Within health services research, we have long recognized that the development and testing of effective health interventions does not always result in widespread access to quality health care nor the population health benefit that full implementation of these interventions would permit. This gap between research and practice has fueled the expansion of dissemination and implementation (D&I) research, which intends to develop the knowledge base that supports optimal use of evidence and evidence-based practices in clinical and community systems of care and in health policy. While still gaining traction within the biomedical research community, D&I research has expanded to include thousands of investigators in the United States and most other countries, and is supported by multiple research funders, international conferences and workshops, and a range of professional societies.
Over the past decade, leaders in D&I research have worked to build the capacity of the field through multiple training programs, run by research funders, academic institutions, societies and conferences. One of the longest running programs—the Training Institute for Dissemination and Implementation Research in Health (TIDIRH), was initiated by the National Institutes of Health with support from the Department of Veterans Affairs in 2011 as a week-long residential program for researchers seeking to develop as independent D&I investigators. Through the first five years, approximately 40 researchers annually were able to participate in the training, while six or seven times as many applicants were unsuccessful in their effort to enlist in the course.
By 2015, the NIH looked to develop a model for TIDIRH that would reduce the travel burden on faculty and fellows, while enabling a longer period for didactic sessions and concept paper feedback. Based upon models used by the National Cancer Institute (NCI) and partners to train investigators in global health research, TIDIRH was re-envisioned as a hybrid online/in-person course, with six modules including recorded video lectures, related readings, individual assignments, and online feedback. It was relaunched in 2016 and is currently in its ninth year overall as a D&I research training program. In 2018, a parallel program—TIDIRC—with the “C” standing for “cancer,” was started by the NCI to build additional capacity for D&I research in cancer.
Despite the multiple cohorts who have successfully completed TIDIRH and TIDIRC, not to mention those who have benefitted from other training programs, NIH staff recognized that there are still far more who apply to participate in the program than slots available year after year. As a result, the NCI has just recently created an Open Access version of TIDIRC, which now makes all materials and assignments from the most recent iteration of the course available to all who wish to use them. We hope that TIDIRC Open Access will enable investigators interested in learning about D&I research at their own pace to have the core materials necessary to familiarize themselves with fundamental concepts and supports to develop a range of D&I studies. While a number of examples used within the course are cancer-related, the course is intended to be relevant to all areas of D&I research.
The course includes six modules:
- Module 1: Introduction to Dissemination & Implementation Science
- Module 2: Fidelity & Adaptation of Interventions in Implementation Science
- Module 3: Implementation Science Models, Theories, & Frameworks
- Module 4: Implementation Science Measures
- Module 5: Study Designs in Implementation Science
- Module 6: Implementation Strategies
Each module includes faculty lectures, key readings and specific assignments relevant to the presented materials. We expect that TIDIRC Open Access may also be helpful to those who are looking to launch their own programs to further extend the reach of available D&I research training. While this does not fully replicate the past training programs (which we expect will continue in mentored, in-person courses), we hope that more will use TIDIRC Open Access to learn more about the field. We also encourage these individuals to participate in the annual D & I conferences that NCI co-hosts with AcademyHealth to hear the latest findings and meet colleagues at every career stage of work in this area.
Please reach out via email at dchamber@mail.nih.gov if you have any questions about the course or have suggestions for additional training needs for the field.