What is translational research?

Today, we’re talking with Elaine Wethington, associate professor in the Departments of Human Development and Sociology at Cornell. Wethington is a medical sociologist and an expert in the areas of stress and social support systems. She’s also one of the nation’s leading experts in translational research methods.

Cornell’s College of Human Ecology is pursuing a translational research model to better link social and behavioral science research to extension and outreach, creating a more seamless link between science and service. But the question arises: What is “translational research?”

Evidence-Based Living sat down with Wethington to talk about the growing field of translational research.

To start off, what exactly is translational research?

Many definitions have been given for translational research, but the definition I like best is that it is a systematic effort to convert basic research knowledge into practical applications to enhance human health and well being. 

Translational research was designed for the medical world.  It emerged in response to concern over the long time lag between scientific discoveries and changes in treatments, practices, and health policies that incorporate the new discoveries.

What is applied research, and how does it differ?

Translational research is broader than the traditional term “applied research.”  Applied research is any research that may possibly be useful for enhancing health or well-being. It does not necessarily have to have any effort connected with it to take the research to a practical level. 

For example, an applied research study might analyze longitudinal data that tracks participants’ health and social relationships.  The researchers would report their findings in an academic journal.

But in translational research, the same study would include some “action steps.”  The researchers would partner with a community and ask for ideas about how their findings might apply there.  Together, they would come up with an intervention plan that would also include scientific evaluation of its effectiveness. 

Why are social science researchers slower to adopt these models compared to the medical community?

I think the answer to this question is that researchers have followed where the money has been allocated. The opportunities for social and behavioral scientists have not been established as rapidly.

More recently, three major government institutions have been funding projects that emphasize public health outreach using translational research – the Centers for Disease Control, the National Institutes of Health and the National Institute on Aging.  All three have been establishing translational research centers across the country, primarily focused on underserved communities and health disparities.

Thus, social scientists are only now being encouraged to take part.  More recently economic stimulus funds dispersed the National Institute of Health funded a number of translational research projects headed by social scientists, including three funded at Cornell.  I predict that soon there will be social scientists engaged in translational research across the country, not just at funded centers.

What are the benefits of moving toward translational research?

For researchers, there is benefit to being affiliated with a center that provides seed funding for projects, methodological assistance, advice on developing proposals and experience in getting community input into research projects.

For universities, translational research centers provide a tactical advantage for attracting more funding.  Translational research centers also provide a way for universities to meet public service goals in their strategic plans.

For communities, translational research provides opportunities to make a difference in their own communities.  As part of one of the Cornell centers, we engaged public service agency directors in events where they could contribute to our research agenda.  With a stake in the research, communities feel that they are making a valued and important contribution.  We heard over and over from the community members that this was a real source of pride and accomplishment for them.

How can extension programs participate?

One way local extension programs can participate in translational research is to take part in community stakeholder groups that meet with researchers who are designing intervention and prevention research programs.  Typically, a wide variety of stakeholders need to be engaged.  County Cooperative Extension offices have many collaborative relationships in their counties and can work with researchers to make contacts.

Typically, local extension professionals do not have time to engage in research themselves.  Yet they have valuable experience that can be shared.  This makes Cooperative Extension an ideal contributor for implementing programs.

Video feature: Science education outreach

Researchers and scientists across the country are making new discoveries every day, but continually must find the best ways to share that knowledge with the public.  The Cornell Center for Materials Research sets outstanding example of the best way to accomplish this.

The center’s mission is to advance, explore and exploit the science and engineering of advanced materials. It is part of a  national network of centers for Materials Research encompasses 29 centers funded by the National Science Foundation.

Nev Singhota is the director of the center’s Educational Programs Office, which reaches out to thousands of students, hundreds of parents and teachers, and many undergraduates from across the country. Many Cornell faculty, post-doctoral fellows, graduate and undergraduate students contribute to the center’s outreach efforts by visiting schools, hosting family and teacher workshops and coordinating an “Ask the Scientist” column in the local newspaper.

Singhota describes her role a facilitating interactions between Cornell scientists and all sorts of people in the community. “We create this web,” she said. “We’re like the spider who is trying to connect everyone together .” 

Interested in hearing more about Cornell Center for Materials Research’s outreach efforts?  Check out this conversation with Singhota:

Cornell NutritionWorks: Addressing obesity at the community level

Approximately one-third of all adults in the United States are obese and nearly 17 percent of youth are obese.  This national epidemic leads to an increased risk of diabetes, high cholesterol, high blood pressure, sleep disorders, joint problems, as well as social and psychological problems for millions of Americans.  

While there is an urgent need to address obesity with a focus on prevention, it can be difficult – even for a professional – to sort through all of the information about diet and health in the media, on the Internet, and even at grocery stores.

Enter Cornell NutritionWorks, an online professional development program for nutrition, health, and youth professionals such as registered dietitians, extension nutrition and 4-H educators, public health nutritionists, health education specialists, and school food service directors.   

Cornell NutritionWorks uses distance-learning technology to provide cutting edge nutrition information, interaction with Cornell experts, discussion forums for practitioners and continuing education credit for nutrition professionals. The program is lead by Cornell Senior Extension Associate Christina Stark, who’s spent nearly 30 years interpreting and communicating research-based information on food and nutrition issues to extension educators, other professionals, consumers and the media.

“To prevent childhood obesity, professionals need to look beyond focusing just on individual behavior change,” Stark says “We need to work collaboratively with community partners to change local environments so they support healthy eating and active living. For many professionals, this is a new way of thinking and working. Cornell NutritionWorks provides training in using this new evidence-based approach.”

Current offerings on the website include:

  • Preventing Childhood Obesity: An Ecological Approach, an in-depth six-week online course, offered three times a year, that helps participants use an ecological approach to identify local factors that contribute to childhood obesity and develop an action plan for their communities.  The next session will be offered fall 2010. There is a fee for this course.
  • Has the Food Revolution Reached Washington?, a cyber-presentation by Marion Nestle, professor of nutrition, food studies and public health at New York University and a visiting professor at Cornell. The talk examines how the U.S. food system contributes to our obesity epidemic, describes current food industry trends that affect consumers’ ability to choose healthy foods, and outlines the evidence for a food revolution in the United States.
  • The Built Environment, Food, and Physical Activity, a cyber- presentation by Ann Forsyth, professor in Cornell’s Department of City and Regional Planning, that discusses ways to think about the built environment, food, and physical activity measures to improve community health.

To get the latest, research-based information on nutrition and health, Cornell NutritionWorks is the place to go.  All of the content, with the exception of the in-depth course, is available to members at no charge. And membership is free.

Educating parents: The parts of a successful program

Before having children, many parents-to-be – me included – assume that taking care of a child will come naturally every step of the way. They think, “Of course I’ll know what to do when my toddler has a temper tantrum in the middle of the grocery store, or when my kid hits someone at the playground.” Until it actually happens.

The good news is parent education programs abound. Cooperative extension offices, medical facilities, government agencies and non-profit organizations across the country offer a wide-range of workshops and courses to help parents who need additional information and even practice at parenting. We recently heard from Jennifer Birckmayer, a true pioneer of parenting education in New York State, who asked Evidence-based Living about the evidence base for such programs. She wondered, does the research show they really work?

The answer is yes. Two recent analyses by the Center for Disease Control and researchers at the University of Kansas demonstrate parent education programs are effective, and that specific program components work better than others to help parents learn new skills and reduce children’s negative behaviors.

The research shows that parent training programs yield better results for parents and children when they:

  • teach parents emotional communication skills, like actively listening to their children and identifying children’s emotions.
  • teach parents the correct use of time out including removing all forms of attention and using a designated location when possible.
  • teach parents to respond consistently when disciplining their child.
  • teach parents positive interaction skills, like playing with their children and praising good behavior.
  • require parents to practice with their child during the training sessions so the facilitator can provide the parent with immediate feedback.

There are also some aspects of parent education programs that are clearly less effective in teaching parents new skills and modifying children’s behavior, according to the research.  They are:

  • teaching parents how to problem solve about child behaviors
  • teaching parents how to promote children’s academic and cognitive skills
  • including ancillary services, such as  job skills training or anger management, as part of the parenting program

According to the analyses, a major component of improving children’s behavior boils down to providing

parents with the skills they need to improve their relationships with their children. This reflects a major conclusion of child development research: Children who have positive relationships with their parents are much less likely to misbehave.

For more information about parent education programs, check out Parent Training Programs: Insight for Practitioners and “A Meta-analytic Review of Components Associated with Parent Training Program Effectiveness” in the Journal of Abnormal Child Psychology.

Do you have a question for Evidence-Based Living?  E-mail it to Karl Pillemer at kap6@cornell.edu. 

Sheri Hall

Evidence-based cheese!

It’s summer-time in the Finger Lakes – a great time of year to sample regional wines along one of the three local wine trails.  On your tour this year, you can pair that wine with some delicious, local cheese.

Cornell Cooperative Extension has teamed up with regional cheese-makers to create the Finger Lakes Cheese Trail – a driving tour of local creameries where you can learn about the craft of cheese-making and sample local varieties including sheep’s milk cheese, goudas, goat cheese, cheddars, jacks, Colby and even cheese curds.

They’re absolutely delicious!  But are they good for our diets?

The evidence says yes. In fact, cheese provides a myriad of health benefits. A single serving of cheese provides about 300 mg of calcium – nearly one-third of the daily recommended amount.  And a study published in the American Journal of Clinical Nutrition demonstrated that getting calcium from cheese rather than supplements leads to improvements in bone density. Cheese packs in other key nutrients, too, including like protein, magnesium, folate, B1, B2, B6, B12, and vitamins A, D, and E.

Unfortunately, there’s a downside to cheese. Many cheeses are also high in cholesterol, sodium and saturated fat, which can contribute to obesity, high blood pressure, heart disease and cancer. But that doesn’t mean you should eliminate cheese from your diet.

Nutritionists at Yale-New Haven Hospital have published some guidelines on incorporating cheese in a healthy diet. Among their recommendations are:

  • If you like to eat hard cheeses , look for “fat free,” “reduced fat” or “low fat” versions.
  • When looking for soft cheeses, low fat , part-skim or light products are available.
  • If you do use full-fat cheese in a recipe, cut the amount in half to reduce your fat and sodium intake.

So, go ahead. Melt some cheddar on that burger, sprinkle a bit of gorgonzola in your salad or visit a Finger Lakes creamery. As long as you indulge in moderation, you’ll reap all of the health benefits from cheese.

Sheri Hall

Is it okay to tinker? Evidence-based programs and “fidelity”

There is a lot to be said in favor of using evidence-based programs. They have been rigorously tested, and for that reason we can be pretty sure they will have the effects we want them to have. But often an agency or community educator will find an evidence-based program, try it out, and then want to tweak it in one way or the other. It may seem like it doesn’t quite fit your audience, or you might feel like replacing one component with something else, or skipping part of the program.

If you do that, is the program still “evidence-based?” How much can you change a program without making it less effective? The term scientists use is “fidelity” – that is, the faithfulness with which a practitioner implements a program. If you are engaging in fidelity to the program, you are implementing it pretty much as it is written, without changing its core components.

What some people do, however, is adaptation – making changes in the program to make it fit your clientele or the organization you work in. This isn’t necessarily a bad thing, and it might be necessary to fit a program into a given time frame, to accommodate people of different cultures or with different languages, or even just to have more “ownership” of the curriculum. However, if the program is changed too much, it can reduce the strength of the program. (The University of Wisconsin Extension has a helpful fact sheet that differentiates between “acceptable” and “risky” adaptation of programs.)

A recent talk given at Cornell addresses these issues in a very interesting and informative way. The wonderful Cornell Human Development Multimedia Website offers a video of Lori Rollen presenting on “Making Informed Adaptations to Evidence-based Sex and HIV Education Programs.”

(While you are there, take a look at the dozens of other videos with speakers discussing their research. It is an amazing site. I take the occasional lunch at my desk and use this site to catch up on what’s new in the world of research on human development.)

Lori helps you think out when adaptation of a program is a good idea and when it isn’t. She uses a clear “green light, yellow light, red light” system to show when it’s okay to adapt, when you should be cautious, and when it’s best to leave the program just as it is. And the programs she reviews on sex and HIV education are interesting in and of themselves.

Have you had any experience in adapting programs? We’re interested to hear from you.

Research re-imagined at USDA: New “Roadmap” published

The venerable U. S. Department of Agriculture (USDA) has pioneered agricultural research for more than a century (see related post). Over the past several years,  the USDA has been reshaping its research priorities and funding programs, in part through the creation of the new National Institute of Food and Agriculture. NIFA has the mission to “advance knowledge for agriculture, the environment, human health and well-being” through funding research, education, and extension projects.

 USDA has just published a “Roadmap for USDA Science,” that is worthwhile reading. It calls for new approaches to foster robust food, agricultural, and natural resource science.

 The report begins in an interesting way. It asks us to:    

 Imagine a world in which…    

  …Radically improved children’s diets and nutrition slash long-term health care costs in the United States;

  …Farmers, ranchers, and forest landowners are recognized as significant contributors to large and sustainable reductions in global greenhouse gases;  

  …Farmers in sub-Saharan Africa have easy, affordable access to new seeds and animal breeds so well adapted to local conditions and so resilient to changing conditions that they feed five times as many people domestically and eliminate persistent hunger;  

  …Trends in availability of high-quality water and new options for watershed management outpace increasing demand for water even as climate change alters the geography of water resources; and

  …Technologically advanced production, processing, and foodborne pathogen detection methods make food product recalls nonexistent.  

 Farfetched, ask the authors of the Roadmap? Not at all, according to them — They believe that these goals are achievable through the kind of science the USDA will now promote. 

Among other things, the Roadmap calls for a focus on a limted number of “outcome-driven priorities,” cooperation with other agencies and institutions, concentration on both fundamental science and extension, and a “rejuvenation” of the USDA competitive grant system.

All in all, a very interesting read.

Drugs, Medicare, and the older consumer: Economics to the rescue

Okay, let’s have a show of hands. First, how many of you have a relative or someone you care about who is age 65 or older? Thanks.

Now, how many of you tried to help one of these beloved relatives or friends understand and choose a plan under Medicare Part D, the prescription drug benefit for older Americans? Thanks again.

My final question: How many of you who tried to help someone understand their options under Medicare Part D sighed, wept, and eventually wanted to pound your head against the wall in an attempt to lose consciousness? I thought so.

I had this experience myself, trying to help my 80-year old mother-in-law decide which program was best for her. I’m a gerontologist, for heaven’s sake, and I tore out what little hair I have left trying to figure out what her best option was.

 To the rescue comes a highly innovative and effective translational research project, led by Cornell Professor Kosali Simon (Department of Policy Analysis and Management). An economist, Prof. Simon’s desire to apply her expertise to this real-world problem has helped people in New York and across the country make this complex and important decision.

 Medicare Part D was passed in 2003 and is the federal program that subsidizes the costs of prescription drugs for people on Medicare (the federal health insurance program for Americans 65 and over). Some people were basically going broke paying for prescription drugs, and the federal government stepped in.

It sounds good, but here’s the problem: It is extraordinarly difficult to understand the coverage. A beneficiary has to choose among dozens of plans, which include dizzying combinations of deductibles and co-payments, and use different terminology for what they cover.

 

That’s the problem Prof. Simon took on. She had spent her career studying things like the economics of state regulation of private health insurance markets for small employers. But then she did an exercise for one of her classes, and students looked at Medicare Part D. Their work led her to become interested in the topic, and she began to do research on it.

Then she got in touch with psychologist Joe Mikels (Cornell Department of Human Development), who looks at how older people make decisions. Together, they used psychological theory and experimental methods to study older persons’ perceived difficulties of choosing a plan when the number of options available under Medicare Part D is increased in a lab setting. She also studied how seniors may actually benefit from increased breadth of choice in plan offerings using econometric methods and data on plan enrollment.

But here’s where it gets really interesting. Prof. Simon saw that there was practical value in learning how to help older people to understand the differences in medication coverage between plans. She used her data to create guides that can form the basis for choosing the right plans based on examining the coverage of medications, rather than simply going by general marketing materials that were mailed to older people.

Working with Project Manager Robert Harris, an experienced pharmacist, she has expanded the reach of the program in many different ways. Based on the research evidence, they have created a variety of materials such as pocket guides to Medicare Part D, posters, counter cards for pharmacies, customized mailings to residents of nursing homes, and an email newsletter and website with thousands of hits per month. 

All of this is very nicely summarized on her project web site CURxED, which I recommend you visit not just for the information, but as a great example of how complex information can be disseminated on the web.

Prof. Simon summed up the translational research approach very well when she told me: “It is very rewarding to be able to use the same data I collect for my research in ways that are practically useful to actual human beings being served by the program I study.”

Master Gardener Volunteers: Good new blog, great benefits

We were recently alerted to a new blog about all things Master Gardener, which got us thinking about the program. For those of you who don’t know, the Master Gardner Volunteer (MGV) program is an extension effort based on volunteers who promote public education in horticulture. The volunteers provide educational assistance about trees, lawns, vegetables, ornamentals and a host of other topics. Volunteers go through extensive training, pass an exam, and make a minimum time commitment to the program.

My Cornell colleague Lori Bushway has done a great job of educating me about the MGV program. And I think it’s hard to find a better example of how to harness the power of volunteering. There are over 90,000 Master Gardener Volunteers nationwide, and it’s estimated that they create an annual service value of over $100 million. The benefit to communities is huge and well-documented.

But after our visit from volunteering researcher Mark Snyder, we wondered: What about the benefits to participants? We’d expect MGV participation to be good for the volunteers, but true to our name, on this blog we obsessively look for research evidence.

Well, from the preliminary research available, it’s not just local gardeners who benefit from MGV, but also the volunteers. First, they get new knowledge. Emilie Swackhammer and Nancy Ellen Kiernan found that MGVs made clear knowledge gains over time in areas like botany, soils, plant disease, integrated pest management, and other areas. In addition, their confidence increased in their ability to answer questions from community members in these areas (here’s the article).

What about areas beyond horticultural knowledge? T.M. Waliczek and Roxanne Boyer’s article looked at more personal outcomes. They found that MGV training and participation led to increased physical activity, social activity, self-esteem, and other positive effects among Master Gardener volunteers.

Talk about a win-win situation: Volunteers work to improve their communities through promoting citizen involvement in horticulture, and along the way increase the knowledge and quality of life of the volunteers themselves. Go Master Gardener Volunteers!

Want better volunteers? Understand their motivation

We just had a fantastic visit today by Prof. Mark Snyder, Professor of Psychology at the University of Minnesota. Prof. Snyder is a top researcher who also has a strong interest in improving people’s lives in the “real world.” A dominating interest of his is, to put it simply, why people do good things. Why do people help others when they don’t have to, and when it even may not seem in their selfish interests to do so?

This led him to a two-decades long program of research on volunteering. Research shows that most people endorse volunteering and see it as a good thing. However, only a minority of those who hold this positive value actually volunteer. Prof. Snyder is exploring what can be done to move general motivation into actually volunteering. As part of his research, he has developed the Volunteer Functions Inventory, which identifies main motivations for volunteering.

You can find out more about his research and intervention programs here. Two points of particular interest for everyone trying to recruit volunteers:

First, volunteers stay on the job longer if their original motivation for volunteering is met. So someone who comes to an organization primarily interested in making friends could best be put in a more social situation, whereas someone coming to explore a new career could get a different set of tasks. The take-home for groups that use volunteers is this: It’s critically important to explore why volunteers want to work for the organization, and to try to match tasks to that motivation.

Second, many of the longest-term volunteers are motivated at least in part by what we might call “selfish” reasons. They want peronal growth, career experience, social contact, or other personally rewarding things. This doesn’t mean they aren’t altruistic — they are that, too. Prof. Snyder coined the term “selfish altruism” to describe this mix of motives. The implication is that it’s okay to want to benefit from the volunteer work, and organizations should feel free to market their volunteer positions that way (focusing on the potential benefits to volunteers).

So Prof. Synder’s work definitely falls in the “research you can use” category. Many of his publications are listed on his web site. He has also created a center that studies positive action, including volunteerism and civic engagement, and it’s well worth a look.

Building extension’s public value: We can be more convincing

Those of us who work in the Cooperative Extension system tend to love it. Over the past weeks, I’ve been involved in an interview project with older people who have been involved in extension most of their lives, either as volunteers or as paid employees. Their devotion to extension’s mission shines through every interview. From the inside, the value of what we do seems self-evident.

Then we come up against the harsh reality: Extension is heavily dependent on public funding. Many other constituencies, and in particular elected officials and the general public, need to see the value of what we do. How can we convince those who hold the purse-strings that the work of extension has public value, worth spending government funds on?

I recently came across the work of Laura Kalambokidis, a faculty member in the Department of Applied Economics at the University of Minnesota. One of the pleasures of writing a blog is that you start reading other people’s, and Laura’s brings a fascinating perspective to extension.

In an article in the Journal of Extension, Laura raises the issue of identifying the public value of extension. She lays out the problem facing us succinctly:

The current economic climate has placed significant pressure on the budgets of state and county governments. In turn, those governments have compelled state Cooperative Extension Services to defend their continued receipt of state and county funding. Even when policymakers are persuaded of the efficacy of an Extension program, they have questioned whether the program should be supported with scarce public dollars rather than through user charges.

To address this issue, Laura translates economic theory and research from public sector economics to practical issues of extension. What policymakers need to be convinced of is that extension work has public value – that is, why should the public pay for our services rather than being purchased on the private market? The challenge is to show that extension activities are a public good, one that benefits society as a whole (in addition to benefitting specific program participants). In her words: “Extension staff must also be able to explain why citizens and policymakers who are not direct program participants should value the program.”

In the extension programs I’ve created, I confess that I haven’t done this. When I justify my programs, I point to the good outcomes and satisfaction for program participants. But I don’t really look at the public good – how they have benefits  for the larger community, beyond my participants. For example, I’ve created extension programs to train nursing home staff. But someone could ask: “That’s well and good, but why shouldn’t those programs be paid for by nursing homes as a private good? What’s the public value for what you do?”

Laura’s work suggests that the most effective case can be made for public value when there is market failure – we provide something that isn’t effectively offered privately – and when there are issues of fairness and justice not addressed by private markets. Her article gives a detailed process for identifying public value.

To give one example, extension folks typically believe that they address market failure by providing information. But Laura suggests we consider this carefully, asking questions like:

  • Is there a demonstrable information gap?
  • Can you show that other entities are providing wrong or incomplete information to consumers?
  • Does your information direct consumers (and producers) toward activities that have external benefits?
  • Are you providing information to a population that does not have access to private information sources?

Laura has developed a workshop program where she helps extension associations determine public value of their programs and how to present them as such. More information is available on her web site, which includes a blog.

Reimagining Extension and Outreach at Cornell: Strategic Plan for “Public Engagement”

Have you heard about “Reimagining Cornell?” Universities like to reimagine themselves every once in a while, and Cornell is no exception. In Cornell’s case, this strategic planning process will have profound and long-term effects on the university – and not least for extension and outreach. Cornell’s approach should be of key interest to Cornell Cooperative Extension educators, as well as to others interested in university outreach efforts.

Reimagining Cornell is the name for  a coordinated planning and implementation effort upon which, as the leaders put it “the future health of our great university depends,” There are two main goals:  (1) to position Cornell for excellence in priority areas, and (2) to ensure the ongoing financial health of the university. Over the past year, activities have included gathering ideas from throughout Cornell, launching 20 task forces, and releasing a draft strategic plan. They’ve done a great job of putting all the information together on a user-friendly Reimagining Cornell web site.

There is major attention in the plan to the area of extension and outreach, included under the broad area of “Promoting Excellence in Public Engagement.”

The plan strongly endorses the importance of engaging with the community and extending the work of Cornell to benefit citizens of New York State and beyond. It also points to goals for extension that may imply a shift in focus. The plan proposes to integrate extension activities more closely with the many other public engagement activities at Cornell, including departments not part of the land-grant side of the university. It also calls for better integration of extension activities with the research and teaching efforts at Cornell, and an emphasis on evidence-based programming and evaluation of extension programs.

The five main recommendations are:

  1. Construct a unified concept and coherent organizational model for the University’s outreach and public engagement mission.
  2. Strongly connect extension and outreach to on-campus research and educational strengths.
  3. Develop rigorous, systematic evaluations of all outreach and extension programs.
  4. Promote stronger collaborations and partnerships between the University and stakeholders that can make use of and strengthen Cornell’s research (e.g., industry, K-12 schools, nonprofit organizations, government).
  5. Make public engagement a distinctive feature of education at Cornell.

You can read more detailed discussion of these points on the web page.

What do you think? Feel free to start a dialogue by posting comments here. We are very interested in your reactions and thoughts about these recommendations and their relevance to work in the counties.

Skip to toolbar