Implementation of evidence-based mental health assessment and intervention in community public health practice is a high priority for multiple stakeholders. Academic-community partnerships can assist in the implementation of efficacious treatments in community settings; yet, little is known about the processes by which these collaborations are developed. In this paper, we discuss our application of community-based participatory research (CBPR) approach to implementation, and we present six lessons we have learned from the establishment of an academic-community partnership.
With older adults with psychosis as a focus, we have developed a partnership between a university research center and a public mental health service system based on CBPR. The long-term goal of the partnership is to collaboratively establish an evidence-based implementation network that is sustainable within the public mental healthcare system.
In building a sustainable partnership, we found that the following lessons were instrumental: changing attitudes; sharing staff; expecting obstacles and formalizing solutions; monitoring and evaluating; adapting and adjusting; and taking advantage of emerging opportunities. Some of these lessons were previously known principles that were modified as the result of the CBPR process, while some lessons derived directly from the interactive process of forming the partnership.
The process of forming of academic-public partnerships is challenging and time consuming, yet crucial for the development and implementation of state-of-the-art approaches to assessment and interventions to improve the functioning and quality of life for persons with serious mental illnesses. These partnerships provide necessary organizational support to facilitate the implementation of clinical research findings in community practice benefiting consumers, researchers, and providers.
Broad-based community partnerships are seen as an effective way of addressing many community, health issues, but the partnership approach has had relatively limited success in producing measurable improvements in long-term health outcomes. One potential reason, among many, for this lack of success is a mismatch between the goals of the partnership, and its structure/membership. This article reports on an exploratory, empirical analysis relating the structure of partnerships to the types of issues they address. A qualitative analysis of 34 “successful” community health partnerships, produced two relatively clear patterns relating partnership goals to structurel membership: (1) “collaboration-oriented” partnerships that included substantial resident involvement and focused on broader determinants of health with interventions aimed at producing immediate, concrete community improvements; and (2) “issueoriented” partnerships that focused on a single, typically health-related issue with multilevel interventions that included a focus on higher-level systems and policy change. Issue-oriented partnerships tended to have larger organizations governing the partnership with resident input obtained in other ways. The implication of these results, if confirmed by further research, is that funders and organizers of community health partnerships may need to pay closer attention to the alignment between, the membership/structure of a community partnership and its goals particularly with respect to the involvement of community residents.
Collaboration; Community health partnerships; Community-based health promotion; Resident involvement
Development and implementation of non-communicable disease (NCD) prevention polices in the developing countries is a multidimensional challenge. This article highlights the evolution of a strategic approach in Pakistan. The model is evidence-based and encompasses a concerted and integrated approach to NCDs. It has been modelled to impact a set of indicators through the combination of a range of actions capitalizing on the strengths of a public-private partnership. The paper highlights the merits and limitations of this approach. The experience outlines a number of clear imperatives for fostering an enabling environment for integrated NCD prevention public health models, which involve roles played by a range of stakeholders. It also highlights the value that such partnership arrangements bring in facilitating the mission and mandates of ministries of health, international agencies with global health mandates, and the non-profit private sector. The experience is of relevance to developing countries that have NCD programs running and those that need to develop them. It provides an empirical basis for enhancing the performance of the health system by fostering partnerships within integrated evidence-based models and permits an analysis of health systems models built on shared responsibility for the purpose of providing sustainable health outcomes.
Community-based participatory research (CBPR) is an approach to scientific research that is gaining broader application to address persistent problems in health care disparities and other hypothesis-driven research. However, information on how to form CBPR community-academic partnerships and how to best involve community partners in scientific research is not well-defined. The purpose of this paper is to share the experience of the Partnership for Improving Lifestyle Interventions (PILI) `Ohana Project in forming a co-equal CBPR community-academic partnership that involved 5 different community partners in a scientific research study to address obesity disparities in Native Hawaiians and other Pacific Peoples (i.e., Samoans, Chuukese, and Filipinos). Specifically, the paper discusses 1) the formation of our community-academic partnership including identification of the research topic; 2) the development of the CBPR infrastructure to foster a sustainable co-equal research environment; and 3) the collaboration in designing a community-based and community-led intervention. The paper concludes with a brief summary of the authors' thoughts about CBPR partnerships from both the academic and community perspectives.
Reducing mental health disparities among underserved populations, particularly African American elders, is an important public health priority. The authors describe the process and challenges of developing a community/academic research partnership to address these disparities.
The authors are using a Community-Based Participatory Research approach to gain access to underserved populations in need of depression treatment. The authors identify six stages: 1) Collaborating to Secure Funding; 2) Building a Communications Platform and Research Infrastructure; 3) Fostering Enduring Relationships; 4) Assessing Needs/Educating about Research Process; 5) Initiating Specific Collaborative Projects (meeting mutual needs/interests); and 6) Maintaining a Sustainable and Productive Partnership. Data from a needs assessment developed collaboratively by researchers and community agencies facilitated agreement on mutual research goals, while strengthening the partnership.
A community/academic-based partnership with a solid research infrastructure has been established and maintained for 3 years. Using the results of a needs assessment, the working partnership prioritized and launched several projects. Through interviews and questionnaires, community partners identified best practices for researchers working in the community. Future research and interventional projects have been developed, including plans for sustainability that will eventually shift more responsibility from the academic institution to the community agencies.
To reach underserved populations by developing and implementing models of more effective mental health treatment, it is vital to engage community agencies offering services to this population. A successful partnership requires “cultural humility,” collaborative efforts, and the development of flexible protocols to accommodate diverse communities.
Community partnerships; depression; community-based participatory research
Various rural prevention research challenges have been articulated through a series of sessions convened since the mid 1990s by the National Institutes of Health, particularly the National Institute on Drug Abuse. Salient in this articulation was the need for effective collaboration among rural practitioners and scientists, with special consideration of accommodating the diversity of rural areas and surmounting barriers to implementation of evidence-based interventions. This paper summarizes the range of challenges in rural prevention research and describes an evolving community-university partnership model addressing them. The model entails involvement of public school staff and other rural community stakeholders, linked with scientists by Land Grant University-based Extension system staff. Examples of findings from over 16 years of partnership-based intervention research projects include those on engagement of rural residents, quality implementation of evidence-based interventions, and long-term community-level outcomes, as well as factors in effectiveness of the partnerships. Findings suggest a future focus on building capacity for practitioner-scientist collaboration and developing a network for more widespread implementation of the partnership model in a manner informed by lessons learned from partnership-based research to date.
A partnership between health services researchers from Queen’s University and the University of Ottawa, a community nursing agency and a home care authority in Ottawa led to major improvements in the quality of care for people with leg ulcers. The synthesis of both external and local evidence played a key role in the adoption of an evidence-based protocol and provided the critical context to support a significant reorganization of the existing service delivery model. This case demonstrates that, with a collaborative partnership approach, systematic and transparent research processes can be rapidly developed to support policy change.
Partnerships are increasingly common in conducting research. However, there is little published evidence about processes in research-policy partnerships in different contexts. This paper contributes to filling this gap by analysing experiences of research-policy partnerships between Ministries of Health and research organisations for the implementation of the Mental Health and Poverty Project in Ghana, South Africa, Uganda and Zambia.
A conceptual framework for understanding and assessing research-policy partnerships was developed and guided this study. The data collection methods for this qualitative study included semi-structured interviews with Ministry of Health Partners (MOHPs) and Research Partners (RPs) in each country.
The term partnership was perceived by the partners as a collaboration involving mutually-agreed goals and objectives. The principles of trust, openness, equality and mutual respect were identified as constituting the core of partnerships. The MOHPs and RPs had clearly defined roles, with the MOHPs largely providing political support and RPs leading the research agenda. Different influences affected partnerships. At the individual level, personal relationships and ability to compromise within partnerships were seen as important. At the organisational level, the main influences included the degree of formalisation of roles and responsibilities and the internal structures and procedures affecting decision-making. At the contextual level, political environment and the degree of health system decentralisation affected partnerships.
Several lessons can be learned from these experiences. Taking account of influences on the partnership at individual, organisation and contextual/system levels can increase its effectiveness. A common understanding of mutually-agreed goals and objectives of the partnership is essential. It is important to give attention to the processes of initiating and maintaining partnerships, based on clear roles, responsibilities and commitment of parties at different levels. Although partnerships are often established for a specific purpose, such as carrying out a particular project, the effects of partnership go beyond a particular initiative.
Partnership; Mental health; Africa; Research-policy; Ministry of health
The Kenya Partnership for Health (KPH) program began in 1999, and is currently one of the 12 field projects participating in the WHO's 'Towards Unity for Health initiative' implemented to develop partnership synergies in support of the Primary Health Care (PHC) approach .
This paper illustrates how Program-linked Information Management by Integrative-participatory Research Approach (PIMIRA) as practised under KPH has been implemented within Trans-Nzoia District, Kenya to enhance community-based health initiatives. It shows how this model is strategically being scaled-up from one community to another in the management of political, social, cultural and economic determinants (barriers and enhancers) of health.
Target rural communities in the development of a community-based health information management and feedback initiatives that can provide insights on the social, cultural, political and economic determinants of health for utilization in informed health service management.
Key Findings and Achievements
1. Cues for health seeking and health service utilization are determined by the social, cultural, political and economic factors as seen by the individual and as defined by the community but not due to the pathological nature of the illness.
2. Establishment of community-based health surveillance and health action initiatives as the best practices in transferring health as a resource that can be 'owned and guarded' by the community.
3. Establishment of Healthy Villages Initiative (HVI) through which health service delivery and scale-up can be sustained at the community level.
4. Provision of actionable health information necessary for health planning and evaluation of preventive health programs thorough PIMIRA.
It has been realized that for every one person who visits a health facility for medication, there are nine others who had the same condition but sought health care from other sources including self-medication and five others who never sought health care. Innovative means of involving the community in health information management and utilization such as PIMIRA are hence the best ways of guaranteeing equitable delivery of health services that are accessible and sustainable by the community.
built-in health information management; communities' health needs; service-linked data; social; cultural; political and economic determinants of health; community-based health information management; community-based health surveillance; health seeking behaviour; Healthy Villages Initiative
Integrating mental health and public health chronic disease programs requires partnerships at all government levels. Four examples illustrate this approach: 1) a federal partnership to implement mental health and mental illness modules in the Behavioral Risk Factor Surveillance System; 2) a state partnership to improve diabetes health outcomes for people with mental illness; 3) a community-level example of a partnership with local aging and disability agencies to modify a home health service to reduce depression and improve quality of life among isolated, chronically ill seniors; and 4) a second community-level example of a partnership to promote depression screening and management and secure coverage in primary care settings. Integration of mental health and chronic disease public health programs is a challenging but essential and achievable task in protecting Americans' health.
There is a growing consensus that the response to complex and difficult social problems—being the convergence of ageing and disability one of them– requires public agencies to be prepared to work in partnership with other public, civil society and business organisations. However, initiatives aimed at promoting health and social care providers working in partnership have had limited success so far.
To provide an analytical framework to assess the different kinds of organisational strategies to promote cross-sector collaboration.
The paper draws on empirical research studies in the fields of organization theory and public governance. At a macro level, it refers to the changing role of governments in advanced democracies and the emergence of the relational state as a response to the crisis of the welfare state. At a micro level, it discusses the different modes of non-hierarchical coordination between organisations (or horizontal coordination) as well as the different types of partnerships, their governance forms (market, hierarchy or network) and their organisational and institutional implications (e.g. organisational values, resources and capabilities needed, legal framework and incentives for collaboration).
There are significant obstacles and barriers to cross-sector collaboration which arise from the nature of the different organisations involved (policy domain, public or private status, geographical scope of activity, dominant professional group), their endowment in terms of resources and organisational capabilities, and the institutional framework that regulates their interplay. There is not such a thing as ‘one best way’ to achieve effective collaboration; instead decision-makers have a range of alternative collaboration arrangements, hence the importance of making the right choices and designing context-specific relational strategies.
relational strategies; horizontal coordination; cross-sector partnerships; network governance
With growing interest in the CBPR approach to cancer health disparities research, mechanisms are needed to support adherence to its principles. The Carolina Community Network (CCN), 1 of 25 Community Network Programs funded by the National Cancer Institute (NCI), developed a model for providing funds to community-based organizations.
This paper presents the rationale and structure of a Community Grants Program (CGP) model, describes the steps taken to implement the program, and discusses the lessons learned and recommendations for using the grants model for CBPR.
Three types of projects—cancer education, implementation of an evidence-based intervention, and the development of community–academic research partnerships—could be supported by a community grant. The CGP consists of four phases: Pre-award, peer-review process, post-award, and project implementation.
The CGP serves as a catalyst for developing and maintaining community–academic partnerships through its incorporation of CBPR principles.
Providing small grants to community-based organizations can identify organizations to serve as community research partners, fostering the CBPR approach in the development of community–academic partnerships by sharing resources and building capacity.
NCI’s Community Networks Program; cancer health disparities; community-based participatory research; community–academic research partnerships; microgrants
This study describes the partner selection process in 15 U.S. communities developing community-researcher partnerships for the Connect to Protect® (C2P): Partnerships for Youth Prevention Interventions, an initiative of the Adolescent Trials Network for HIV/AIDS Interventions.
Each site generated an epidemiological profile of urban youth in their community, selected a focus population and geographic area of youth at risk for HIV, conducted a series of successive structured interviews, and engaged in a process of relationship-building efforts culminating in a collaborative network of community agencies.
Sites chose as their primary target population young women who have sex with men (n=8 sites), young men who have sex with men (n=6), and intravenous drug users (n=1). Of 1,162 agencies initially interviewed, 281 of 335 approached (84%) agreed to join the partnership (average 19/site). A diverse array of community agencies were represented in the final collaborative network; specific characteristics included: 93% served the sites' target population, 54% were predominantly youth-oriented, 59% were located in the geographical area of focus, and 39% reported provision of HIV/STI prevention services. Relationship-building activities, development of collaborative relationships, and lessons learned, including barriers and facilitators to partnership, are also described.
Study findings address a major gap in the community partner research literature. Health researchers and policy makers need an effective partner selection framework whereby community-researcher partnerships can develop a solid foundation to address public health concerns.
Collaboration; Coalition; Community Involvement; Partnership Selection; Community Researcher Partnership; Neighborhood Collaboratives
Governments may be overwhelmed by a large-scale public health emergency, such as a massive bioterrorist attack or natural disaster, requiring collaboration with businesses and other community partners to respond effectively. In Georgia, public health officials and members of the Business Executives for National Security have successfully collaborated to develop and test procedures for dispensing medications from the Strategic National Stockpile. Lessons learned from this collaboration should be useful to other public health and business leaders interested in developing similar partnerships.
The authors conducted a case study based on interviews with 26 government, business, and academic participants in this collaboration.
The partnership is based on shared objectives to protect public health and assure community cohesion in the wake of a large-scale disaster, on the recognition that acting alone neither public health agencies nor businesses are likely to manage such a response successfully, and on the realization that business and community continuity are intertwined. The partnership has required participants to acknowledge and address multiple challenges, including differences in business and government cultures and operational constraints, such as concerns about the confidentiality of shared information, liability, and the limits of volunteerism. The partnership has been facilitated by a business model based on defining shared objectives, identifying mutual needs and vulnerabilities, developing carefully-defined projects, and evaluating proposed project methods through exercise testing. Through collaborative engagement in progressively more complex projects, increasing trust and understanding have enabled the partners to make significant progress in addressing these challenges.
As a result of this partnership, essential relationships have been established, substantial private resources and capabilities have been engaged in government preparedness programs, and a model for collaborative, emergency mass dispensing of pharmaceuticals has been developed, tested, and slated for expansion. The lessons learned from this collaboration in Georgia should be considered by other government and business leaders seeking to develop similar partnerships.
Partnerships between different health services are integral to addressing the complex health needs of vulnerable populations. In Australia, partnerships between Aboriginal1 community controlled and mainstream services can extend health care options and improve the cultural safety of services. However, although government funding supports such collaborations, many factors can cause these arrangements to be tenuous, impacting the quality of health care received. Research was undertaken to explore the challenges and enhancers of a government initiated service partnership between an Aboriginal Community Controlled alcohol and drug service and three mainstream alcohol rehabilitation and support services.
Sixteen staff including senior managers (n=5), clinical team leaders (n=5) and counsellors (n=6) from the four services were purposively recruited and interviewed. Interviews were semi-structured and explored staff experience of the partnership including the client intake and referral process, shared client care, inter-service communication and ways of working.
Results & discussion
Communication issues, partner unfamiliarity, ‘mainstreaming’ of Aboriginal funding, divergent views regarding staff competencies, client referral issues, staff turnover and different ways of working emerged as issues, emphasizing the challenges of working with a population with complex issues in a persistent climate of limited resourcing. Factors enhancing the partnership included adding a richness and diversity to treatment possibilities and opportunities to explore different, more culturally appropriate ways of working.
While the literature strongly advises partnerships be suitably mature before commencing service delivery, the reality of funding cycles may require partnerships become operational before relationships are adequately consolidated. Allowing sufficient time and funding for both the operation and relational aspects of a partnership is critical, with support for partners to regularly meet and workshop arrangements. Documentation that makes clear and embeds working arrangements between partners is important to ameliorate many of the issues that can arise. Given the historical undercurrents, flexible approaches are required to focus on strengths that contribute to progress, even if incremental, rather than on weaknesses which can undermine efforts. This research offers important lessons to assist other services collaborating in post-colonial settings to offer treatment pathways for vulnerable populations.
Aboriginal; Mainstream; Vulnerable populations; Partnerships; Health services
Although partnerships between park and recreation agencies and health agencies are prevalent, little research has examined partnership characteristics and effectiveness among communities of different sizes. The objective of this study was to determine whether park and recreation leaders’ perceptions of partnership characteristics, effectiveness, and outcomes vary by community size.
A web-based survey was completed in 2007 by 1,217 National Recreation and Park Association members. Community size was divided into 4 categories: very small, small, medium, and large. Questions measured agencies’ recognition of the need for partnerships, their level of experience, and the effectiveness and outcomes of partnerships.
Larger communities were significantly more likely to recognize the need for and have more experience with partnerships than smaller communities. Very small and large communities partnered significantly more often with senior services, nonprofit health promotion agencies, and public health agencies than did small and medium ones. Large and small communities were significantly more likely than very small and medium communities to agree that their decision making in partnerships is inclusive and that they have clearly defined goals and objectives. Large communities were significantly more likely than very small communities to report that their partnership helped leverage resources, make policy changes, meet their mission statement, and link to funding opportunities.
Community size shapes partnership practices, effectiveness, and outcomes. Very small communities are disadvantaged in developing and managing health partnerships. Increasing education, training, and funding opportunities for small and rural park and recreation agencies may enable them to more effectively partner with organizations to address community health concerns.
This article describes the work of the East Side Village Health Worker Partnership as a case study of an initiative that seeks to reduce the disproportionate health risks experienced by residents of Detroit's east side. The Partnership is a community-based participatory research and intervention collaboration among academia, public health practitioners, and the east side Detroit community. The Partnership is guided by a steering committee that is actively involved in all aspects of the research, intervention, and dissemination process, made up of representatives of five community-based organizations, residents of Detroit's east side, the local health department, a managed care provider, and an academic institution. The major goal of the East Side Village Health Worker Partnership is to address the social determinants of health on Detroit's east side, using a lay health advisor intervention approach. Data collected from 1996 to 2001 are used here to describe improvements in research methods, practice activities, and community relationships that emerged through this academic-practice-community linkage.
Concerns about the appropriate use of EBP with ethnic minority clients and the ability of community agencies to implement and sustain EBP persist and emphasize the need for community-academic research partnerships that can be used to develop, adapt, and test culturally responsive EBP in community settings. In this paper, we describe the processes of developing a community-academic partnership that implemented and pilot tested an evidence-based telephone cognitive behavioral therapy program. Originally demonstrated to be effective for urban, middle-income, English-speaking primary care patients with major depression, the program was adapted and pilot tested for use with rural, uninsured, low-income, Latino (primarily Spanish-speaking) primary care patients with major depressive disorder in a primary care site in a community health center in rural Eastern Washington. The values of community-based participatory research and community-partnered participatory research informed each phase of this randomized clinical trial and the development of a community-academic partnership. Information regarding this partnership may guide future community practice, research, implementation, and workforce development efforts to address mental health disparities by implementing culturally tailored EBP in underserved communities.
This paper describes the application of a university-community partnership model to the problem of adapting evidence-based treatment approaches in a community mental health setting. Background on partnership research is presented, with consideration of methodological and practical issues related to this kind of research. Then, a rationale for using partnerships as a basis for conducting mental health treatment research is presented. Finally, an ongoing partnership research project concerned with the adaptation of evidence-based mental health treatments for childhood internalizing problems in community settings is presented, with preliminary results of the ongoing effort discussed.
effectiveness research; partnership research; children’s mental health; evidence-based treatments
Women with substance use issues and their children have unique needs that are best met through collaborative and coordinated service delivery offered by a variety of agencies. However, in Canada and elsewhere, services tend to be fragmented and fail to address children’s needs. This study aimed to describe the partnership patterns, activities, and qualities among Canadian agencies serving women with addictions and to determine predictors of partnerships. We found that a number of partnerships exist, and that the extent and characteristics of these partnerships vary. Agency responsiveness to clients was predictive of sending referrals whereas friendliness predicted joint programming and consultation. Four central agencies played key linkage roles. Efforts should be made to build on the social capital inherent in these agencies to strengthen existing networks, further develop linkages to improve service delivery, and promote evidence-informed practice in a field where there is an identified research-practice gap.
Substance abuse; Women; Agency partnerships; Service collaboration; Social network analysis
North–South partnerships for health aim to link resources, expertise and local knowledge to create synergy. The literature on such partnerships presents an optimistic view of the promise of partnership on one hand, contrasted by pessimistic depictions of practice on the other. Case studies are called for to provide a more intricate understanding of partnership functioning, especially viewed from the Southern perspective. This case study examined the experience of the Tanzanian women's NGO, KIWAKKUKI, based on its long history of partnerships with Northern organizations, all addressing HIV/AIDS in the Kilimanjaro region. KIWAKKUKI has provided education and other services since its inception in 1990 and has grown to include a grassroots network of >6000 local members. Using the Bergen Model of Collaborative Functioning, the experience of KIWAKKUKI's partnership successes and failures was mapped. The findings demonstrate that even in effective partnerships, both positive and negative processes are evident. It was also observed that KIWAKKUKI's partnership breakdowns were not strictly negative, as they provided lessons which the organization took into account when entering subsequent partnerships. The study highlights the importance of acknowledging and reporting on both positive and negative processes to maximize learning in North–South partnerships.
synergy; partnership; Africa; HIV/AIDS
This paper examines the challenges and opportunities in establishing and sustaining north–south research partnerships in Africa through a case study of the UK-Africa Academic Partnership on Chronic Disease. Established in 2006 with seed funding from the British Academy, the partnership aimed to bring together multidisciplinary chronic disease researchers based in the UK and Africa to collaborate on research, inform policymaking, train and support postgraduates and create a platform for research dissemination. We review the partnership’s achievements and challenges, applying established criteria for developing successful partnerships. During the funded period we achieved major success in creating a platform for research dissemination through international meetings and publications. Other goals, such as engaging in collaborative research and training postgraduates, were not as successfully realised. Enabling factors included trust and respect between core working group members, a shared commitment to achieving partnership goals, and the collective ability to develop creative strategies to overcome funding challenges. Barriers included limited funding, administrative support, and framework for monitoring and evaluating some goals. Chronic disease research partnerships in low-income regions operate within health research, practice, funding and policy environments that prioritise infectious diseases and other pressing public health and developmental challenges. Their long-term sustainability will therefore depend on integrated funding systems that provide a crucial capacity building bridge. Beyond the specific challenges of chronic disease research, we identify social capital, measurable goals, administrative support, creativity and innovation and funding as five key ingredients that are essential for sustaining research partnerships.
This article articulates joint priorities for the fields of prevention science and community psychology. These priorities are intended to address issues raised by the frequent observation of natural tensions between community practitioners and scientists. The first priority is to expand the knowledge base on practitioner–scientist partnerships, particularly on factors associated with positive outcomes within communities. To further articulate this priority, the paper first discusses the rapid growth in community-based partnerships and the emergent research on them. Next described is an illustrative research project on a partnership model that links state university extension and public school delivery systems. The article then turns to the second, related priority of future capacity-building for diffusion of effective partnership-based interventions to achieve larger-scale health and well-being across communities. It outlines two salient tasks: clarification of a conceptual framework and the formulation of a comprehensive capacity-building strategy for diffusion. The comprehensive strategy would require careful attention to the expansion of networks of effective partnerships, partnership-based research agendas, and requisite policy-making.
prevention; community–university partnership; practitioner–scientist; capacity-building; partnership networks; public health; well-being
In response to policy recommendations, nine National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) were established in England in 2008, aiming to create closer working between the health service and higher education and narrow the gap between research and its implementation in practice. The Greater Manchester (GM) CLAHRC is a partnership between the University of Manchester and twenty National Health Service (NHS) trusts, with a five-year mission to improve healthcare and reduce health inequalities for people with cardiovascular conditions. This paper outlines the GM CLAHRC approach to designing and evaluating a large-scale, evidence- and theory-informed, context-sensitive implementation programme.
The paper makes a case for embedding evaluation within the design of the implementation strategy. Empirical, theoretical, and experiential evidence relating to implementation science and methods has been synthesised to formulate eight core principles of the GM CLAHRC implementation strategy, recognising the multi-faceted nature of evidence, the complexity of the implementation process, and the corresponding need to apply approaches that are situationally relevant, responsive, flexible, and collaborative. In turn, these core principles inform the selection of four interrelated building blocks upon which the GM CLAHRC approach to implementation is founded. These determine the organizational processes, structures, and roles utilised by specific GM CLAHRC implementation projects, as well as the approach to researching implementation, and comprise: the Promoting Action on Research Implementation in Health Services (PARIHS) framework; a modified version of the Model for Improvement; multiprofessional teams with designated roles to lead, facilitate, and support the implementation process; and embedded evaluation and learning.
Designing and evaluating a large-scale implementation strategy that can cope with and respond to the local complexities of implementing research evidence into practice is itself complex and challenging. We present an argument for adopting an integrative, co-production approach to planning and evaluating the implementation of research into practice, drawing on an eclectic range of evidence sources.
This article provides a description of a Community/University Collaborative Board, a formalized partnership between representatives from an inner-city community and university-based researchers. This Collaborative Board oversees a number of research projects focused on designing, delivering and testing family-based HIV prevention and mental health focused programs to elementary and junior high school age youth and their families. The Collaborative Board consists of urban parents, school staff members, representatives from community-based agencies and university-based researchers. One research project, the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project) Family Program Study, an urban, family-based HIV prevention project will be used to illustrate how the Collaborative Board oversees a community-based research study. The process of establishing a Collaborative Board, recruiting members and developing subcommittees is described within this article. Examples of specific issues addressed by the Collaborative Board within its subcommittees, Implementation, Finance, Welcome, Research, Grant writing, Curriculum, and Leadership, are detailed in this article along with lessons learned.
Community collaborative board; family-based HIV prevention and mental health; community board recruitment and development; elementary and junior high school age youth and their families