This study aimed to describe medical students’ perceptions and experiences with health policy and advocacy training and practice and define motivations and barriers for engagement.

This was a mixed-methods study of medical students from May to October 2022. Students were invited to participate in a web-based survey and optional follow-up phone interview. Surveys were analyzed using descriptive statistics. Phone interviews were audio-recorded, transcribed, and de-identified. Interviews were coded inductively using a coding dictionary. Themes were identified using thematic analysis.

35/580 survey responses (6% response rate) and 15 interviews were completed. 100% rated social factors as related to overall health. 65.7% of participants felt “very confident” or “extremely confident” in identifying social needs but only 11.4% felt “very confident” in addressing these needs. From interviews, six themes were identified: (1) participants recognized that involvement in health policy and/or advocacy is a duty of physicians; (2) participants acknowledged physicians’ voices as well respected; (3) participants were comfortable identifying social determinants of health but felt unprepared to address needs; (4) barriers to future involvement included intimidation, self-doubt, and skepticism of impact; (5) past exposures and awareness of advocacy topics motivated participants to engage in health policy and/or advocacy during medical school; and (6) participants identified areas where the training on these topics excelled and offered recommendations for improvement, including simulation, earlier integration, and teaching on health-related laws and policies.

This study highlights the importance of involvement in health policy and advocacy among medical students and the need for enhanced education and exposure.

Research faculty often experience poor mentoring, low vitality, and burnout. We report on our logic model inputs, activities, measurable outcomes, and impact of a novel mentoring intervention for biomedical research faculty: the C-Change Mentoring & Leadership Institute. We present a) a detailed description of the curriculum and process, b) evaluation of the program’s mentoring effectiveness from the perspective of participants, and c) documentation of mentoring correlated with key positive outcomes.

A yearlong facilitated group peer mentoring program that convened quarterly in person was conducted twice (2020–2022) as part of an NIH-funded randomized controlled study. The culture change intervention aimed to increase faculty vitality, career advancement, and cross-cultural competence through structured career planning and learning of skills essential for advancement and leadership in academic medicine. Participants were 40 midcareer MD and PhD research faculty, half women, and half underrepresented by race or ethnicity from 27 US medical schools.

Participants highly rated their mentoring received at the Institute. Extent of effective mentoring experienced correlated strongly with the measurable outcomes of enhanced vitality, self-efficacy in career advancement, research and work-life integration, feelings of inclusion in the program, valuing diversity, and skills for addressing inequity.

The mentoring model fully included men and women and historically underrepresented persons in medicine and minimized problems of power, gender, race, and ethnicity discordance. The intervention successfully addressed the urgencies of sustaining faculty vitality, developing faculty careers, facilitating cross-cultural engagement and inclusion, and contributing to cultivating cultures of inclusive excellence in academic medicine.

Translational science and implementation science are two disciplines that integrate scientific findings into practice within healthcare. One method to assess the integration of these fields is to review the academic crossover between the disciplines with respect to shared citations in the peer-reviewed literature.

This paper used direct citation network analysis to identify potential conceptual gaps and connections between the literature in implementation science and translational science. Bibliographic references were downloaded from Web of Science to create directed citation network maps in VosViewer. Heat maps visualized the top cited literature in each field.

A literature search yielded 6,111 publications in translational science and 7,003 publications in implementation science. When all publications were combined in a directed citation network map, two separate groups of publications emerged, representing the two fields of implementation science and translational science. When the top 50 cited translational science publications were combined with implementation science publications, 14% had a 100%+ increase in citation links, 44% had a mean increase of 2.4%, and 42% shared no links. When the top 50 cited implementation science publications were combined with translational science publications, 2% had a 100%+ increase in citation links, 92% had a 3.3% mean increase, and 6% had no shared links.

Results suggest moderate academic overlap in the way published authors cite each other between translational science and implementation science. We hope the implications of this paper may promote continued collaborations between these fields to disseminate lessons learned and bridge research into practice more efficiently.

The primary purpose of this study was to assess perceived burdens and benefits of participating in implementation research among staff employed in resource-constrained healthcare settings. Another objective was to use findings to generate considerations for engaging staff in research across different phases of implementation research.

This qualitative focus group and consensus building study involved researchers affiliated with the National Cancer Institute Implementation Science Centers in Cancer Control program and nine Community Health Centers (CHCs) in Massachusetts. Six focus groups (n = 3 with CHC staff; n = 3 with researchers) assessed barriers and facilitators to staff participation in implementation research. During consensus discussions, we used findings to develop considerations for engaging staff as participants and partners throughout phases of implementation research.

Sixteen researchers and 14 staff participated in separate focus groups; nine researchers and seven staff participated in separate consensus discussions. Themes emerged across participant groups in three domains: (1) influences on research participation; (2) research burdens and benefits; and (3) ways to facilitate staff participation in research. Practical considerations included: (a) aligning research with organizational and staff values and priorities; (b) applying user-centered design to research methods; (c) building organizational and individual research capacity; and (d) offering equitable incentives for staff participation.

Engaging staff as participants and partners across different phases of implementation research requires knowledge about what contributes to research burden and benefits and addressing context-specific burdens and benefits.

Mentorship education has been shown to positively impact the experiences of mentors and mentees. Entering Mentoring, an evidence-based mentor training curriculum, has been widely implemented to train research mentors across the country, including the mentors of clinical and translational scientists. Facilitating Entering Mentoring, a train-the-trainer based workshop, has been used as a dissemination strategy to increase the number of facilitators prepared to implement mentor training in their local contexts. The objective of this research was to examine individual and institutional factors promoting and limiting mentor training implementation efforts of trained facilitators.

Using the Consolidated Framework for Implementation Research (CFIR), we examined self-reported data from surveys administered annually to Facilitating Entering Mentoring participants. Data analyses included t-tests to compare differences between the implementer and non-implementer groups and binary logistic regression to determine which factors best predict implementation status.

Factors associated with the inner setting domain were found to have the most impact on implementation efforts, with administrative support, leadership support, and interest from potential participants being the most significant predictors of implementation. Additionally, those who implemented were more likely to report receiving institutional support compared with those who did not implement the intervention. Those who did not implement were more likely to report the presence of perceived institutional barriers.

The CFIR model provides a useful framework for understanding factors that promote and limit implementation outcomes of an evidence-based research mentor training intervention. Findings emphasize the role of institutional support to promote the implementation of research mentor training.

Team Methods to Advance Processes and Performance in Science (TeamMAPPS) is an evidence-based Team Science competency model and intervention. TeamMAPPS was developed by experts in the Science of Team Science with translational teams in mind. TeamMAPPS focuses on three core teamwork competencies: (1) psychological safety, (2) awareness and exchange, and (3) self-correction and adaptation. In 2023, the TeamMAPPS framework was operationalized into five online training modules that can be used to train whole teams or individuals, with or without facilitation, in any order. This article reports formative findings from the pre-implementation stage of the TeamMAPPS Dissemination and Implementation (D&I) study.

We conducted 27 interviews and participant-observation fieldwork with 23 individuals involved in the conceptualization, design, or implementation of TeamMAPPS (four were interviewed twice). All implementers were affiliated with a Clinical and Translational Science Award (CTSA) hub. Data were collected during pre-implementation, when modules were being tested and early-stage implementers were being trained. We used D&I theories and frameworks to structure the study, analyze interview data, and recommend implementation strategies.

“Adoption,” “reach,” and “effectiveness” emerged as key implementation outcomes. TeamMAPPS was perceived to be evidence-based, highly adaptable, and a Team Science intervention offering unique benefits. We draw on participants’ responses and expert recommendations to suggest implementation strategies.

CTSAs and other organizations can use varied strategies to implement TeamMAPPS. The flexibility of the intervention and its rootedness in an evidence-base synthesized by Team Science leaders make TeamMAPPS appealing for CTSAs seeking to enhance their team training offerings.

In recent years, there has been a growth in awareness of the importance of equity and community engagement in clinical and translational research. One key limitation of most training programs is that they focus on change at the individual level. While this is important, such an approach is not sufficient to address systemic inequities built into the norms of clinical and translational research. Therefore, it is necessary to provide training that addresses changing scientific norms and culture to ensure inclusivity and health equity in translational research.

We developed, implemented, and assessed a training course that addressed how research norms are based on histories and legacies of white supremacy, colonialism, and patriarchy, ultimately leading to unintentional exclusionary and biased practices in research. Additionally, the course provides resources for trainees to build skills in how to redress this issue and improve the quality and impact of clinical and translational research. In 2022 and 2023, the course was offered to cohorts of pre and postdoctoral scholars in clinical and translational research at a premier health research Institution.

The efficacy and immediate impact of three training modules, based on community engagement, racial diversity in clinical trials, and cancer clusters, were evaluated with data from both participant feedback and assessment from the authors. TL1 scholars indicated increased new knowledge in the field and described potential future actions to integrate community voices in their own research program.

Results indicate that trainings offered new perspectives and knowledge to the scholars.

Tufts Clinical and Translational Science Institute (CTSI) developed an online self-paced course to address the gap identified in critical thinking skills related to peer-reviewed nutrition science publications. Initial engagement was low, prompting the launch of a quality improvement project utilizing Dissemination and Implementation (D&I) science principles to enhance participation. This report details the development and execution of the dissemination strategy, course promotion methods, and outcomes related to participant engagement and feedback.

A dissemination plan was designed and implemented using the Value-Added Research Dissemination Framework and the Consolidated Framework for Implementation Research (CFIR). Dissemination efforts targeted registered dietitians and university nutrition program instructors, along with their students.

During the active dissemination period from January to May 2023, the cumulative numbers of learners increased from 23 to 118. Instructors from three nutrition degree programs found the course valuable, reporting that it introduced new content or reinforced existing material. Learner participation continued past the active dissemination period into 2024. Findings from the course evaluation survey provided insights to guide future course improvements.

This project demonstrates the successful use of D&I frameworks to support the dissemination and implementation of educational innovations such as online learning initiatives.

The Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium’s (Consortium) Office of Community Outreach & Engagement (OCOE) joined Stanford Medicine and Morehouse School of Medicine in implementing Engage for Equity Plus (E2PLUS), a multi-institutional community of practice to learn and share patient-centered and community-engaged research (P/CEnR) practices. University of New Mexico (UNM) facilitated this collaboration.

The Consortium formed a Champion Team of 12 people who participated in two virtual workshops facilitated by UNM. Consortium executive leadership (n = 4) participated in interviews, and investigators (n = 4) and community members/patient advocates (n = 8) participated in focus groups to provide institutional context regarding P/CEnR. This is a paper on the process and findings.

Through E2PLUS engagement, the Champion Team identified four strategies to address institutional health inequities: 1) increase participation of underrepresented groups at all levels of institutional leadership and advisory boards; 2) create an Office of Patient Engagement to train and support patients who participate in institutional initiatives and advise research teams; 3) expand community engagement training, resources, and institutional commitment to focus on community-identified social and health needs; and 4) establish an umbrella entity for health equity efforts across the Consortium.

While the Consortium had longstanding community advisory boards and faculty and staff with P/CEnR expertise, it did not have centralized and institutionally supported P/CEnR resources, policies, and infrastructure. By participating in E2PLUS, the Champion Team received technical assistance to leverage qualitative data to influence strategies to guide the development of Consortium health equity infrastructure and capacity for P/CEnR in Washington.

The diversity gap in precision medicine research (PMR) participation has led to efforts to boost the inclusion of underrepresented populations. Yet our prior research shows that study teams need greater support to identify key decision-making issues that influence diversity and equity, weigh competing interests and tradeoffs, and make informed research choices. We therefore developed a Diversity Decision Map (DDM) to support the identification of and dialogue about study practices that impact diversity, inclusion, and equity.

The DDM is empirically derived from a qualitative project that included a content analysis of documents, observations of research activities, and interviews with PMR stakeholders. We identified activities that influenced diversity goals and created a visual display of decision-making nodes, their upstream precedents, and downstream consequences. To assess the potential utility of the DDM, we conducted engagements with stakeholder groups (regulatory advisors, researchers, and community advisors).

These engagements indicated that the DDM helped diverse stakeholder groups trace tradeoffs of different study choices for diversity, inclusion, and equity, and suggest paths forward. Stakeholders agreed that the DDM could facilitate discussion of tradeoffs and decision-making about research resources and practices that impact diversity. Stakeholders felt that different groups could use the DDM to raise questions and dilemmas with each other, and shared suggestions to increase the utility of the DDM.

Based on a research life course perspective, and real-world research experiences, we developed a tool to make transparent the tradeoffs of research decisions for diversity, inclusion, and equity in PMR.

Electronic Health Records (EHR) analysis is pivotal in advancing medical research. Numerous real-world EHR data providers offer data access through exported datasets. While enabling profound research possibilities, exported EHR data requires quality control and restructuring for meaningful analysis. Challenges arise in medical events (e.g., diagnoses or procedures) sequence analysis, which provides critical insights into conditions, treatments, and outcomes progression. Identifying causal relationships, patterns, and trends requires a more complex approach to data mining and preparation.

This paper introduces EHRchitect – an application written in Python that addresses the quality control challenges by automating dataset transformation, facilitating the creation of a clean, formatted, and optimized MySQL database (DB), and sequential data extraction according to the user’s configuration.

The tool creates a clean, formatted, and optimized DB, enabling medical event sequence data extraction according to users’ study configuration. Event sequences encompass patients’ medical events in specified orders and time intervals. The extracted data are presented as distributed Parquet files, incorporating events, event transitions, patient metadata, and events metadata. The concurrent approach allows effortless scaling for multi-processor systems.

EHRchitect streamlines the processing of large EHR datasets for research purposes. It facilitates extracting sequential event-based data, offering a highly flexible framework for configuring event and timeline parameters. The tool delivers temporal characteristics, patient demographics, and event metadata to support comprehensive analysis. The developed tool significantly reduces the time required for dataset acquisition and preparation by automating data quality control and simplifying event extraction.

Community-based participatory research (CBPR) and patient/ community engaged research (P/CEnR) are shown to be effective approaches that improve health inequities, particularly among disadvantaged populations. While the science of CBPR demonstrates promising partnering practices that lead to effective interventions, there are institutional and structural barriers to creating and sustaining patient/community research within academic health centers (AHCs). As the field matures, there is a growing need to enhance patient/community leadership so that communities can set their own research agendas and priorities.

Engage for Equity PLUS sought to address these challenges by implementing an engagement intervention aimed at transforming AHCs through supporting champion teams of academic, community, and patient partners to strengthen research infrastructures for P/CEnR. This paper uses a qualitative, case study analysis to describe how E2PLUS enabled champion teams at Stanford School of Medicine, Fred Hutchinson/University of Washington Cancer Consortium, and Morehouse School of Medicine to pursue institutional change strategies through coaching, workshops, contextual data analysis, and a community of practice.

This paper describes key themes of how E2Plus helped identify targets of change by a) using institutional data collection as core to generating critical consciousness of contextual conditions; b) implementing feasible E2PLUS strategies to leverage conditions for catalyzing a champion team for advocacy and achievable actions; c) identifying the critical role of patients/community members in stimulating change; and d) the role of continual collective reflection.

We discuss the overall implications for E2 PLUS for other AHCs working toward sustainable community/patient engaged research policies and practices.