Dissemination and Implementation Science
Dissemination and implementation science is the systematic study of how evidence-based methods and procedures are adopted, implemented and sustained in practice. The goal of the Dissemination and Implementation Science Program in the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery is to improve health care delivery processes and outcomes and reduce the time it takes to translate evidence-based practices into routine use.
Evidence-based practices that are developed and studied in controlled research environments often languish or fail when they move to real-world settings such as patients' daily lives or busy clinic and hospital settings. Dissemination and implementation science researchers aim to address this knowledge-practice gap by engaging stakeholders early, identifying their needs and preferences, and tailoring strategies to increase their knowledge and adoption of evidence-based practices.
The program helps researchers embed implementation science methods and techniques in their work to support:
- Development and refinement of feasible and acceptable practices
- Deployment of targeted strategies to increase their adoption
- Assessment of implementation outcomes
This approach can ultimately improve patient outcomes and reduce costs, while being responsive to the needs of patients and care teams.
The Dissemination and Implementation Science Program team provides timely consultation and scientific support aligned with Mayo Clinic's practice priorities, resulting in collaborations that:
- Support innovation and continuous learning. Team members provide consultation on tools and educational opportunities in dissemination and implementation science that enable rapid and reliable practice transformation.
- Transform delivery of care and patient experience. To ensure that practice changes meet patients' needs, the program equips clinical and operational teams with the knowledge, skills and strategies they need to implement new patient-centered models of care, and it actively seeks and incorporates patients' perspectives during implementation.
- Enhance and accelerate provider decision-making. The center's dissemination and implementation science experts partner with stakeholders to support validation and implementation of novel digital and artificial intelligence-based clinical decision-support tools.
- Seek to eliminate racism. The program applies sociocultural lenses that seek and engage the perspectives of diverse stakeholders to promote a just and inclusive work environment. It aims to identify factors related to racial disparities in care delivery, including ways in which the implementation of clinical practices may exacerbate disparities.
The Dissemination and Implementation Science Program comprises a multidisciplinary team of researchers with diverse backgrounds in:
- Behavioral science
- Community engagement
- Dissemination and implementation science
- Health communication
- Human-computer interaction
- Public health
- Qualitative research
The team has expertise in applying implementation science principles and methods to plan, guide and evaluate implementation projects, including:
- Designing novel, pragmatic implementation study proposals and protocols
- Engaging stakeholders to understand their implementation-related needs, preferences and values
- Assessing implementation context and setting to identify barriers and facilitators to implementation success
- Applying appropriate implementation theories, models and frameworks to guide implementation planning and evaluation
- Developing tailored implementation strategies and providing implementation facilitation for interactive problem-solving
- Evaluating implementation process and outcomes using quantitative, qualitative and mixed methods approaches
The Dissemination and Implementation Science Team collaborates on multiple practice-transforming projects.
Risk communication during the COVID-19 pandemic
The program team implemented and evaluated a community-engaged, bidirectional pandemic crisis and emergency risk communication framework with immigrant and refugee populations during the COVID-19 pandemic.
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- Brewer LC, Asiedu GB, Jones C, Richard M, Erickson J, Weis J, Abbenyi A, Brockman TA, Sia IG, Wieland ML, White RO, Doubeni CA. Emergency preparedness and risk communication among African American churches: Leveraging a community-based participatory research partnership COVID-19 initiative. Preventing Chronic Disease. 2020; doi:10.5888/pcd17.200408.
- Wieland ML, Asiedu GB, Lantz K, Abbenyi A, Njeru JW, Osman A, Goodson M, Ahmed Y, Molina LE, Doubeni CA, Sia IG, Rochester Healthy Community Partnership COVID-19 Task Force. Leveraging community engaged research partnerships for crisis and emergency risk communication to vulnerable populations in the COVID-19 pandemic. Journal of Clinical and Translational Science. 2020; doi:10.1017/cts.2020.47.
Home-based tampon sampling for endometrial cancer
In this formative evaluation, the Dissemination and Implementation Science Program team conducted community focus groups with Black and white women to explore the acceptability and feasibility of a home-based tampon sampling approach for endometrial cancer.
- Ridgeway JL, Albertie ML, Williams S, Pantoja E, Stephenson N, Pacheco-Spann L, Ball CT, Radecki Breitkopf C, Bakkum-Gamez JN, Chase L, Destephano CC, Sherman Me. Development of novel home-based tampon sampling for endometrial cancer: Findings from community-based focus groups with Black and White women. Journal of Clinical and Translational Science. 2021; doi:10.1017/cts.2021.787.
ECG AI-Guided Screening for Low Ejection Fraction (EAGLE)
The Dissemination and Implementation Science Program's EAGLE study is a randomized trial to validate an artificial intelligence (AI) algorithm that screens for low ejection fraction from an electrocardiogram (ECG) and recommends actions that providers can take to make a diagnosis.
- Yao X, McCoy RG, Friedman PA, Shah ND, Barry BA, Behnken EM, Inselman JW, Attia ZI, Noseworthy PA. Clinical trial design data for electrocardiogram artificial intelligence-guided screening for low ejection fraction (EAGLE). Data in Brief. 2019; doi:10.1016/j.dib.2019.104894.
- Yao X, McCoy RG, Friedman PA, Shah ND, Barry BA, Behnken EM, Inselman JW, Attia ZI, Noseworthy PA. ECG AI-Guided Screening for Low Ejection Fraction (EAGLE): Rationale and design of a pragmatic cluster randomized trial. American Heart Journal. 2020; doi:10.1016/j.ahj.2019.10.007.
Home-based pulmonary rehabilitation with health coaching
The goal of this project is to make pulmonary rehabilitation available at home synergized by self-management support through health coaching. It aims to determine the comparative effectiveness of this intervention on physical quality of life compared with an active control group.
Nurse-based care coordination to reduce hospital readmissions
This pragmatic trial compares the effectiveness of adult medical care coordination versus the usual standard of care in reducing unplanned hospital readmissions among high-risk patients. The project team is using an integrated mixed methods assessment of patients' and clinicians' experiences with the program to gain a comprehensive understanding of implementation and dissemination.
Using the electronic heath record (EHR) to control cancer symptoms
This research aims to develop, implement and evaluate an EHR-supported system of symptom monitoring and management for patients with cancer during and after active treatment. The project team is conducting the randomized cluster pragmatic clinical trial across 18 disease groups and clinical practice sites at Mayo Clinic in Rochester, Minnesota, and the Mayo Clinic Health System.
- Finney Rutten LJ, Ruddy KJ, Chlan LL, Griffin JM, Herrin J, Leppin AL, Pachman DR, Ridgeway JL, Rahman PA, Storlie CB, Wilson PM, Cheville AL. Pragmatic cluster randomized trial to evaluate effectiveness and implementation of enhanced EHR-facilitated cancer symptom control (E2C2). Trials. 2020; doi:10.1186/s13063-020-04335-w.
- Yang HP, Cook LS, Weiderpass E, Adami HO, Anderson KE, Cai H, Cerhan JR, Clendenen TV, Felix AS, Friedenreich CM, Garcia-Closas M, Goodman MT, Liang X, Lissowska J, Lu L, Magliocco AM, McCann SE, Moysich KB, Olson SH, Petruzella S, Pike MC, Polidoro S, Ricceri F, Risch HA, Sacerdote C, Setiawan VW, Shu XO, Spurdle AB, Trabert B, Webb PM, Wentzensen N, Xiang YB, Xu Y, Yu H, Zeleniuch-Jacquotte A, Brinton LA. Infertility and incident endometrial cancer risk: A pooled analysis from the epidemiology of endometrial cancer consortium (E2C2). British Journal of Cancer. 2015; doi:10.1038/bjc.2015.24.
Shared decision-making for individualized cardiovascular event prevention
This project aims to integrate a tool to facilitate shared decision-making about cardiovascular health into preventive care settings and study strategies that foster its adoption and routine use. The project team is conducting the trial at three diverse health care systems of the Mayo Clinic Care Network, a collaborative network linking more than 40 health systems around the globe with the research, education and clinical expertise of Mayo Clinic.
- Ridgeway JL, Branda ME, Gravholt D, Brito JP, Hargraves IG, Hartasanchez SA, Leppin AL, Gomez YL, Mann DM, Nautiyal V, Thomas RJ, Behnken EM, Torres Roldan VD, Shah ND, Khurana CS, Montori VM. Increasing risk-concordant cardiovascular care in diverse health systems: A mixed methods pragmatic stepped wedge cluster randomized implementation trial of shared decision making (SDM4IP). Implementation Science Communications. 2021; doi:10.1186/s43058-021-00145-6.
Mayo Clinic Expert Advisor implementation evaluation
This project seeks to increase and evaluate the use of Mayo Clinic Expert Advisor, a tool embedded in the electronic heath record that's aimed at reducing cognitive burden on clinicians.
Video telemedicine for newborn resuscitation
In this study, members of the Dissemination and Implementation Science Program team assessed the implementation of video telemedicine for newborn resuscitation with the goal of better understanding health care providers' acceptance, utilization and integration of this technology in community hospital settings.
Nonpharmacological options in postoperative, hospital-based and rehabilitation pain management (NOHARM)
NOHARM is a clinical trial conducted across the Mayo Clinic enterprise. It promotes guideline-concordant use of nonmedication pain management strategies for patients after surgery. This intervention was designed to ensure that it's compatible with clinical workflows and that the materials patients receive are acceptable to them.
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