming) Translation: Dissemination and Implementation Issues in Public Health for an Aging Society, T. Prohaska, B. Anderson, and R. Binstock (eds.). Sloane, P. & Zimmerman, S. (2005) Improvement and Innovation in Long Term Care: A Research Agenda and Recommendation from a Consensus Conference ( Woolf, S.H. (2008) The Meaning of Translational Research and Why It Matters, Journal of the American Medical Association, 229 (2),
13 Thank you! Questions or comments?
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