Evaluating systemic changes to support clinical and translational health research.

In evaluation research, "programs" are often conceptualized as clearly bounded, narrow in scope, focused on specific outcomes, using a well-defined linear causal model, and hence, suitable for standard evaluation methods. The evaluation work reported here was carried out in a more challenging context, where large, complex, interwoven systems were targets for change as a means to influence a diffuse array of outcomes. Our evaluation of an NIH-funded program to improve statewide infrastructure for clinical and translational health research ("Advance-CTR") used qualitative data provided by investigators who used the program's services, were funded awardees, or were members of an internal advisory committee (leadership representatives from partnering institutions). We examined perceived barriers to systemic changes to enhance research, as well as how systems have changed due to the Rhode Island Advance-CTR program's efforts, to what degree, and with what effects. Using the causal logic of our program to connect these more distal systemic outcomes to the services and components of Advance-CTR, we discuss the effects this program has had on researchers and their environments, contributing to the development of sustainable programs of research that ultimately improve the health and well-being of our state's residents.

Improving the quality and quantity of clinical and translational research statewide: An application of group concept mapping.

INTRODUCTION: Advance Clinical and Translational Research (Advance-CTR) serves as a central hub to support and educate clinical and translational researchers in Rhode Island. Understanding barriers to clinical research in the state is the key to setting project aims and priorities. METHODS: We implemented a Group Concept Mapping exercise to characterize the views of researchers and administrators regarding how to increase the quality and quantity of clinical and translational research in their settings. Participants generated ideas in response to this prompt and rated each unique idea in terms of how important it was and feasible it seemed to them. RESULTS: Participants generated 78 unique ideas, from which 9 key themes emerged (e.g., Building connections between researchers). Items rated highest in perceived importance and feasibility included providing seed grants for pilot projects, connecting researchers with common interests and networking opportunities. Implications of results are discussed. CONCLUSIONS: The Group Concept Mapping exercise enabled our project leadership to better understand stakeholder-perceived priorities and to act on ideas and aims most relevant to researchers in the state. This method is well suited to translational research enterprises beyond Rhode Island when a participatory evaluation stance is desired.

Advance-CTR: Statewide Infrastructure to Improve Health in Rhode Island through Clinical and Translational Research.

The universities, hospitals, government agencies, and community organizations in Rhode Island (RI) are well-positioned to bridge gaps between basic and clinical science. RI's manageable size, population demographics, and organizational structure present opportunities to test and implement impactful, transformative clinical and translational research. However, the state's resources had not been optimally coordinated to develop a multi-institutional, clinical and translational research infrastructure to improve clinical practice effectiveness and impact health care in RI. The objective of Advance Clinical and Translational Research (Advance-CTR) is to bridge these gaps by creating a statewide hub to coordinate and leverage existing research resources and provide new career development support and funding for academic researchers, particularly junior investigators. Research support offerings are responsive to a wide variety of needs and readily available via a service request form on AdvanceCTR.org, the first of its kind on a statewide level.