RESUMO
Despite understanding its impact on organizational effectiveness, practical guidance on how to train translational team (TT) leaders is lacking. Previously, we developed an evolutionary learning model of TT maturation consisting of three goal-directed phases: (1). team assembly (Formation); (2). conducting research (Knowledge Generation); and (3). dissemination and implementation (Translation). At each phase, the team acquires group-level knowledge, skills, and attitudes (KSAs) that enhance its performance. Noting that the majority of team-emergent KSAs are promoted by leadership behaviors, we examine the SciTS literature to identify the relevant behaviors for each phase. We propose that effective team leadership evolves from a hierarchical, transformational model early in team Formation to a shared, functional leadership model during Translation. We synthesized an integrated model of TT leadership, mapping a generic "functional leadership" taxonomy to relevant leadership behaviors linked to TT performance, creating an evidence-informed Leadership and Skills Enhancement for Research (LASER) training program. Empirical studies indicate that leadership behaviors are stable across time; to enhance leadership skills, ongoing reflection, evaluation, and practice are needed. We provide a comprehensive multi-level evaluation framework for tracking the growth of TT leadership skills. This work provides a framework for assessing and training relevant leadership behaviors for high-performance TTs.
RESUMO
BACKGROUND: The University of Wisconsin Institute for Clinical and Translational Research hub supports multiple pilot award programs that engage cross-disciplinary Translational Teams. To support those teams, our Team Science group aims to offer a learning experience that is accessible, active, and actionable. We identified Collaboration Planning as a high-impact intervention to stimulate team-building activities that provide Translational Team members with the skills to lead and participate in high-impact teams. METHODS: We adapted the published materials on Collaboration Planning to develop a 90-minute facilitated intervention with questions in 10 areas, presuming no previous knowledge of Science of Team Science (SciTS) or team-science best practices. Attendees received a short follow-up survey and submitted a written collaboration plan with their first quarterly progress report. RESULTS: Thirty-nine participants from 13 pilot teams from a wide range of disciplines engaged in these sessions. We found that teams struggled to know who to invite, that some of our questions were confusing and too grounded in the language of SciTS, and groups lacked plans for managing their information and communications. We identified several areas for improvement including ensuring that the process is flexible to meet the needs of different teams, continuing to evolve the questions so they resonate with teams, and the need to provide resources for areas where teams needed additional guidance, including information and data management, authorship policies, and conflict management. CONCLUSIONS: With further development and testing, Collaboration Planning has the potential to support Translational Teams in developing strong team dynamics and team functioning.
RESUMO
BACKGROUND: Neonatal mortality has been perceived as one of the critical and sensitive measures that reflect not only the heath status of infants and their mothers, but also the general well-being of a society. However, our knowledge of racial disparities in neonatal mortality associated with low birth weight and short gestation is relatively limited. As part of continuing statewide efforts to achieve better birth outcomes, this study intends to develop a better understanding of potential mechanisms contributing to the discrepancy in neonatal mortality rates (NMR) to help public health practitioners formulate more effective interventions to prevent unnecessary infant deaths. OBJECTIVES: To assess racial/ethnic disparities in neonatal morality risks by infant birth weight and gestational age in Wisconsin from 1991 through 2005, and to provide more information for programs emphasizing the development of policies and environmental changes to reduce and prevent infant mortality in minority populations. METHODS: Linked birth/infant death data were obtained from the Wisconsin Interactive Statistics on Health (WISH) query system by birthweight, prematurity, race/ethnicity for the periods, 1991-1995, 1996-2000, and 2001-2006. The probability of neonatal mortality was analyzed through log-linear Poisson regression models to test for the pattern of variation of neonatal mortality risks in relation to infant's race/ethnicity, birth weight, prematurity, and their interactions. RESULTS: The proportion of the neonatal deaths to the infant deaths has gradually increased over time, and accounted for more than two-thirds of Wisconsin infant deaths. Despite a large decrease in white NMRs, neonatal mortality risks for blacks and Hispanics did not significantly change. This discord led to a widened racial/ethnic gap in NMRs. Substantial variations on neonatal mortality risks by birth weight and preterm birth were found among whites, blacks, and Hispanics infants. Notably, among low birth weight and preterm infants, blacks and Hispanics appeared to have more favorable NMRs than whites. White infants had the lowest NMRs only delivered at full-term and about 2500 g. CONCLUSION: Wisconsin infant mortality rates are largely driven by neonatal deaths. This shows an urgent need to develop effective public health interventions to prevent early neonatal deaths. To reduce racial/ethnic disparities in NMRs, the design of the interventions should also take into account the variation of the effects of birth weight and gestation age on neonatal mortality among racial/ethnic groups. It is hoped the result of this study will provide a critical understanding: when it comes to racial/ethnic disparities, there is far more to low birth weight or short gestational age than simply not having enough weight or days.
