The Advancement of Team Science and the Role of Stakeholders in Clinical and Translational Science C&C Team Present: Presented by: Elaine A. Borawski, PhD Anna Matos MPH, Community and Collaboration Component Meredith Goodwin PhD, Briana McIntosh MPH, Clinical and Translational Science Collaborative Rachel Gardenhire MS
OVERVIEW • CTSC and Community and Collaboration Component • Translational Science • Team Science • Stakeholders – What are they? Who are they? • Aims and Activities of Community and Collaboration
WHAT IS THE CTSA? • CTSA – Clinical and Translational Science Award. Started in 2005. • Funded by the NCATS (National Center for Advancing Translational Sciences – part of NIH). • Provides resources to research institutions to build infrastructure and support for clinical and translational research. • Why was this needed? – So few scientific findings are disseminated beyond the walls of academia and even fewer are translated into practices that can/will improve health.
HISTORY OF THE CTSC IN CLEVELAND • NIH recognized a need to streamline research systems and encourage cross-institution collaboration with broad-based, innovative interdisciplinary teams. • CTSA is the award, we are the Clinical and Translational Science Collaborative (CTSC) • The Cleveland CTSC (for Collaborative) consists of CWRU and four health systems: University Hospital, MetroHealth, Cleveland Clinic and the VA. • Initially awarded in 2007, currently in Year 2 of our third 5-year funding cycle.
GOAL OF THE CLEVELAND CTSC To utilize the power of the multi-institutional collaborative: • to ensure rigorous and innovative training of the clinical and translational workforce, • to accelerate the translation of discoveries to patients and communities; and, • to improve the health of Cleveland and provide scalable models for other locations throughout the nation.
CTSC RESOURCES TO SUPPORT C/T RESEARCH INFORMATICS NETWORK CAPACITY HUB RESEARCH “Big data”, EHR data, tools to CAPACITY Trial Innovation Network; collaborative collect, analyze and visualize data research with other CTSA hubs across Study recruitment, assessments, the country. management, and Integrating RESOURCES TO Special Populations SUPPORT CLINICAL AND TRANSLATIONAL TRANSLATIONAL ENDEAVORS RESEARCH RESEARCH Workforce development and METHODS TRAINING pilot grant funding PROGRAMS COMMUNITY AND Biostatistics, Epidemiology and Research Design (BERD) and COLLABORATION KL2 TL1 Regulatory Knowledge and Support Scholars Scholars Promote collaboration through team science, with intentional stakeholder engagement
Purpose of the Community and Collaboration Component (2018-2023) Promote collaboration through team science, with intentional stakeholder engagement
COMMUNITY AND COLLABORATION TEAM Elaine Borawski Kurt Stange Mark Chance Shirley Moore Darcy Freedman Heidi Gullett Anne DeChant Briana McIntosh Meredith Goodwin Anna Thornton Matos Rachel Gardenhire
THE TRANSLATIONAL SCIENCE CONTINUUM SOURCE: Institute of Medicine. 2013. The CTSA Program at NIH: Opportunities for Advancing Clinical and Translational Research . Washington, DC: The National Academies Press.
DEFINING TRANSLATION IN 2019 • Translation is “the process of turning observations in the laboratory, clinic, and community into interventions that improve the health of individuals and populations – from diagnostics and therapeutics to medical procedures and behavioral interventions.” --NIH National Center for Advancing Translational Sciences (NCATS)
COMMUNITY….REDEFINED The term community includes all stakeholders connected to clinical and translational research. Communities may include but are not limited to non-profit or industry entities engaged in translational research, and might include disease advocacy groups, local health providers, community-based organizations, and other national or local communities. --NIH National Center for Advancing Translational Sciences (NCATS)
WHAT (AND WHOM) IS A STAKEHOLDER • Stakeholder is an independent, engaged, individual or group who has a stake in the outcome, and whose input could greatly enhance the research endeavor. • Type of stakeholder may vary depending on the focus of the problem, the type of research conducted, and the composite and orientation of the investigative team.
WHY STAKEHOLDER ENGAGEMENT IS IMPORTANT KNOWLEDGE TO ACTION (K2A) FRAMEWORK
WHY STAKEHOLDER ENGAGEMENT IS IMPORTANT KNOWLEDGE TO ACTION (K2A) FRAMEWORK Where Where researchers stakeholders/ mostly spend practitioners mostly their time spend their time
KNOWLEDGE TO ACTION (K2A) FRAMEWORK Products: • Pubs and Reports • Actionable interventions: drugs, devices, programs, protocols, guidelines, toolkits
While stakeholder engagement may seem challenging, team science is easy and natural… RIGHT??
WHAT IS A SCIENTIFIC RESEARCH TEAM? ….think of it as a continuum….. LOW HIGH Level of Interaction and Integration Research Collaboration Integrated Research Team Investigator-Initiated Research • Group works on a scientific problem, • Team works on a research problem each bringing some expertise to the with each member bringing specific Investigator works on a problem. expertise to the table. scientific program – largely • Each member works on a separate • There are regular meetings and on his or her own. part, which are integrated at the end. discussions of the team’s overall goals, • The interaction of the lead investigators objectives of the individuals on the varies from limited to frequent with team, data sharing, and next steps. • One person takes the lead while other regard to data sharing or brainstorming. members have key leadership roles in achieving the goal. SOURCE: Bennett, L. M., & Gadlin, H. (2012). Collaboration and team science: from theory to practice. Journal of Investigative Medicine , 60 (5), 768-775.
WHAT IS TEAM SCIENCE? “…a collaborative effort to address a scientific challenge that leverages the strengths and expertise of professionals trained in different fields” – National Cancer Institute Collaboration TEAM SCIENCE Interdisciplinarity
THE VALUE AND POTENTIAL OF TEAMS Disis, ML, Slattery, JT. Science Translational Medicine 10 Mar 2010: Vol. 2, Issue 22
IMPACT OF TEAMS Studies of 19.9 million research articles over 5 decades as recorded in the Web of Science database, and an additional 2.1 million patent records from 1975-2005 found three important facts: 1. For virtually all fields, research is increasingly done in teams. 2. Teams typically produce more highly cited research than individuals do (excluding self-citations), and this team advantage is increasing. 3. Teams now produce the exceptionally high impact research, even where that distinction was once the domain of solo authors. Sources: Wuchty, Jones, and Uzzi, 2007
PRODUCTIVITY IN TEAM SCIENCE • Comparison of publications between transdisciplinary science teams with traditional investigator- initiated research grants (R01) • Centers initially produced fewer publications, gap eliminated by year 4. * From Hall et all Am J Prev Med 2012; 42(2):157-163
WHO ARE THE INVESTIGATORS ON THESE TEAMS? Cell/Animal Patients People ( with or without diseases) Laboratory Clinic/Hospital Public Health, Community INFORMATICS/DATA SCIENCE
WHAT (AND WHOM) IS A STAKEHOLDER • Stakeholder is an independent, engaged, individual or group who has a stake in the outcome, and whose input could greatly enhance the research endeavor. • Type of stakeholder may vary depending on the focus of the problem, the type of research conducted, and the composite and orientation of the investigative team.
WHO ARE THE STAKEHOLDERS? Patients Cell/Animal People ( with or without diseases) Clinic/Hospital Laboratory Public Health, Community Council to Advance Human Health National Center for Accelerated Innovations Safety Net Provider Alliance
OUR GOAL: PROMOTE A CULTURE OF TEAM SCIENCE WITH STAKEHOLDER ENGAGEMENT Cross-disciplinary teams conducting translational research Research Teams that include relevant Stakeholders – individuals, groups and/or organizations that have a stake in the outcome, whose input could greatly enhance the research endeavor, and that can serve as Research teams that critical partners in the include both cross- translational process. disciplinary investigators AND stakeholders, collectively approaching a problem.
BARRIERS TO TEAM SCIENCE • Labor Intensive (coordination, communication, training) • Administrative complexities (disagreements, conflict, financial agreements) • Time cost (up to 200% longer) • Lack of reward / incentive in academia • Career jeopardy (less individual recognition, slower productivity)
COMMUNITY AND COLLABORATION Promote collaboration through team science, with intentional stakeholder engagement
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