PGIF Implementation Science Global Health Workshop
The Columbia Global Centers| Nairobi, in collaboration with Columbia University’s ICAP Mailman school of Public Health hosted a five-day health workshop at the Center that ran from 18th November 2019 to 22nd November 2019. The training was facilitated by, Dr. Andrea A. Howard, MD, MS an Associate Professor of Epidemiology at Columbia University Mailman School of Public Health who is also a Clinical & Training Unit Director at ICAP and Dr. Julie Kornfeld, PhD, MPH the Vice Dean for Education and Associate Professor of Epidemiology at Columbia University Mailman School of Public Health.
Through the lens of their works in Public Health, they saw it important to explore and make the present 28 participants all Kenyan health practitioners and health students from Columbia University understand the study of methods to promote the integration of research findings and evidence into healthcare policy and practice. Assisted by: Dr. Mercy Mugo, Ph.D., a Senior Lecturer at the School of Economics (SOE), University of Nairobi (UON), Kenya. Dr. Joanne Mantell, Ph.D. a Professor of Clinical Psychology in psychiatry at Columbia University and Research Scientist at the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute. Ms. Trena Mukherjee, a doctoral candidate in Epidemiology at the Columbia University Mailman School of Public Health. Dr. Ivy Mushamiri a Ph.D. Candidate in Epidemiology at the Columbia University Mailman School of Public Health. Dr. Harriet Nuwagaba-Bironwoha, MBChB, Ph.D. the Assistant Professor of Epidemiology at Columbia University’s Mailman School of Public Health and Research Director at ICAP in Eswatini. They all saw to it that the participants understood the role of implementation science in public health programs through presentations and group work discussions during the five day period.
Dr. Murugi Ndirangu , Director of Columbia Global Centers| Nairobi in her opening remarks gave an introduction of Columbia Global Centers Network and how they collectively engage University faculty, students and alumni for knowledge enhancement.
During her presentation on the Introduction to Implementation Science, Dr, Harriet emphasized on Implementation Science as the study of methods to promote the integration of research findings and evidence into healthcare policy and practice. Most importantly the goal in this essence according to Dr, Harriet was to: Understand the behavior of healthcare professionals and other stakeholders as a key variable in the sustainable uptake, adoption, and implementation of evidence-based interventions. To investigate and address the major bottlenecks ranging from social, behavioral, economic and management of which in turn impedes effective implementation. Testing new approaches in implementation science to improve health programming. Determining a causal relationship between the intervention and its impact. Following all this, one is then able to come up with an implementation research question by: Identifying the gap/ challenge that one would like to address, what works in addressing the challenge and what is the ‘know-do’ gap. All this then leads to summing up that Implementation Science is important because it provides effective health services, better prevention services, decreased health disparities, addresses the root cause of disease and generally produces better health outcomes by lowering morbidity and mortality rates in communities.
Thereafter, Dr. Andrea Howard highlighted on the conceptual basis for implementation research models, research theories and research frameworks. Stating that research models always ensure the inclusion of key information related to system-wide processes, organizational factors, and measures that are required for implementation research. They also provide a systematic structure for development, management, and evaluation of implementation efforts as well as helping in explaining why evidence-based intervention or implementation strategy works or does not work. In choosing a model, one should choose a model based on: flexibility, focus on dissemination or implementation, and levels of socio-ecological frameworks.
Dr. Julie Kornfeld, in her presentation on Implementation strategies, Discussed generally on the importance of identifying and operationalizing implementation strategies in the context of complex processes and systems. She also highlighted the importance of identifying fundamental principles of defining and operationalizing implementation strategies as well as explaining the challenges experienced in measuring and effectively employing implementation strategies.
The other presentations in the five-day Implementation Science Global Health workshop training included:
- Organizational Processes and Participatory Approaches to Maximize Stakeholder Participation in Implementation Science Research. Presented by (Dr. Joanne E. Mantell)
- A brief overview of methods and application to HIV self- testing in Kenya. Presented by (Ms. Trena Mukherjee)
- Role of Economic Evaluation In Implementation research. Presented by (Dr. Mercy Mugo).
- Measurement Issues in Implementation Research. Presented by (Dr. Ivy Mushamiri)
- Study Designs in Implementation Research. Presented by (Dr. Andrea A. Howard)
- Ethical Issues in Implementation Research. Presented by (Dr. Harriet Nuwagaba Biribonwoha)
- Fidelity and External Validity. Presented by (Dr. Ivy Mushamiri)
- Case Study: Process Evaluations. Presented by (Dr. Andrea A. Howard)
- Evaluation Approaches for Implementation Research. Presented by (Dr. Joanne E. Mantell)
- Mixed- Methods Evaluation in Implementation Research. Presented by (Dr. Joanne E. Mantell)
- Case Study: Mixed Methods for Implementation Research. Presented by (Dr. Harriet Nuwagaba Biribonwoha)
- Obtaining funding for Implementation Research. Presented by (Dr. Andrea A. Howard)
Through the five-day learning process, the health practitioners from their interactive group work presented five Implementation Pieces of research namely:
- Acceptability and continuation of PrEP (Pre- Exposure prophylaxis) among at-risk adolescent girls and women
- The impact of utilization of CHVs (Community Health Volunteers) on the retention of care of newly diagnosed HIV patients in Nairobi, Kenya.
- School-based HPV ( Human papillomavirus) vaccinations for girls in Kenya.
- Adapting youth-friendly health services for HIV positive pregnant Adolescent girls.
- Delivering PrEP at the community level in Kenya.
Dr. Julie Kornfeld noted that the Global Health Workshop training allowed the health practitioners not only to enhance their knowledge on health issues, but it also allowed them to see and device methods on how to shorten the gap from health priorities to health practices. The health practitioners will continue to interact with the online uploaded materials from the workshop as they continue to grow their knowledge and sharpen their skills on Implementation Research.