Section 1: Program Design and Curriculum Planning

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1 1 ESTABLISHING COMMUNITY-BASED RESEARCH NETWORKS Deliverable #3: Summary Report of Curriculum Planning and Research Nurse Participant Conference Section 1: Program Design and Curriculum Planning The long term objective of this project is to accelerate high impact -engaged research (CEnR). The overarching goal is to establish -based research networks comprised of research nurses from the Penn State College of Nursing and stakeholders in order to identify, prioritize, and respond to the s health needs in collaboration with Penn State researchers. In order to achieve these goals, we will design and test a model for establishing -based research networks that can be replicated in other settings. The curriculum plan was designed using a design backward/deliver forward approach. This process guides developers to consider the highest level of desired outcomes and then work backward to design specific learning activities. This approach ensures tight alignment as the desired outcomes are reflected in objectives and, ultimately, in the learning activities. We applied a three step process in the design backward phase: Outcomes & Objectives/ Learning Activity Alignment/ Learning Needs Assessment. Outcomes & Objectives In order to reach desired program outcomes, it is essential to focus attention on learner outcomes (i.e., research nurses and partner learners). Thus, the curriculum plan is designed to address three segments: the program model; research nurses; and partners. Desired outcomes and objectives for each segment are described below. Program Model Segment Program Outcomes (as stated in proposal): 1. Development and testing of a model for building capacity for CEnR that supports active engagement across all phases of patient centered outcomes and comparative effectiveness research 2. Model of implementation and tools needs to implement model in other settings 3. Metrics for evaluating outcomes (of project objectives) Program Objectives (as stated in proposal): 1. Provide training in engagement, principles of CEnR, -based participatory research (CBPR) for research nurses, comparative effectiveness research (CER), and patient centered outcomes research (PCOR). 2. Mentor research nurses in conducting a assessment to identify partners relevant to their specialization.

2 2 3. Provide training in basic research principles relevant to CER/PCOR, engagement and the potential impact of CEnR on the health of the for partners. 4. Mentor research nurse and partner interactions to prioritize health needs of targeted populations and expand stakeholder representation. 5. Facilitate linkages to the Penn State research to develop robust CEnR that addresses needs through nurse-led initiatives. Research Nurse-Participant Segment Learner Outcomes: By the conclusion of the two-year project, the research nurses will feel competent to activate a based network of stakeholders in order to collaboratively conceptualize, implement, and disseminate research designed to improve health. Learner Objectives: By the conclusion of the program, the research nurses will be able to: 1. Describe the principles of: a. Community Engagement b. Community Engaged Research c. Community Based Participatory Research d. Comparative Effectiveness Research e. Patient Centered Outcomes Research 2. Conduct a needs assessment to identify needs and resources 3. Identify relevant stakeholders in the by completing a stakeholder analysis 4. Form relationships with key stakeholders in the 5. Demonstrate capacity to lead team meetings in order to achieve desired objectives 6. Apply the CHANGE (Community Health Assessment and Group Evaluation) collaboratively with partners to prioritize health needs 7. Communicate prioritized needs to senior researchers in order to stimulate collaborative research. Community Partners Segment Learner Outcomes: By the conclusion of the two-year project, identified partners will feel competent to engage in research conceptualization, operationalization, and dissemination to enhance the health of the. Learner Objectives: By the conclusion of the program, the stakeholders will be able to: 1. Differentiate varied approaches to engaged research in communities, including: a. Community Engaged Research b. Participatory research c. Comparative Effectiveness Research d. Patient Centered Outcomes Research 2. Discuss strategies for meaningful compensation of partners 3. Contribute to implementation of the CHANGE model to prioritize health needs

3 3 4. Describe the members roles in conceptualizing, implementing, and disseminating research 5. Dialogue with nurse researchers and senior researchers to describe health needs

4 4 Learning Activity Alignment: Working backward from the outcomes/objectives, learning activities were aligned. In this phase, the learning objectives were mapped across the learning activities designed for the Research Nurse-Participant and Community Member Participant segments. Notations in the following tables refer to the nature of the educational experience planned across the project period. I=Introduced; R=Reinforced; A= Applied Table 1. Learning Activity Alignment: Research Nurse-Participants LEARNER OBJECTIVES: Differentiate varied approaches to engaged research in communities Conduct a needs assessment to identify needs and resources Identify relevant stakeholders in the by completing a stakeholder analysis Form relationships with key stakeholders in the Demonstrate capacity to lead team meetings in order to achieve desired objectives Apply the CHANGE (Community Health Assessment and Group Evaluation) collaboratively with partners to prioritize health needs Communicate prioritized needs to senior researchers in order to stimulate collaborative research. Conference 1 I I I I I I (May 2016) Mentoring R A A A R R I Sessions (May December 2017) A Conference 2 A R R A R R (February 2017) Grantsmanship R A A R A A

5 5 Conference (September 2017) Table 2. Learning Activity Alignment: Community Partner Participants LEARNER OBJECTIVES: Differentiate varied approaches to engaged research in communities Discuss strategies for meaningful compensation of partners Contribute to implementation of the CHANGE model to prioritize health needs Describe the members roles in conceptualizing, implementing, and disseminating research Dialogue with nurse researchers and senior researchers to describe health needs Mentoring Sessions* (July December 2017) Conference 2 (February 2017) Grantsmanship** Conference (September 2017) I I R A I R R R A R R A A A I A I R A * Mentoring sessions include team mentoring and on-site group mentoring. Not all mentoring sessions will include partners. ** Not all partners are expected to attend the Grantsmanship Conference; therefore, this learning activity is designated as Reinforcement and Application only

6 6 Learning Needs Assessment In the final phase of curriculum design, the needs of the individual learners are evaluated to specify the content and process of learning activities in order to maximize growth toward objectives. In this project, a Learning Needs Assessment was designed to guide curriculum development to best address the targeted learners needs. A Likert scale was used to measure progression toward competency in each objective (primary learner outcome). Research Nurse Participants The Learning Needs Assessment was implemented using online survey software (REDCap). This program provides easy retrieval of group- and individual- level data. Group-level data is being used to direct booster sessions as needed during the ongoing Mentoring Series. Individual-level data will be used in two ways. First, each participant will be able to view earlier responses as they complete serial measurements to reinforce progress toward goals. In addition, the Co-Leaders will monitor each individual s progress toward achievement of objectives in order to determine if any participants are lagging behind group progress. In these cases, individualized remediation will be developed and implemented. (Please refer to Appendix A to review the online survey format of the Learning Needs Assessment.) During the recruitment phase research nurse participants completed a baseline assessment of competency in each learning objective. These data informed the first learning activity, Conference 1. At the end of Conference 1, the assessment was repeated to gauge movement toward objectives and to inform the content for the Mentoring Series. The Learning Needs assessment will be administered every three months to monitor progress toward achieving program objectives. Based on the curriculum map, our goal is to reach a rating of competency in each objective as follows: LEARNER OBJECTIVES (Nurse-Participants) OBJ 1: Describe the principles of: a. Community Engagement b. Community Engaged Research c. Community Based Participatory Research d. Comparative Effectiveness Research e. Patient Centered Outcomes Research OBJ 2: Conduct a needs assessment to identify needs and resources OBJ 3: Identify relevant stakeholders in the by completing a stakeholder analysis OBJ 4: Form relationships with key stakeholders in the OBJ 5: Demonstrate capacity to lead team meetings in order to achieve desired objectives OBJ 6: Apply the CHANGE (Community Health Assessment and Group Evaluation) collaboratively with partners to prioritize health needs Target Date for achieving Competency December 2016 September 2016 September 2016 October 2016 February 2017 June 2017

7 7 OBJ 7: Communicate prioritized needs to senior researchers in order to stimulate collaborative research Community Partner Participants September 2017 A similar protocol is planned for the partner participants. The nurse-participants will be actively engaging partners in early fall of year 1. As the partnerships are stabilized (i.e., member identified and committed to continued involvement), the baseline needs assessment will be administered to partner participants. These data will inform the curriculum development of Conference 2 (February 2017). The survey will be administered again at the conclusion of Conference 2, then repeated every three months to identify continued learning needs and to monitor progress toward achievement of learning objectives. Co-Leaders will address group and individual needs via ongoing mentoring sessions involving partners and small group meetings, as needed. REDCap surveys are very user-friendly. While we anticipate that our partners will be able to access and complete the online survey, we have contingency plans in case a participant does not have access or is uncertain about their capacity to complete the survey. First, we will provide support by guiding the nurseparticipants to facilitate access or provide support to individuals needing help. Second, if this approach is inconvenient or rejected by the partner, we will revert to paper copy of the survey. In this case, the responses be entered on the paper form will be entered into the survey program by the Co-Leader so that the data set is complete. Based on the curriculum map, our goal is to reach a rating of competency in each objective as follows: LEARNER OBJECTIVES (Community Partner-Participants) OBJ 1: Differentiate varied approaches to engaged research in communities, including: a. Community Engaged Research b. Participatory research c. Comparative Effectiveness Research d. Patient Centered Outcomes Research OBJ 2: Discuss strategies for meaningful compensation of partners OBJ 3: Contribute to implementation of the CHANGE model to prioritize health needs OBJ 4: Describe the members roles in conceptualizing, implementing, and disseminating research OBJ 5: Dialogue with nurse researchers and senior researchers to describe health needs Target Date for achieving Competency March 2017 June 2017 June 2017 September 2017 September 2017

8 8 SECTION 2: RESEARCH NURSE CONFERENCE Curriculum Development for Nurse-Participant Training Conference The key content areas for the Nurse-Participant Training Conference were engagement, principles of -engaged research (CEnR), -based participatory research (CBPR) methods (CBPR), comparative effectiveness research (CER), and patient-centered outcomes research (PCOR). Each nurse-participant completed a self-assessment of their knowledge related to each of our specific objectives for the training conference (see Appendix A). These results assisted with our decisions on the weight and depth of content to include in each of our identified key areas. Using these data, specific objectives, content, and learning activities were designed for the research nurse-participant conference. As noted in our project proposal, we did not want our curriculum to duplicate readily available and vetted teaching-learning products, such as those previously made available by Clinical and Translational Science Award (CTSA) program institutions. Therefore, the second step in our curriculum development process was to conduct a thorough review of currently available teaching-learning materials, online lessons, and webinar content in our key content areas. We began by reviewing training products made available by CTSA member institutions, the Agency for Healthcare Research and Quality (AHRQ), and PCORI, as we had previously identified these organizations as ideal sources for training materials. Next, we collaborated with our colleagues in the College of Medicine, Penn State s Clinical Sciences and Translational Institute (CTSI), and the College of Nursing s research librarian to conduct a broader search. Through this process we identified 29 unique content sources to evaluate, including online training modules, curricula, research guides, and organizational reports. The Project Leader (Penrod) and Co-Leader (Hill) reviewed these materials for their fit with the Nurse-Participant Training Conference objectives. We selected some content for direct inclusion and other content to be adapted for our project s specific needs. Once our curriculum content was drafted, we vetted this content with experts in based research to ensure that our content was comprehensive. Following their positive feedback, we developed the specific content, learning activities, and evaluation strategies for each segment of the training. Conference Summary The Establishing a Community-Based Research Network conference was held on May 18 & 19, 2016 at the Penn Stater Conference Center Hotel. The conference was approved for hours of continuing nursing education units through the Penn State College of Nursing (an approved provider of continuing education by the PA State Nurses Association, an accredited approver by the American Nurses Credentialing Center s Commission on Accreditation). A total of 27 nurse participants from eight Penn State campuses attended the two-day conference, representing eight unique communities across the Commonwealth of Pennsylvania: Abington, Altoona, Erie, Fayette, Mont Alto, Schuylkill, State College, and Worthington- Scranton areas. (See map below for geographic distribution.)

9 9 Each participant was provided a Conference binder including: Participant Directory (photos and full contact information) CBRN Overview (copy of the Memorandum of Understanding and project proposal) Content slides Activity worksheets Supplemental materials for each session Principles of Community Engagement (2 nd Ed.) Community Health and Group Evaluation (CHANGE) Action Guide Community Health Needs Assessment for the home During the first day of the conference, we introduced the Community Based Research Network (CBRN) project, the project team, nurse participants, and project objectives. The curriculum focused on defining communities, the principles of engagement (including the Clinical and Translational Science Awards Consortium book of the same name), needs assessment, as well as the process of stakeholder identification, analysis, and communication. Didactic content was integrated with active practice applying the concepts learned to the participants communities and areas of interest. Over a dinner meeting, Dr. Eugene Lengerich presented to the group and engaged them in discussion regarding his successful experiences with engagement in the Northern Appalachia Cancer Network, a -academic partnership begun in 1992 to reduce cancer health disparities in rural communities of Pennsylvania and New York. The second day of the conference included introducing, comparing, and contrasting -based participatory research, comparative effectiveness research, and patient-centered outcomes research, including the overlap in these research approaches. In the afternoon, Dr. Sheridan Miyamoto joined the group and presented regarding her program of research, including her role in the PCORI-funded project, Patient and Provider Engagement and Empowerment through Technology (P2E2T2) Program to Improve Health in Diabetes. Our final day concluded with introduction of the group mentorship model that will be used to advance the CBRN over the coming months, as well as bringing the group together in collaboration around their areas of research interest and discussing next steps.

10 10 Conference Evaluation The conference was extremely well received by participants, as evidenced by the evaluation ratings obtained through the Continuing Education evaluation presented below. CE Program Content & Speaker Evaluation Scale: 1= Poor, 2 = Fair, 3 = Good, 4 = Excellent Achievement of learning outcomes Mean Rating 1. Describe the Principles of Community Engagement and engaged research 2. Identify the value of a needs assessment (CNA) prior to engagement 3. Identify relevant stakeholders in the 4. Discuss challenges and benefits of engaged research 5. Describe the principles of based participatory research 6. Describe the principles of Comparative Effectiveness Research 7. Describe the principles of Patient Centered Outcomes Research 8. Describe group mentoring Resources and materials used were beneficial (i.e. videos, handouts, PowerPoint, case studies, activities, etc.) I would recommend this course to a colleague Teaching effectiveness (Janice Penrod, PhD, RN) Teaching effectiveness (Nikki Hill, PhD, RN) Teaching effectiveness (Eugene Lengerich, DVM, MS) Teaching effectiveness (Sheridan Miyamoto, FNP, PhD) Overall quality of Establishing a Community-Based Research Network % (n=29) Participants commented on the most helpful parts of the session, including: Stakeholders; approaching those in the Very comprehensive Discussion of difference between CBPR, CER, PCOR The entire session Every part through the 2 days Review of all forms of research and parts of project All of it Group work Activities Guest speakers

11 11 Post-Conference Learning Needs Assessment At the conclusion of Conference 1, the research nurses again completed the Learning Needs Assessment in order to measure progress on the identified objectives. Mean scores improved for all objectives, and those emphasized in the Conference 1 program demonstrated higher levels of improvement. It is important to note that when we aligned learning activities and objectives, this conference was designed as introductory. However, as noted by the green shading below, several project objectives have already met the desired outcome of competency based on participant self-assessment. This achievement amplifies the success of our detailed curriculum planning process. These data will continue to guide project activities, as the objectives are emphasized in subsequent learning activities designed to reinforce and apply content. Learning Needs Assessment: Group Means Pre- and Post-Conference Scale: 1=Not Competent, 2=Somewhat Competent, 3=Competent, 4=Highly Competent Objective Pre-Conference 1 Post- Baseline Conference 1 Describe the principles of Community Engagement Describe the principles of Community-Engaged Research (CEnR) Describe the principles of Community-Based Participatory Research (CBPR) Describe the principles of Comparative Effectiveness Research (CER) Describe the principles of Patient Centered Outcomes Research (PCOR) Conduct a needs assessment to identify needs and resources Identify relevant stakeholders in the by completing a stakeholder analysis Form relationships with key stakeholders in the Demonstrate capacity to lead team meetings in order to achieve desired objectives Apply the CHANGE (Community Health Assessment and Group Evaluation) model collaboratively with partners to prioritize health needs Communicate prioritized needs to senior researchers in order to stimulate collaborative research

12 Appendix A. Learning Needs Self-Assessment 12

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