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Mobile Intervention Development and Implementation Research Involving Clustered SMART Designs

MAY 3, 2019

Shawna N. Smith, PhD
Research Assistant Professor
Departments of Psychiatry & Internal Medicine (General Medicine)
Medical School
Quantitative Methods Program
Survey Research Center
Institute for Social Research
University of Michigan
About the Presentation: Over the past 10-15 years, the field of implementation science has grown exponentially, attempting to remediate the research-to-practice gap and improve public health by increasing access to evidence-based practices (EBPs). Much of this work has focused on identifying toolkits of implementation “strategies” than can be deployed to address specific barriers to EBP adoption. However, little empirical evidence as yet supports the ability of certain strategies to overcome extant barriers, or the comparative effectiveness of different implementation strategies. A next step in this line of scholarship, then, is developing and testing “implementation interventions” that provide support for overcoming barriers to EBP uptake. However, sites, providers, and patients differ in the barriers they experience to EBP adoption, and implementation strategies vary substantially in cost, intensity, and/or burden. As such, there is a strong rationale for developing implementation interventions that are adaptive, or use ongoing information about site/provider/patient needs to inform changes in type or intensity of implementation support provided. Adaptive implementation interventions notably hold promise for hastening EBP uptake by meeting health care organizations and providers where they are, and tailoring implementation support to ongoing needs. This presentation will cover three of the first trials designed to test and optimize the effectiveness of adaptive implementation interventions, including key study findings, opportunities for next steps in implementation intervention development, and some ongoing challenges related to developing, testing, and ultimately delivering large-scale adaptive implementation interventions.

About the Presenter:  Shawna Smith is a Research Assistant Professor at the University of Michigan Medical School, where she works in the departments of Psychiatry and General Medicine. She is also a faculty affiliate at Michigan’s Institute for Social Research, where she is a member of the Data Science for Dynamic Decision-Making (d3) lab. Shawna is an implementation scientist and organizational sociologist whose research focuses on improving population health outcomes by hastening implementation and adoption of evidence-based practices. Much of her work involves the development and optimization of adaptive interventions, and methodologically has focused on using SMART designs to inform adaptive implementation interventions, as well as micro-randomized trials to optimize just-in-time adaptive interventions.