Incorporating translational research with clinical research to increase effectiveness in healthcare for better health

Abstract

Background The transfer of new scientific discoveries into healthcare interventions requires that basic and clinical researchers work together with health care providers to generate team science. These innovative models require translational teams, and need to extend beyond the academic environment. The future of translational science requires partnerships with the healthcare community as well as the broader, general community. This new integrated model of effective translational teams holds promise for addressing thorny and persistent health disparities, is consistent with the nation's strategic priority of eliminating health disparities, and bodes well for increasing healthcare effectiveness aimed at better health for all. Discussion As part of the 13th Research Centers in Minority Institutions (RCMI) International Symposium on Health Disparities, several senior academic leaders joined efforts to hold a workshop to discuss a model that considers the incorporation of two translational research strategies in research career development programs: Comparative effectiveness research (CER) and community‐based participatory research (CBPR) for increasing healthcare effectiveness and eliminating healthcare disparities. Discussion included what issues may be most germane to the concept of a unified model for research workforce development through formal training and career development leading to increased effectiveness in healthcare for better health. Summary We believe that there is a gap in knowledge and skills in formal research career development programs that will enable physicians, other clinicians, and basic scientists to actively participate in these two translational research strategies. The purpose of this paper is to share the outcomes of these discussions, and encourage further discussion and possible innovation in the formulation of a new model for translational research workforce development.

On using ethical principles of community-engaged research in translational science

“…Moreover, because translational research is a diverse field, 3 some of our participants were uncertain about the applicability of these novel ethical principles to all translational projects, regardless of the fact that translational science as a discipline has become more stakeholder-engaged. 6,7 …”

“…6 Comparative effectiveness methods and stakeholder engagement techniques aim to increase healthcare effectiveness and reduce healthcare disparities by addressing “the gap that exists between research and practice,” which is a known roadblock in translational research. 7 Indeed, research suggests that engagement of a broad range of stakeholder groups, including academic and non-academic partners, can foster ownership of the research process and results; promote two-way capacity-building; improve recruitment in scientific research, especially among under-represented minority populations; increase relevance of research findings to a larger number of stakeholders; and ultimately facilitate the use of research findings in practice. 1,2,8 …”

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“…Arguably, the gold standard rating system is the Cochrane Grading of Recommendations Assessment, Development and Evaluation (GRADE) [1] which strongly encourages and is anchored in randomized controlled trial (RCT) methodology. Yet in many fields, clinical translation research occurs at point of service where RCT's may be neither feasible nor contextually valid [2]. Often, clinical service research is more pragmatic and utilises mixed methodologies [3].…”

Leading by Success: Impact of a Clinical and Translational Research Infrastructure Program to Address Health Inequities

“…Concepts and ideas to increase capacity to address clinical and translational gaps in the health of the population included new approaches to discovery, developing partnerships between government and private sectors, identifying research teams, and redesigning the clinical research paradigm 6, 10 . A number of research initiatives were instituted by various funding agencies to address clinical and translational gaps to bring entities together to accelerate the pace of discovery, from the earliest discovery stages through clinical research 11–17 . What followed in the USA, amongst many other infrastructure programs, were the Clinical and Translational Sciences Award program (CTSA) funded by the National Center for Advancing Translational Sciences (NCATS) 18, 19 , Research Centers in Minority Institutions (RCMI) Infrastructure for Clinical and Translational Research (RCTR) funded by National Institute of Minority Health and Health Disparities (NIMHD) 20 , and the Institutional Development Award Program Infrastructure for Clinical and Translational Research (IDeA-CTR) funded by National Institute of General Medical Sciences (NIGMS), Table 1.…”

“…On a smaller scale and owing to the limitations placed by the NIH IDeA Program, institutions from IDeA-eligible states developed clinical and translational research capacity at their institutions beginning in 2014 26 . In a similar fashion, RCMI institutions were provided opportunities to develop infrastructures to conduct clinical and translational research 11–17 . The University of Hawaii (UH), as an RCMI institution, established the RCMI Multidisciplinary And Translational Research Infrastructure Expansion (RMATRIX) Program as an RCTR which has grown to be a successful clinical and translational research foundation for faculty members at UH.…”