Ryan Bailey, MA is a Project Coordinator and Business Analyst at Rho. He has over 10 years of experience conducting multicenter asthma research studies, including the Inner City Asthma Consortium (ICAC) and the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) project. Ryan also coordinates Rho’s Center for Applied Data Visualization, which develops novel data visualizations and statistical graphics for use in clinical trials.
How can we ensure that successful clinical trial interventions will lead to long-term improvements in healthcare? Novel research and information dissemination projects like the CHAMPS program offer promise for bridging the gap between clinical trials and health practice.
How can we ensure that successful clinical trial interventions will lead to long-term improvements in healthcare?
If we're honest, clinical researchers often fail to give this question the attention it deserves. To be fair, we have many urgent questions that press for our time and focus instead. Do we have the best trial design? Can we recruit the study population in question? Are we taking the proper safety precautions? Is the intervention efficacious? These are important questions in their own right, but what happens when the trial is over?
For many interventions, the answer is depressing. Despite demonstrating efficacy, evidence-based interventions are too often sparsely disseminated and poorly adopted. This problem has been dubbed the "discovery-delivery gap"1. The crisis of conscience for researchers is obvious - what good is an efficacious trial if it never leads to sustained improvements in healthcare?
Fortunately, research and advocacy groups are seeking to overcome this disconnect. In particular, the fields of Implementation Science and Translational Research are concerned with taking the discoveries of clinical trials and basic science research and translating them into everyday health practice. Rho has spent the past 5 years contributing to one such translational project, the Community Healthcare and Asthma Management for the Prevention of Symptoms or "CHAMPS" program, which was funded by the Merck Childhood Asthma Network.
CHAMPS was founded on 25 years of established asthma research that began with two landmark clinical trials for asthma - the National Cooperative Inner City Asthma Study (NCICAS) in the early 1990s and the Inner City Asthma Study (ICAS) in the late 1990s. Both clinical trials demonstrated strong results for their asthma interventions. The objective of CHAMPS was twofold:
1. test whether the efficacious clinical trial interventions could be adopted and implemented in the "real world" setting of federally qualified health clinics (FQHCs)
2. provide resources that other health practices could use to implement CHAMPS within their centers
After replicating the effectiveness of the clinical trials in the FQHC setting, the CHAMPS team turned its attention to share the procedural knowledge of the intervention with the public.
In November of this year, in partnership with the EPA, the CHAMPS team released a series of publicly-accessible web-based resources on the EPA-supported website: www.asthmacommunitynetwork.org. The CHAMPS materials on the site are designed to equip any health practice to conduct the CHAMPS asthma counselor intervention, and include short eLearning videos, educational handouts, a library of supporting asthma research, and a detailed procedural manual. The CHAMPS resources are all available at: http://www.asthmacommunitynetwork.org/Champs
CHAMPS represents an important step in overcoming the discovery-delivery gap – first, by taking the pragmatic step of replicating the findings of the clinical trials in the less controlled environment of primary health clinics, and second, by making a concerted effort to share the "how-to" resources that will equip any health provider with the knowledge needed to implement an effective asthma intervention in their practice.
1Kerner, J.F. (2006). Knowledge translation versus knowledge integration: A “funder’s” perspective. Journal of Continuing Education in the Health Professions, 26, 72-80.