CAPS Implementation Science and Sustainability Core

Innovations in HIV prevention and care have provided powerful tools towards ending the HIV epidemic. A key challenge at this stage of the epidemic is to ensure effective innovations are implemented appropriately and sustained for long-term impact, particularly in the context of increasing budget and workforce constraints. More than ever, scientists need implementation science skills, tools, and capacity to institutionalize existing HIV interventions and to integrate consideration of sustainability into the initial design and implementation of new programs. The Implementation Science and Sustainability Core (IsSc) will provide foundational knowledge, rigorous methods, and connections to policy and community to ensure CAPS researchers are equipped to address implementation and sustainability throughout the cycle of research and intervention scale up. First, the IsSc Core will support intervention implementation through training in foundational implementation science theories, strategies, and approaches to adaptation and scaling. Workshops will demonstrate the application of implementation science theory to the complex context of populations with comorbidities and co-occurring factors. Second, the Core will provide training, consultations, and tools to facilitate the use of rigorous methods for implementation and sustainability research, including implementation trial design, measurement approaches for community and organizational contexts, and cost-effectiveness analysis to inform policy. The Core will provide guidance on the use of emerging technologies to facilitate implementation research, such as the application of large language models to routine health information data, and will compile best practices in measuring sustainability (potential for program longevity) and sustainment (actual longevity) to facilitate their use. Third, the Core will provide consultations and seminars to help research teams navigate local, state, and national policy contexts and build strong community partnerships to situate research insights within the socialstructural dynamics that shape HIV prevention and care outcomes at the community, societal, and population levels. Working with other CAPS Cores, IsSc will highlight opportunities for team science and shared learning across disciplines in events such as CAPS Research Community Days. These activities renew CAPS’ commitment to implementation science while advancing an innovative focus on sustainability, emphasizing its consideration throughout the research and intervention cycle. IsSc will prioritize Early-Stage Investigators within the Core and throughout Core activities to foster a new generation of research leadership. Through workshops, consultations, seminars, and cultivating team science approaches, the IsSc will work to bridge the gap between innovation and sustained programming. IsSc activities will promote research that fosters program continuity, increases efficiencies, and maintains progress toward ending the HIV epidemic and HIV-related health disparities.

Consultation

The IsSc provides consultations to investigators developing, adapting, implementing, scaling, and evaluating interventions.

To request a consultation, please contact Rochelle Blanco.

Examples of consultation areas include:

• Intervention development research
  • Methods for gathering formative data
  • Designing an intervention from formative research
  • Using theory (e.g., behavioral models) and methods (e.g., intervention mapping) to develop an intervention
  • Incorporating public health considerations at the community-, structural-, individual-levels
  • Utilizing mixed-methods approaches to intervention design
• Intervention efficacy research
  • Clinical trial designs
  • Approaches for establishing intervention efficacy when a traditional clinical trial design is not feasible
  • Utilizing a data safety and monitoring board (DSMB)
  • Building on intervention efficacy (moving towards effectiveness research)
• Implementation Science research
  • Issues to consider in clinic-based implementation research
  • Theories and frameworks that guide implementation science design
  • Adapting evidence-based interventions to new settings
  • Quasi-experimental and hybrid designs in implementation research
  • Mixed-methods evaluation of implementation processes
  • Using research and analysis approaches to understand and shape HIV-related policies
  • Approaches to gain an understanding of organizational, political, and social structures impacting implementation and sustainability of programming
• Health systems research
  • Integrating interventions and services in both traditional (health care facilities) and nontraditional healthcare settings (community settings, retail locations, mobile vans, home-based)
  • Measurement methods to assess organizational systems, clinical and community contexts, and process and outcome measures
  • Leveraging the benefits of electronic health record (EHR) data to advance health systems research
  • Matching interventions to participant needs (e.g., personalized and patient-centered medicine)
  • Conducting analyses of policies that affect health systems, including environmental scans
  • Mapping health systems

Town Halls, Skills Building Workshops, and Mini-Conferences

The IsSc sponsors Town Halls highlighting innovative intervention and implementation science.  Sessions are held as part of the Division’s standing CAPS/PRC Town Hall series, which is held on Tuesdays at 11:00 AM. 

To present your work at our Town Halls or request speakers of interest, please contact Rochelle Blanco.

The Implementation Science and Health Systems (IS/HS) Core YouTube Play List.

2020/21 Town Hall Series highlights:

1. Adapting HIV and Other Health Interventions to Distance Models and Interruptions in times of COVID-19: A 4-Part Implementation Science Series

This series explored means of adapting our research in the era of COVID-19, including digital approaches and adaptations to intervention implementation, ethical considerations around study adaptations; data analysis approaches for studies spanning the pre- and during-COVID eras; and study designs for evaluating the impact of COVID-19-related interventions and interruptions.

2. Laying Foundations of Trust: Moving Towards Greater Health YouTube Playlist

This series explored core social and behavioral aspects of trust and engagement with public health measures in relation to the COVID-19 pandemic with an eye towards lessons from work in HIV.  It aimed to stimulate dialogue that can shape programmatic and research agendas that address structural issues in public health and medicine through discussions on building trust, community engagement, risk and decision-making, and harm reduction.

Workshops and Conferences: 

The IsSc leadership is currently designing skills-building seminars and workshops to address topics such as: implementation science theory and strategies; methods to select implementation strategies that encourage intervention uptake and integration; and approaches for adaptation of proven effective interventions into health systems or nontraditional settings.  

In future years, the IsSc will co-sponsor small conferences with UCSF partners to catalyze innovations in evidence-based programming.  Information on conferences is forthcoming.  All workshop and conference information will be announced on the website and promoted on the CAPS listserv.  To sign up for the listserv, please contact Rochelle Blanco.

Peer Review

IsSc faculty and scientists are available to peer review conference abstracts, manuscripts, and grant proposals. Send peer review requests to Stuart Gaffney.

Collaboration Opportunities and Bi-Directional Learning

The Core will offer structured activities (talks, seminars, consultations) to develop capacity and partnerships to work across systems (e.g. housing, correctional facilities, food subsidies) to develop, implement, and evaluate interventions that address the needs of individuals facing multiple vulnerabilities. Towards this end, in collaboration with the CE Core, the IsSc will continue to build an extensive network of collaborators, with partners from within and outside the traditional health system.  

To inquire into potential partnerships and collaborative opportunities, please contact Barbara Green-Ajufo.

IsSc Faculty

Primary Faculty

The Core’s primary faculty are responsible for developing and managing most of the Core’s programming, and are available for consultation in their areas of expertise.

To request a consultation with a faculty member, please contact Rochelle Blanco.

Table 1. Core Faculty
Name	Role on Core	Areas of Expertise
Sheri Lippman, PhD, MPH	Core Director	Epidemiology, international intervention and implementation research, study design, situational/contextual analysis, measurement methods
Wayne Steward, PhD, MPH	Core Co-Director	Health services and systems research, HIV policy, health record systems, social psychology, domestic intervention and implementation research
Judith Auerbach, PhD	Core Scientist	Science policy, HIV treatment & prevention plans, sociology; socio-behavioral aspects of biomedical prevention
Edwin Charlebois, PhD, MPH	Core Scientist	Analytic approaches for IS, modeling and simulations, epidemiology, biostatistics, co-morbidities
Margaret Handley, PhD	Core Scientist	Implementation science theory, frameworks, study design, integrated care models, chronic disease prevention
Janet Myers, PhD, MPH	Core Scientist	Monitoring and evaluation, health services and systems research, translation of proven-effective interventions, sociology
Ida Sim, MD, PhD	Core Scientist	Primary care, informatics, health data integration, mobile and digital health
Jennifer Velloza, PhD, MPH	Core Scientist	Implementation science theories, models, and frameworks; epidemiology; socio-behavioral intervention development and adaptation; mixed methods; study designs; integrated care models; differentiated care delivery; HIV and mental health

Affiliated Faculty and Investigators

The Core’s affiliated faculty includes additional scientists with expertise relevant to the Core’s mission. Affiliated faculty members work across the intervention spectrum, including intervention development and testing, implementation science research, policy research. Affiliated faculty contribute to Core’s town halls and meetings. They also may be called upon for consultations and peer reviews.

To request a consultation with an affiliated faculty member, please contact Rochelle Blanco.

Table 2. Affiliated Faculty
Name	Role on Core	Areas of Expertise
Oliver Bacon, MD, MPH	Affiliated Faculty	Implementation of Rapid ART, same day PrEP initiation, biomedical prevention of HIV transmission
William Brown III, PhD, DrPH	Affiliated Faculty	Biomedical informatics, data integration, analysis of large data sets (big data), machine learning, data visualization, mHealth
Carol Dawson-Rose, PhD	Affiliated Faculty	Intersection of mental illness, trauma, HIV and substance use; clinical implementation studies, mixed methods
Willi McFarland, MD, PhD, DTM&H	Affiliated Faculty	Epidemiology, surveillance; sampling methods, key population prevention interventions
Jerry Ouner (né Nutor), PhD, RN, MS	Affiliated Faculty	Maternal and child health, and HIV treatment among childbearing women in sub-Saharan Africa, with particular focus on prevention of mother-to-child transmission of HIV
John Sauceda, PhD	Affiliated Faculty	Use of multiphase optimization strategies in study design, cross-cultural intervention research, psychology
Starley Shade, PhD	Affiliated Faculty	Study design, sample size calculation and application of implementation science theory (e.g. Proctor Model, RE-AIM, Precede-Proceed, etc.) to real-world settings
Ariane van der Straten, MD, PhD	Affiliated Faculty	End user preferences, acceptability and adherence to PrEP and other biomedical prevention strategies, qualitative research, research in LMIC settings
Sheri Weiser, MD, MPH	Affiliated Faculty	Impact of social and structural factors on treatment outcomes; impacts of material needs insecurities including food insecurity on HIV treatment outcomes, cardiovascular risk, and aging outcomes among HIV-infected persons; Clinical trials; Evaluating interventions