NURS 550 Discussion Levels of Translational Research
NURS 550 Discussion Levels of Translational Research
NURS 550 Discussion Levels of Translational Research
There are three levels of translational research: -T1- Basic research that is used to develop a new treatment or therapy. This research is conducted in a laboratory setting and aims to understand the fundamental biology behind a disease or condition. -T2- Preclinical research that is used to test the safety and efficacy of a new treatment or therapy in animals (Fort et al., 2017). This research is conducted in a laboratory setting and helps to determine if the treatment or therapy is safe and effective for humans. And -T3- Clinical trials that are used to test the safety and efficacy of a new treatment or therapy in humans. This research is conducted with patients who have the disease or condition being studied.
There are several ways in which translational research is different from evidence-based practice (EBP). The first has to do with the idea of “evidence.” In translational research, scientists strive to move discoveries made in the laboratory into practical applications that can be used in the real world. This means that the findings of translational research are based on sound scientific evidence. In contrast, EBP relies on a body of research that has been evaluated and found to be reliable (Parija, 2020). The goal of EBP is to use this existing body of knowledge to make informed decisions about patient care. Another difference between translational research and has to do with the time frame involved. Translational take longer time compared to EBP given the stages that has to be accomplished in the entire process.
Population health management (PHM) is the field of public health that concerns itself with the health and well-being of defined populations. It is a relatively new field, having been formally recognized only in the past few decades (Fort et al., 2017). PHM is built upon the foundation of translational research, which is the process of applying knowledge and findings from basic science research to practical applications in human health care. The goal of PHM is to improve population health by using knowledge gleaned from translational research to develop and implement interventions at the individual, community, and societal levels. Some common interventions employed by PHM practitioners include educational programs, screenings, targeted treatments, and policy changes.
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NURS 550 Discussion Levels of Translational Research References
Fort, D. G., Herr, T. M., Shaw, P. L., Gutzman, K. E., &Starren, J. B. (2017). Mapping the evolving definitions of translational research. Journal of clinical and translational science, 1(1), 60-66.https://www.cambridge.org/core/journals/journal-of-clinical-and-translational-science/article/mapping-the-evolving-definitions-of-translational-research/39D2FB59ECC2F0C862E49E03E2403E12
Parija, S. C. (2020). Translational Research in Nursing… Vistas Galore.https://web.archive.org/web/20201212092716id_/https://pjn.sbvjournals.com/doi/pdf/10.5005/jp-journals-10084-12165
Population health management requires health care providers, people, and communities to apply up-to-date and relevant approaches to respond to current and emerging health problems. Amid this, discoveries of new approaches to health and strategies of enhancing health outcomes are vital. Translational research’s primary purpose is to produce more meaningful, applicable results that benefit human health directly (Titler, 2018). It comes in different levels whose purposes and outcomes vary. As Fort et al. (2017) explained, phase T1 involves testing findings from basic research for clinical applicability, T2 tests new interventions in controlled environments, and T3 explores ways of applying guidelines in general practice. T4 research examines factors and interventions influencing population health.
From a health perspective, translational research differs from evidence-based practice in meaning and application. To a considerable extent, translational research involves discovering new knowledge. Titler (2018) described it as a process for yielding knowledge and the potential for intervention. If differently stated, translational research generates knowledge to form the basis for clinical application. In health practice, evidence-based practice involves utilizing the most current research to improve patients’ health and safety (Chien, 2019). It is generally a problem-solving approach that combines best practices from research with clinical experience and patients’ preferences to enhance outcomes. In this case, translational research is the foundation of evidence-based practice.
Concerning application to population health management, population health improvement relies heavily on knowledge. Illnesses emerge over time, and illnesses’ dynamics change according to people’s age, gender, blood group, and living environments, among other factors. Such variations complicate public health, and optimal health cannot be achieved if health care providers rely on a general approach or primarily the present knowledge. Solution-driven discoveries must be made as time advances to respond to the emerging health challenges. Translational research generates new knowledge critical in managing population health.
NURS 550 Discussion Levels of Translational Research References
Chien L. Y. (2019). Evidence-based practice and nursing research. The Journal of Nursing Research : JNR, 27(4), e29. https://doi.org/10.1097/jnr.0000000000000346
Fort, D. G., Herr, T. M., Shaw, P. L., Gutzman, K. E., & Starren, J. B. (2017). Mapping the evolving definitions of translational research. Journal of Clinical and Translational science, 1(1), 60-66. doi: 10.1017/cts.2016.10
Titler, M. G. (2018). Translation research in practice: An introduction. OJIN: The Online Journal of Issues in Nursing, 23(2). doi: 10.3912/OJIN.Vol23No02Man01
Description:
Identify the different levels of translational research. Explain how translational research is different from evidence-based practice and discuss application to population health management.
Topic 1 Participation
Description:
NA
Topic 1: Quality Research and Theoretical Frameworks
Description
Objectives:
1. Identify the different levels of translational research.
2. Differentiate translational research from evidence-based practice.
3. Discuss the application of translational research to population health management.
4. Evaluate sources of translational research.
5. Select a valid nursing practice problem for an evidence-based practice project proposal.
Study Materials
Advanced Practice Nursing: Essential Knowledge for the Profession
Description:
Read Chapters 22 and 23 in Advanced Practice Nursing: Essential Knowledge for the Profession.
Evidence-Based Practice in Nursing and Healthcare
Description:
Read Chapter 1 in Evidence-Based Practice in Nursing and Healthcare.
World Health Organization (WHO)
Description:
Explore the World Health Organization (WHO) website.
Centers for Disease Control and Prevention (CDC)
Description:
Explore the Centers for Disease Control and Prevention (CDC) website.
State and County Departments of Health
Description:
Explore the websites of your state and county departments of health and access mortality and morbidity data. The link to the Arizona Department of Health Services website is provided, but students living in other states should access their county and state departments.
Non-Communicable Diseases (NCD) Burden of Disease
Description:
Read “Non-Communicable Diseases (NCD) Burden of Disease,” by the U.S. Department of Health and Human Services, located on the Centers for Disease Control and Prevention website.
GCU Library: Nursing and Health Sciences Research Guide
Description:
Review the “Nursing and Health Sciences” research guide, located on the GCU Library website.
The Electronic Health Record: A Friend or Foe of Translational Research and Evidence-Based Practice?
Description:
Read “The Electronic Health Record: A Friend or Foe of Translational Research and Evidence-Based Practice?” by Chipps et al., from Worldviews on Evidence-Based Nursing (2019).
Evidence-Based Practice
Description:
Read “Evidence-Based Practice” by Melnyk and Fineout-Overholt, from Encyclopedia of Nursing Research (2017).
Translation Research in Practice: An Introduction
Description:
Read “Translation Research in Practice: An Introduction,” by Titler, from Online Journal of Issues in Nursing (2018).
On Biostatistics and Clinical Trials: PICO, PICOTS, PICOTT Framework for Clinical Questions as a Way to Design Clinical Trials
Description:
Read “PICO, PICOTS, PICOTT Framework for Clinical Questions as a Way to Design Clinical Trials,” by Deng, from
On Biostatistics and Clinical Trials (2020).
Course Description
In this course learners examine the process of scientific inquiry, knowledge generation, utilization, and dissemination of evidence into advanced nursing practice in order to propose quality-improvement initiatives that advance the delivery of safe, high-quality care for patient populations. Learners critically evaluate evidence, including scientific findings from the biopsychosocial fields, epidemiology, biostatistics, genetics, and genomics, and apply levels of evidence and theoretical frameworks to design culturally appropriate clinical prevention interventions and population-based care that reduces risks, prevents disease, and promotes health and well-being. Learners also consider strategies to evaluate health policy and advocacy issues, the state of health care delivery, patient-centered care, and ethical principles related to health beliefs, health promotion, and risk reduction for diverse populations. Learners apply these strategies to work towards recognizing gaps in nursing and health care knowledge, identifying potential solutions or innovations for those gaps, planning and implementing practice changes, and evaluating the outcomes in order to improve practice. Prerequisite: NUR-513.
Pre-Requisites
NUR-513.
Co-Requisites
None
NUR-550
Course Materials
Description:
Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L., & Horowitz, M. R. (2019). Population health: Creating a culture of wellness (3rd ed.). Jones & Bartlett Learning. ISBN-13: 9781284047929
Evidence-Based Practice in Nursing and Healthcare : A Guide to Best Practice
Description:
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13: 9781496384539
APA Writing Style
Description:
APA Style is required for all writing assignments in this course, where indicated. Please prepare these assignments according to the APA Style Guide, located in the in the Student Success Center.
You may want to consider purchasing a copy of the APA style guide, as this will be a useful resource throughout your program
The Writing Process Access
Description:
View “The Writing Process” media presentation for information on how to strengthen your writing for future assignments.
University Policy Handbook
Description:
Read the Code of Conduct and Academic Standards section of the University Policy Handbook.
Library Walk Through Tutorial
Description:
View the “Library Walk Through Tutorial.”
Academic Integrity
Description:
Read the “About LopesWrite” and “Plagiarism” sections of the Academic Integrity page of the GCU website.
GCU Library: General Research Guide
Description:
Review the “General Research” guide, located on the GCU Library website.
GCU Library: Persistent Links
Description:
Review “Persistent Links,” located on the GCU Library website, to learn how to locate persistent links for library articles, videos, etc.
RefWorks and EndNote: RefWorks and EndNote Login
Description:
Manage your citations with the RefWorks tool, located on the GCU Library website. RefWorks automates the creation of your reference lists in the format of your choice (APA, MLA, etc.).
GCU Library Research Guides: Citing Sources
Description:
Reference the “GCU Library Research Guides: Citing Sources” resource for information on how to cite sources properly.
Writing Center
Description:
Refer to the resources located in the Writing Center for PowerPoint guidelines, APA style, writing and library tutorials, and research and writing assistance.
Statement on the Integration of Faith and Work
Description:
“Grand Canyon University prepares learners to become global citizens, critical thinkers, effective communicators, and responsible leaders by providing an academically-challenging, values-based curriculum from the context of our Christian heritage” (GCU Mission Statement). Review the “Statement on the Integration of Faith and Work” to become familiar with many fundamental Christian worldviews and consider how they may apply in the context of this course.
Identify the different levels of translational research. Explain how translational research is different from evidence-based practice and discuss application to population health management.
Translational research is the application evidence gained from the basic sciences made through a laboratory research and preclinical studies for the development of clinical trials and studies in humans. (GCU library, n.d.). Translational research evolved with practice and time. (https://www.iths.org/investigators/definitions/translational-research).
It has 5 levels or phases. (T0-T5).
T0- Preclinical and animal studies (T0/Basic Science Research)
T1 - Proof of concept/Phase 1 clinical trials (T1/testing efficacy and safety with small group of humans).
T2&T3 -Phase 2 and Phase 3 clinical trials (T3/testing the efficacy and safety with larger group of humans; compare to common treatments)
T4- clinical trials and clinical outcomes research (T4/Translation to Practice)
T 5- Population-level outcomes research (T5/Translation to Community). (Titler& M G, 2018).
Evidence based practice and translation research, though related, are not interchangeable terms. EBP is the actual application of evidence in practice (the “doing of” EBP), whereas translation science is the study of implementation interventions, factors, and contextual variables that effect knowledge uptake and use in practices and communities. Translation science is research; various research designs and methods are used to address the research questions or hypotheses (Titler, &M G ,2018; Titler, 2014) .
Translational research mainly focuses on testing implementation interventions to improve uptake and use of evidence to improve patient outcomes and population health, as well as to clarify what implementation strategies work for whom, in what settings, and why (Titler, &M G ,2018; Eccles & Mittman, 2006; Titler, 2014). Translation science has emerging body of knowledge and it provides a scientific base for guiding the selection of implementation strategies to promote adoption of EBPs in real-world settings (Titler, &M G ,2018; Dobbins et al., 2009; Titler, 2010; Titler et al., 2016). A development in Translational research, for example can be applied to study the quality of life in population of older people living at home compared to those living in nursing homes (Melnyk & Fineout-Overholt, 2018).
Translation science can expedite integration of evidence in practice to improve care delivery, population health, and health outcomes.(Titler&, M.G,2018). Through the translational phases of research, researchers study health outcomes at the population level to determine the effects of diseases and efforts to prevent, diagnose and treat them. The outcomes of findings will help to guide the scientists to assess the effects of current interventions and to develop new ones. (https://ncats.nih.gov/translation/spectrum).
References:
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-Based practice in nursing and healthcare (4th ed.). Wolters Kluwer Health.
Titler, M.G., , (May 31, 2018) “Translation Research in Practice: An Introduction” OJIN: The Online Journal of Issues in Nursing Vol. 23,
No. 2, Manuscript 1.
Grand Canyon University Library (n.d.). Nursing &health sciences. https://libguides.gcu.edu/Nursing
University of Washington (n.d.). T phases of transitional health research.https://www.iths.org/investigators/definitions/translational-research
National center for advancing translational sciences (n.d.) Translational science spectrum https://ncats.nih.gov/translation/spectrum.
can you give a specific, concrete example of what has been a specific focus outcome of translational research at T3 or T4?
In T3 phase of translational research implementing the evidence-based guidelines into health practice by doing clinical trials through delivery, dissemination, and diffusion research (University of Washington, n.d.). For example, in congestive heart failure patients to improving the outcomes in the care, implementing a CHF guidelines by using the new drug or treatment. It could be sustained and become a nationwide standard of care for all CHF patients. A program, such as the American Heart Association’s Get with the Guidelines program, is a perfect example of a program used to disseminate the new evidence. The T3 research would focus on the strategies to implement the program to sustain compliance nationwide using the new drug or treatment as part of the coronary artery disease secondary prevention treatment guidelines to be implemented for CHF patients by the time of hospital discharge. This guideline will help to improve the outcome of care. What is often referred to as distilling evidence through the implementation of guidelines for care helps take evidence to all practitioners to improve outcomes of care. (White &K.M 2017).
In T4 phase of translational research seeks to evaluate the “real world” health outcomes of population health practice. (University of Washington, n.d.). T4 phase evaluates how effective was CHF guidelines to improve the the outcome of the care .
References:
White, K. M. (2017). Translational research. In J. Fitzpatrick (Ed.), Encyclopedia of nursing research (4th ed.). Springer Publishing Company. Credo Reference:
https://lopes.idm.oclc.org/login?url=https://search.credoreference.com/content/entry/spennurres/translational research/0?institutionId=5865
University of Washington (n.d.). T phases of transitional health research.https://www.iths.org/investigators/definitions/translational-research
Translational research and Evidence-based practice are often mistaken to be the same concepts. Although they are similar in some ways but different in practice. As defined by (Titler, 2018), Evidence-based practice is about applying evidence in practice along with clinical expertise, patient values, and circumstances for clinical decision-making and health outcome enhancements. Whereas translational research is the study about the testing implementation interventions to increase the adoption of evidence in various clinical settings, leading to better patient outcomes and population health. It emphasizes utilizing various strategies, and how and why those would work in various settings (Titler, 2018). Translational research serves as a bridge between different research discoveries and connecting those with each other and at the end applying to the community for health benefits.
As defined by the National Institute for Occupational Safety and Health. (2018), The translational research process involves five different phases, including T0, T1, T2, T3, and T4.
T0 phase- this phase involves basic science research, defining mechanisms, targets, and lead molecules.
T 1- this phase is also known as the development of translation research and focused on how this discovery could be applied to humans.This phase involves laboratory testing, field or a pilot study that results in findings or discoveries, which can be used into health and safety applications. This phase involves a small group of people for testing including clinical trials, new methods of diagnosis or treatment preventions etc.
T 2- This phase is also known as testing translational research and involves a bigger group of patients and testing. This phase reviews the value of new findings, invention process on intervention and are tested in a controlled setting.
T 3- Also known as Institutional translational research and involves application of research or recommendations in a clinical setting. During this phase a determination of effectiveness of the interventions are monitored.
T 4- or Evaluation translational phase survey the influence of the interventions in population health and effects of moving these discoveries into large-scale practice for greater benefit.
Translational research is designed to explore meaningful and applicable results that benefit human health. The implementation of evidence-based practices and translation research play a huge role in population health management through awareness of a disease process, prevention strategies and care and treatment. The translational research also helps with overall high compliance in various healthcare settings and communities given the proof of its results. This helps by providing quality and safe care to everyone. It also aids in reducing health disparities. As shared by health data, there is evidence that racial and ethnic minorities are disproportionately affecting many diseases and illnesses. In communities where people don’t have access to regular checkups or sources of care, translational research provides guidance using evidence-based strategies to eliminate the risks and promote healthy communities (Fleming. et. al., 2008). Although these challenges still exist but the practices and resources are improving with knowledge.
Addressing the gaps for as simple as prevention health including mammograms, or routine colorectal screenings also promote population health benefits. The rising concerns of mental health concerns is another area where translational research can lead the way to solve challenges like suicide, child and young adult mental health and rural mental health, stigma, and other social factors.
References
Fleming ES, Perkins J, Easa D, Conde JG, Baker RS, Southerland WM, Dottin R, Benabe JE, Ofili EO, Bond VC, McClure SA, Sayre MH, Beanan MJ, Norris KC. The role of translational research in addressing health disparities: a conceptual framework. Ethn Dis. 2008 Spring;18(2 Suppl 2):S2-155-60. PMID: 18646340; PMCID: PMC2705204.
The National Institute for Occupational Safety and Health. (May 1st, 2018). Translation Research. Retrieved from
https://www.cdc.gov/niosh/topics/translationresearch/default.html
Titler, M. G. (2018). Translation Research in Practice: An Introduction. Online Journal of Issues in Nursing, 23(2), 1. https://doi-org.lopes.idm.oclc.org/10.3912/OJIN.Vol23No02Man01
Can you give a specific, concrete example of what has been a specific focus outcome of translational research at T3 or T4?
Evidence-based practice research can get mixed up with translational research, but there is a difference between the two. Evidence-based practice is research that assists in enhancement in healthcare quality, assists in improving patient outcomes, reduces healthcare costs, and can empower clinicians (Melnyk & Fineout-Overholt, 2019). Translational research studies how the evidence-based interventions are decoded into the healthcare setting (Melnyk & Fineout-Overholt, 2019). Translation research can be defined in four tiers such as T1, T2, T3, and T4 research. T1 – is completing basic research to determine potential interventions to a health concern that needs to be changed or revamped (University of Minnesota, 2023). T2 research is when the new interventions studied are tested in a controlled environment (University of Minnesota, 2023).
Testing the interventions allow for a better understanding if the intervention would be sufficient and effective in the clinical setting. T3 research determines different ways to apply the new recommendations into a clinical setting (University of Minnesota, 2023). By determining how to apply the interventions in the real world will allow for a better understanding how they would be best effective. T4 research studies how intervention and different elements can influence the health of the population (University of Minnesota, 2023). By following the T1-T4 translational research levels allows for a more effective transition of improvements into the clinical setting once a problem is identified.
By using the translational research is important in many different aspects of healthcare to make overall improvements for quality and safety. Specifically, it will be important to target research on how to improve the health of the population by utilizing research and determining intervention to assist in making change. It will be important to determine the concern /issue of the population and work through the phases of translational research to implement an intervention to effectively manage health improvements. For example, the increase in smoking cessation.
- The issue is nicotine addiction and lung issues.
- After the issue is identified it will be time to determine an intervention to assist in change for health management. For instance, nicotine pills and classes to assist in the addiction. Then, the intervention will need to be studied in a control environment to determining the effectiveness in the real world. As long as it’s determined to be effective than the implementation process can begin.
This scenario is one way to assist in the health of the targeted population by determining interventions for smokers which also eliminates secondhand smoke for non-smokers.
References:
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13: 9781496384539
University of Minnesota. (2023). Clinical and Translational Science Institute. https://ctsi.umn.edu/about/about-ctsi/what-translational-research
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