Recent years have witnessed growing interest in translational research in the biomedical and clinical sciences. Translational research is one of several related terms that connote putting research into practice, but these terms mean different things to different people (83). For scientists, the health care services industry, and many clinical investigators, translational research refers to T1, the bench-to-bedside enterprise of bringing drugs to market and converting basic science discoveries into new diagnostic and therapeutic tools (26). Many health services researchers speak of implementation science (T2–T4) (58), which studies ways to close the gap between optimal and actual care (36, 51). The National Institutes of Health (NIH) funds D&I (dissemination and implementation) research aimed at getting trial findings into practice (29).Translational Research And Population Health Management Essay
These terms share two interesting features: They characterize the work as research (e.g., translational research1), and they view translation as the end of a process. For many investigators, a trial reaches its final step when its results are disseminated. Viewing translational research as an end point differs from viewing research translation as an input to the work of improving population health. Those working to better the health of communities—be they public health officers, clinicians, legislators, or parents—find greater value in research information that relates to their needs and priorities (4). Getting answers to their key questions may do more to improve public health than would the information available in most journal articles.Translational Research And Population Health Management Essay
Translational research has a long history in public health. Decades ago, the research that identified evidence-based health behaviors (e.g., smoking cessation, physical activity), screening tests (e.g., mammography), and immunizations spawned its own form of implementation science: behavioral science research on how to help people adopt healthier behaviors; health services research on how health systems can improve uptake of clinical preventive services; and policy research on how to help communities adopt evidence-based policies. But in public health as in medicine, uptake of research evidence has often been disappointingly slow and incomplete (55, 60, 77). For example, rates of physical inactivity and obesity remain high (62), and many Americans are not acting on the evidence of life-saving forms of cancer screening (56). Research does not leap from the pages of journals into daily behavior.
One reason for this slow uptake may be misaligned agendas. Research that conforms to the academy’s interests may be less impactful than research shaped by the needs of decision makers or end users. This difference in agendas is seen in the very questions that scientific studies address, which often reflect the intellectual interests of scientists or funders (e.g., NIH) and the priorities stipulated in calls for proposals. Although they are fundamentally important, these questions may not always be framed to address the priorities of decision makers or to be usable on the front line (67, 80).2 Research may be more translatable if researchers learned more about the user’s agenda before doing the research. The problem may not be—as the academy sees it—how to get the community engaged in research, but how researchers can become engaged in the community and make their studies more relevant to the stakeholders working to improve public health.3 To use a business analogy, the consumer may not be buying the product (research) because developers are ignoring the needs of the market (end users). In such circumstances, lack of uptake is to be expected.Translational Research And Population Health Management Essay
A greater research focus on the needs of stakeholders could enhance the relevance of the academy, but it serves a more urgent purpose: to rectify the failure of the United States to keep pace with the advancing health status of other high-income countries. Americans have lower life expectancy and poorer health status than do their peers in 16 other countries, a pattern that has been worsening since the 1980s (85). A 2013 report documented the alarming scale of the problem and predicted further deterioration without a transformative change in social policy and health system design, including a shift in research priorities (85). The public health community has called on the academy to supply the data urgently needed to inform policy and practice decisions (37, 85).
This article argues that effective research translation to support meaningful change in population health requires better research aimed at user needs, but it also requires three other ingredients for success: an understanding of the decision-making environment, stakeholder eng
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