writing implementation research grant proposals

Writing implementation research grant proposals: 10 key ingredients...and a few reflections

Writing implementation research grant proposals: 10 key ingredients...and a few reflections Russell E. Glasgow Materials adapted from a) Enola Proctor and Washington Univ. colleagues b) Univ. of Colorado School of Medicine ACCORDS D&I Program NIH/Academy Health Technical Assistance, Dec. 2017

Session overview Challenges facing D&I Ten tips for D&I grant writing Additional reflections and recommendations Importance of working with program staff Proctor et al. Writing implementation research grants. Implementation Sci. 2012 7:96 Brownson et al. Successful grant application writing. Clin Transl Sci. 2015 Dec;8(6):710-6. http://www.crispebooks.org/difundingtips

Challenges universal to all grant writers How to successfully communicate: How your proposal is innovative and state of the science Why you and your team should be funded at this time That you can complete the study as proposed

Additional challenges for implementation science researchers Rising scientific bar: Science of implementation demands moving beyond documentation of barriers and facilitators Implementation research is complex, contextual & complicated Literature scattered across disciplines Implementation science is setting specific, but must advance generalizable science Addressing both internal and external validity Brownson, Proctor, & Colditz. Dissem & Impl Research in Health. Oxford: 2017 (2 nd ed.) Glasgow et al. NIH approaches to D&I science. Am J Public Health. 2012;102:1274 1281.

Most important The Question Aims and Approach Talk with Program Officer

Presuming a Compelling Question Ten Key Ingredients of a Competitive D&I Grant Application (no application will have all 10)

1. Need for improvement.reducing gap between care that is and could be Contribution: Project s public health significance & impact Important to demonstrate: Poor health services or wide variation Potential to improve care through proposed work How? SUCCINCT Literature review Preliminary data

2. Evidence-based intervention to be implemented Demonstrate: Strong evidence* of efficacy and/or effectiveness Cochrane or other systematic review (ideally also pragamtism/precis) Ready for implementation How your proposal is different or contributes to what already known How? SUCCINCT Literature review Preliminary data *Mehta et al. Tyranny of evidence. In A. Plough (ed.). Knowledge to action. Oxford, 2017

3. Conceptual model/ theoretical framework Selection and Contribution: Why this model is applicable (and not others) Innovation for implementation science Scientific impact & generalizable knowledge gain Justifies key variables to be tested How? Published papers using the model Use the theory throughout proposal methods, measures, hypotheses, analyses! Tabak et al. Models for dissemination and implementation research. Am J Prev Med. 2012;43(3):337-50 Dissemination-implementation.org

4. Stakeholder priorities, engagement in change & study Contribution: Significance, impact, & feasibility of success. - Meaningful involvement THROUGHOUT and with MULTIPLE stakeholders, at different levels (patients, staff, decision makers) How? Preliminary data (qualitative, quantitative) Evidence of current and past partnerships (joint publications) Method details (partnered research) Letters- unique (not form letters) and from key decision makers

5. Setting s readiness to adopt new intervention Contribution: Scientific generalizabilty & impact Shows PI knowledge of study setting Minor caveat- if large scale (e.g., national) dissemination, may want to take settings with a range of readiness How to convey? Preliminary data Letters from specific organizations and national coordinating or professional organizations

6. Implementation strategy/process The observed/introduced change STRATEGY Contribution: Public health significance Impact Feasibility- address likely challenges How? Detail in planned approach- differentiate impl. strategy vs. Interv. Literature cited Preliminary studies Specify, provide manuals

7. Team experience w/ setting, treatment, implementation Contribution: How? Feasibility Capacity to complete study as proposed, including experience addressing expertise, recruitment, diversity, attrition Build team, cite work Describe relevant experience in preliminary studies Personalized Biosketches, adequate budget justifications Personalized, unique letters of support

8. Feasibility of proposed research design & methods Value: Conveys- Feasibility of completing study as proposed Investigator capacity (understanding of unique D&I issues and challenges) Balance of internal and external validity How? Detailed approach section- save space for this! Address choice junctures & contingencies Preliminary recruitment & enrollment data Letters (re: willingness to be randomized)

9. Measurement and analysis detail Contribution: How? Approach Feasibility of completing study as proposed Relates to theory; advances measurement science Detailed measurement plan- PRAGMATIC measures* Variation data and well-justified power analysis Unit of analysis specified & consistent Specified analyses that will exploit data and answer Q s Glasgow & Riley. Pragmatic measures. Am J Prev Med 2013;45(2):237 243 Kroenke, Monohan & Kean Pragmatic charac.of PROs. J Clin Epidemiol. 2015; 68(9): 1085 92.

10. Policy environment will leverage, support, sustain the change Contribution: How? Public health significance and impact Sustainability Feasibility- including costs, resources and burden- to both participants and settings Background literature on adaptations and sustainability models and research Fit with changing context; feasible and sustainable in these settings Letters with strong, specific commitment to continue Resources & Environment Chambers, Glasgow & Stange. Dynamic sustainability framework. Implementation Science 2013, 8:117 Wiltsey Stirman et al. Sustainability syst. review. Implementation Science 2012, 7:17

Can t fit it all in! Relative importance in eyes of experienced reviewers? The Questions, the Aims, and Approach, Approach, Approach Most essential: Background of Evidence based Tx to be implemented Methods and the team s experience with setting/tx/ implementation strategies and process Research environment s capacity to support IR

How to address these challenges? Make strategic use of all grant application parts...especially Aims and summary Draw on your experiences and unique strengths pilot studies work & research training experiences Caveat: Not every application can/should include equal detail on each component Brownson. Video on aims. https://www.youtube.com/watch?v=twkt2cl7z6o

Russ s Reflections and Biases Work with your program officer- contact multiple ones if needed Importance of Aims and Abstract- for both assignment and reviewers initial impression Tables and Figures- clarify and worth a lot of points Address tough decisions and weaknesses head-on Consider using PRECIS-2 Figure Consider using Standard Reporting for Research in Implementation (StaRI) reporting criteria Loudon et al. (2015). The PRECIS-2 tool: designing trials that are fit for purpose. BMJ, 350, h2147. Pinnock et al. StaRI statement. BMJ Open, doi:10.1136/bmjopen-2016-013318)

https://www.precis-2.org/

StaRI Reporting Criteria 27 criteria- includes almost all CONSORT items... PLUS: Implementation Strategy Implementation Outcome(s) Logic Pathway Context and Representativeness Fidelity Harms and Unintended Consequences Context Changes Adaptations* Costs and Resources Used Policy Implications Pinnock et al. StaRI statement. BMJ Open, doi:10.1136/bmjopen-2016-013318) *Chambers & Norton. The Adaptome. Am J Prev Med. 2016;51(4):S124 S131

Acknowledgments and Key Resources Enola Proctor, Ross Brownson, Ana Bauman and team at Washington University Proctor et al. Writing IR grants. Implementation Sci 2012 7:96 Brownson et al. Successful grant application writing. Clin Transl Sci. 2015 Dec;8(6):710-6. NIH Program Officers Univ. of Colorado School of Medicine ACCORDS D&I team: https://goo.gl/84epnd http://www.crispebooks.org/difundingtips

WORKSHOP ON WRITING WINNING PROPOSALS FOR THE FUNDAMENTAL RESEARCH GRANTS SCHEME (FRGS) 2021

Rmc iium kuantan campus was live..