Goal 3: Advance Translational Research

Improving Evidence-Based Care

By integrating disease orientation and diagnostic classification (e.g., ICD-10 with time-honored treatments) with endotype analysis, will translation of evidence-based care be improved?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

-1 net votes
8 up votes
9 down votes
Active

Goal 2: Reduce Human Disease

Evidence-based holistic care for sickle cell disease

What are the best, evidence-based models to facilitate holistic care across the lifespan for individuals living with sickle cell?

Submitted by (@sicklecellwarrior)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Unless an individual is a candidate for transplantation, sickle cell will be a lifelong challenge. Much effort has been focused in the pediatric area and on physical aspects of the disease. However, adult care and mental/psycho-social health have not been adequately addressed. A holistic approach across the lifespan would fill these gaps and perhaps lead to better health outcomes and addresses NHLBI's goal of reducing the burden of human disease.

Name of idea submitter and other team members who worked on this idea : Sickle Cell Warriors, Inc. community members

Voting

26 net votes
40 up votes
14 down votes
Active

Goal 3: Advance Translational Research

Efficient Evidence-Based Practice

How can we most efficiently utilize limited resources/manpower to facilitate adherence to evidence-based practices and enhance public health?

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

5 net votes
14 up votes
9 down votes
Active

Goal 3: Advance Translational Research

Advancing the science of translating evidence into practice

What are the best ways for the NHLBI to advance the evolving science of translating robust evidence into clinical practice domestically and globally? How to personalize broad research evidence for individual patients? How to predict and evaluate the impact of evidence-based interventions? How to identify implementation methods available in industry and elsewhere that work best and are most translatable in healthcare? ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Reduce mortality and morbidity

• Improved quality of life

• Higher proportion of people receiving evidence-based care and at goal for that care

• Reduced disparities in health and healthcare

Feasibility and challenges of addressing this CQ or CC :

Challenges:

• Lack of research methodology in this area – may need new scientific approaches

 

• Lack of current capacities and capabilities in this area

 

• Current silos that separate research enterprise from industry, as well as NHLBI from other ICs

 

• Divisions between performance of clinical trials and implementation research

 

• Lack of clarity which federal agencies and NIH Institutes are ‘in charge’ of implementation and/or prioritize this as part of their mission and budget

 

• Lack of wide sharing of best practices of other implementation models

 

• Improving the science in this area needs to include methods and metrics development

 

• The accumulated knowledge of clinical trialists and implementation researchers is often not shared

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

13 net votes
27 up votes
14 down votes
Active

Goal 3: Advance Translational Research

Addressing the barriers to the development, adoption of, and adherence to evidence based practices

How do we better understand patient and provider behaviors, as well as health system, community, and socio-cultural factors to effectively address the barriers to the development, adoption of, and adherence to evidence based practices?

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Higher proportion of people receiving evidence-based care and at goal for that care

• Design better interventions

Feasibility and challenges of addressing this CQ or CC :

• Need for interdisciplinary team science

• Lack of understanding of how personal beliefs and cultural impact on health

• Separation of health care and policy communities

• Payers and politics negatively impacting implementation in health care

• Barriers in accessing insurance and health system databases

• Need engagement, education, and participation of individuals and the public in improving personal and public health and knowledge about the importance of implementation research

• Best practices for recruitment and enrollment

• Current clinical trial structure (need to incentivize ‘soldiers’)

• Need detailed phenotyping within diseases

• Tools to predict non-responders

• Translating best practices of other models (e.g. COG, share clinical trial methodology knowledge)

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

7 net votes
23 up votes
16 down votes
Active

Goal 3: Advance Translational Research

Culturally competent T4 research interventions to reduce heart, lung, blood, sleep

Using previous federal and partner infrastructure, what are the best methods to promote culturally competent T4 interventions that will reduce cardiopulmonary risk factors in global populations with a disproportionate burden of heart, lung, blood, sleep diseases?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Reduction of cardiopulmonary risk factors

Reduction of health inequities

Feasibility and challenges of addressing this CQ or CC :

Proven, evidence-based interventions exist for common diseases that can be adapted to reduce burden in low resource settings.

However,determining the best way to adapt existing interventions that are culturally competent and effective is a sensitive issue.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

-7 net votes
9 up votes
16 down votes
Active

Goal 3: Advance Translational Research

Improving heart, lung, blood, sleep Health Outcomes for Minority and Underserved Men

What are the best strategies to improve implementation of evidence-based practices (EBP) to enhance effective health risk communication strategies among racial and ethnic minority males and underserved men? Examples of several issues that need to be addressed are: • Need for better definition of the role of families/communities in EBP (as co-therapists). • Requires less system fragmentation • Need for improved measurement, ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Our improved ability to develop, implement and disseminate EBPs tailored specifically for men in health disparity populations may help us move beyond current obstacles in addressing health inequities and improve health outcomes.

Some current challenges:

• High blood pressure affects more than 40 percent of African Americans.

• The odds for stroke, the third leading cause of death in the United States, are especially high for African American men at 70%.

• African Americans are about 50% more likely to experience stroke than Caucasians.

• Sleep apnea is seen more frequent among men than among women, particularly among African-American and Hispanic men.

• Life expectancy for African American men is 4.7 years less than for white men (2010).

• Native American men have an average life expectancy of 71 years old compared to white men who have an average life expectancy of 76.5 year.

Feasibility and challenges of addressing this CQ or CC :

• Shifting demographics of race as well as ageing of the population in this country will have a major impact on the utilization, organization and delivery of health care.

• Country acknowledges significant economic burden of health inequities in the U.S. in the near future.

• Hospitals and health systems are working hard to align quality improvement goals with disparities solutions. Opportunity to leverage these efforts for the development and implementation of targeted health disparities initiatives is timely.

• HL has a number of large population-based studies (such as JHS, Strong Heart, Hispanic Community Health) that could be leveraged to specifically identify EBP for wider implementation and dissemination to underserved areas.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

14 net votes
32 up votes
18 down votes
Active

Goal 3: Advance Translational Research

Implementation of Evidence-based Guidelines in LMICs

How can implementation strategies be tested in low and middle income countries for contextually and culturally adapted evidence-based clinical care guidelines with a focus on prevalent non-communicable diseases with large burdens such as sickle cell disease, hypertension, heart disease, stroke, asthma, and COPD?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Evidence-based guidelines for heart, lung, and blood diseases, developed within high income countries are challenging to implement within low and middle income countries because delivery capacity and health care infrastructure is often limited. Contextually, culturally and language adapted guidelines implementable within low and middle income countries can impart substantial benefit while distributing more evenly global knowledge of proven effective interventions while improving health equity. Proven effective interventions would get delivered in an effective manner across low and middle income countries which will improve heart, lung, and blood health outcomes.

Feasibility and challenges of addressing this CQ or CC :

The NHLBI Global Health Think Tank recommended research on implementation of contextually, culturally and language-adapted clinical care guidelines in low and middle income countries and encouraged addressing this issue in the near future.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

-10 net votes
8 up votes
18 down votes
Active

Goal 3: Advance Translational Research

Harnessing the ongoing ‘natural experiments’ of quality improvement

How do we harness the ongoing “natural experiments” of quality improvement (QI) activities in various healthcare systems to facilitate hypothesis-driven research, improve scientific validity to address questions in clinical trials, and implement and disseminate research results? • Current restrictions in human subjects research regulations • Diversity in approaches and methodology rigor to QI initiatives across different ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Publication of QI initiatives in peer-review journals

• Wider dissemination and adoption of best practices

• Establishment of methodologically rigorous QI programs with viable career pathways

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

-2 net votes
11 up votes
13 down votes
Active

Goal 3: Advance Translational Research

Facilitation of adoption of evidence-based guidelines in clinical practice for CVD risk factor identification and treatment

Multiple factors contribute to the high mortality from heart and vascular diseases in our population, most prominently genetics, patient behavior, care access, and care quality. Historically, interventions have targeted patient behaviors. Though access remains a problem, those who do receive care may not be getting the best of care based on the evidence. A focus on increasing practitioner adoption of evidence-based ...more »

Submitted by (@rubybenjamingarner)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Wide-spread adoption of evidence-based guidelines could lead to consistency in quality care across sociodemographic subgroups of the population, which could contribute to a reduction in disparities in outcomes, including mortality.

Feasibility and challenges of addressing this CQ or CC :

Interventions to improve quality of care are feasible; however, the real-world of clinical practice presents a challenge, particularly in settings of high patient volume with issues of time constraints. Intervention would need to address these and other issues .

Name of idea submitter and other team members who worked on this idea : Ruby Benjamin-Garner

Voting

1 net vote
3 up votes
2 down votes
Active

Goal 3: Advance Translational Research

Best Implementation Strategies

What are the best implementation strategies to improve adherence to clinical practice guidelines, protocols, and other evidence-based practices that actually lead to the elimination of inequities in preventable disability and death from heart, lung, blood, and sleep diseases?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

12 net votes
20 up votes
8 down votes
Active