T2 research yields knowledge about the efficacy of the interventions in optimal settings. The core constructs are facilitation, innovation, recipients and context, with facilitation represented as the active element assessing, aligning and integrating the other three constructs (Harvey & Kitson, 2016; Helfrich et al, 2010; Kitson, Harvey, & McCormack, 1998). CER is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat and monitor a clinical condition, or to improve the delivery of care. NIEHS provides many opportunities for funding to individual researchers, organizations, and businesses. d. translational research. doi:10.1186/s13012-016-0437-z, Kitson, A., Harvey, G., & McCormack, B. Implementation Science 12(62). Diffusion of innovations (5th edition). Introduction to library and information resources for students studying for a PhD in the translational sciences. doi:10.1016/j.ajic.2011.09.020. Policy dissemination and implementation research is focused on generating knowledge to effectively spread research evidence among policymakers and integrate evidence-based interventions into policy designs (Purtle, Peters, & Brownson, 2016). Supportive Care in Cancer, 25(11), 33953406. A classic sociological-cognitive theory of mechanisms of adoption and use of innovations by individuals and groups. Titler, M.G., & Shuman, C.S. (2017). Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. The phrases translation research, translational research, and translational science have been used to describe the systematic effort to convert basic research outputs into practical applications to enhance human health and well-being. Sving, E., Gunningberg, L., Hogman, M., & Mamhidir, A.-G. (2012). The impact category is where we assess the broader environmental, clinical, or public health impact of a practice, guideline, or policy. 3. (1983) Using research to improve nursing practice: A guide. T1 research T1 research tests findings from basic research for clinical effect and/or applicability. American Journal of Public Health, 103(6), e38e46. doi:10.2147/JHL.S45077. This site was built using the UW Theme | Privacy Notice | 2023 Board of Regents of the University of Wisconsin System. Dissemination and implementation research funded by the US National Institutes of Health, 2015-2012. Consider nominating individuals or teams for practice excellence awards offered by the health system, or professional organizations. Setting encompasses the structural factors, such as the physical or operational characteristics of the setting (e.g., staffing, unit size, types of patients) (Birken, Powell, Presseau et al., 2017; May et al., 2016). Implementation Science, 9(118). . NIEHS intramural scientists have defined descriptive terms of particular relevance to their own research, and have ranked those terms accordingly. Step 3: Clinical . Translation research explores the processes by which research findings are successfully implemented in the workplace. NUR 550 Topic 1 DQ 1 Identify the different levels of translational research. 717 Delaware Street SE, Second Floor doi:10.1146/annurev-publhealth-032013-182447, Alexander, J.A., & Hearld, L.R. Dr. Titler is the PI of the T32 institutional training grant Complexity: Innovations in Promoting Health and Safety (T32 NR016914). A Thematic Analysis of Theoretical Models for Translational Science in Nursing: Mapping the Field Article Full-text available Nov 2010 Sandra A. Mitchell Cheryl A Fisher Clare Hastings Gwenyth R. Doran, D., Haynes, B.R., Estabrooks, C.A., Kushniruk, A., Dubrowski, A., Bajnok, I., Bai, Y.Q. Examples include biomarker, screen, or assay validation, clinical testing, tool validation and use, and effectiveness testing. In June 2013, the Institute of Medicine (IOM) released an independent appraisal of the Clinical and Translational Science Award (CTSA) program that supplies major funding for ICTR and more than 60 other CTSA sites nationwide. The Translation Research Programs efforts focus on the research-to-practice continuum to learn how to make any given step better and how to improve its impact. Actions of CC include 1:1 education and mentoring, auditing EBP performance indicators, making changes in organizational documents to incorporate EBP recommendations. The RE-AIM framework: A systematic review of use over time. Implementation Science, 12(2). 5. (2009). NIOSH continues to gather translation research, promote goals for internal research competitions, and develop the skills of staff. There's two forms of translational research, the Type 1 and Type 2. Nursing science and evidence-based practice. Implementation Science, 9(157). They help us to know which pages are the most and least popular and see how visitors move around the site. Implementation Science, 4(1), 78. doi:10.1186/1748-5908-4-78. Haas EJ, Willmer D., Cecala AB. Implementation Science, 12(1), 21. doi:10.1186/s13012-017-0552-5, Purtle, J., Peters, R., & Brownson, R.C. A number of healthcare practices have an evidence-base but they are not yet a part of routine care. The goal of many clinical trials is to obtain data to support regulatory approval for an intervention. When enough research evidence is available, practice should be guided by research findings in conjunction with clinical expertise and patient values. Translational research has traditionally referred to the translation of basic research findings to the clinical level, commonly termed 'bench to bedside'. American Journal Epidemiology 172: 517-524. doi:10.1186/s13012-017-0663-z, Mark, D.B., Titler, M.G., & Latimer, R.W. Developing theory-informed behaviour change interventions to implement evidence into practice: A systematic approach using the Theoretical Domanis Framework. Thus EBP and translation science, though related, are not interchangeable terms. At all levels, scientific results are communicated through existing networks, from FDA announcements, scholarly journals, Morbidity and Mortality Weekly Review, and press releases to the general public. Instrumentation issues in implementation science. There are different levels of translational research which includes, basic to clinical and clinical to population. Titler, M.G. Tags: EBP public health clinical and translational emergent clinical expertise ways to apply evidence T1 research yields knowledge about human physiology and the potential for intervention. Emerging areas of science: Recommendations for nursing science education from the Council for the Advancement of Nursing Science Idea Festival. The T0 to T4 classification system replaced the Type 1 Translational Research (T1TR) and Type 2 Translational Research (T2TR) categories to allow more precise identification of supported research and development of a diverse, balanced research portfolio. & Moore, J. Clinical and Health Informatics Institute (CHI2), Clinical and Data Management Tools: OnCore & REDCap, Dissemination & Implementation (D&I) Launchpad, Communities of Practice for Clinical & Translational Research, Graduate Program in Clinical Investigation, Workshops, Short Courses & Other Training, Institute for Clinical and Translational Research. These cookies may also be used for advertising purposes by these third parties. How might one consider Snow's conclusions regarding the Soho cholera epidemic to be an example of translational research?c. (2001). In 2016 NIOSH developed a framework for a wide-ranging plan for translation research. Iowa Model of EBP to Improve the Quality of Care. Retrieved from https://www.nap.edu/catalog/12648/initial-national-priorities-for-comparative-effectiveness-research, Jacobs, S.R., Weiner, B.J., & Bunger, A.C. (2014). doi:10.1186/1748-5908-8-107, McEvoy, R., Ballini, L., Maltoni, S., ODonnell, C.A., Mair, F.S., & MacFarlane, A. The nodes that we have included reflect potential translational research activities related to environmental health science research. Dollard M, Skinner N, Tuckey MR, Bailey T. National surveillance of psychosocial risk factors in the workplace: An international overview. Ongoing auditing of performance indicators, aggregating data into reports, and discussing the findings with practitioners on a regular basis during the practice change. Journal of Professional Nursing Scholarship, 13(62). Compared with other workplace safety and health efforts, translation research is a new field without a large base of scientific papers. Newhouse, R., Bobay, K., Dykes, P.C., Stevens, K.R., & Titler, M.G. The practice category focuses on moving established ideas into common practice. This focus on improving the implementation of science shows NIOSHs value as the nations primary occupational safety and health research institute. Research to practice in the military healthcare system. Translational research definitions courtesy ofHarvard Catalystand the Harvard Clinical and Translational Science Center, a Clinical and Translational Science Award (CTSA) member institution. Her program of research is in outcomes effectiveness and implementation science and is supported by federal and foundation funding. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. doi:10.1177/1049731509335569, Department of Health and Human Services (2018). The JBI model of evidence-based healthcare depicts the four major components of the evidence-based healthcare process as: (i) healthcare evidence generation; (ii) evidence synthesis; (iii) evidence/knowledge transfer; (iv) evidence utilization. Those patients (57.1%) with low level of distress (DT 3) chose the social support (28.3%), problem solving (25%), distancing (23.9%), positive reappraisal (8.7%) and self-control (7.6%). Implementation Science, 8(18). Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2012/Living-Well-with-Chronic-Illness/livingwell_chronicillness_reportbrief.pdf, IOM (Institute of Medicine). Simply stated, translational research represents the transi-tion between basic laboratory research and evidence-based practice, described by Sung and colleagues15 as Translation 1 and Translation 2. The T0 to T4 classification system is a way to describe where research sits on the translational science spectrum. Washington, D.C.: The National Academies Press. International Journal of Nursing Studies, 60, 5468. Multiple opportunities abound for implementation of evidence to improve population health and healthcare delivery (Institute of Medicine [IOM], 2009; IOM, 2011a; IOM, 2011b, IOM, 2012a; IOM, 2012b; IOM, 2013a; National Academies of Sciences, Engineering and Medicine [NAM], 2015). We take your privacy seriously. 22. All rights reserved. Translational research is the process of translating basic scientific discoveries into medical interventions that improve public health. The success of coronavirus disease 2019 (COVID-19) mRNA vaccines (6, 7) has begun to foster the development of mRNA vaccines against other infectious diseases and different types of cancer.Various mRNA vaccine platforms have been developed that use either non-replicating (nr) or self-amplifying (sa) mRNA (8, 9). move to strengthen Translational Research, defined as the movement of discoveries in basic research (the Bench) to application at clinical level (the Bedside). Widely considered favorable to the CTSA program, the report nevertheless contained a number of recommendations to further strengthen the consortium, including one to change research classification definitions. Ogilvie D, Craig P, Griffin S, Macintyre S and Wareham NJ [2009]. Translating research into practice: Considerations for critical care investigators. It is essential that clinicians delivering the EBPs have the knowledge and skills necessary to deliver the EBPs. T4 research ultimately results in improved global health. Retrieved from https://www.sciencedirect.com/journal/nursing-clinics-of-north-america/vol/49/issue/3, Martinez, R.G., Lewis, C.C., & Weiner, B.J. Table 3 provides examples of implementation strategies organized by the four components of the TRM. Examples: bonus payments, salary increases, provision of educational funds. A translational framework for public health research. This level of detail allows researchers to tailor the model to tell a specific translational research story. Implementation theories are those that have been developed or adapted by researchers for use in implementation science (e.g., Normalization Process Theory) to guide the understanding and explanation of certain aspects of implementation. The translation research process should be a never-ending loop of research and translation, allowing for ongoing integration of effective approaches. we live in today. Context matters and is widely acknowledged as an important influence on implementation outcomes.Context matters and is widely acknowledged as an important influence on implementation outcomes (Birken et al., 2016; Jacobs, Weiner, & Bunger, 2014; May, 2013; May et al., 2016). In what sense is operational research an example of . In response to the report, ICTR and many other CTSA sites adopted the IOM recommended T0 to T4 research classification to better track our research portfolio along the entire research continuum from basic discovery research to changes in community health. By the time you get up to population level it's much more difficult to control for the other things that could be influencing the question you're trying to answer . Examples of Translation Research for Different Types of Hazards. Translational Research. Nurse scientists have a rich history and are making major contributions to EBP and translation science. Nightingale, F. (1863b). St. Louis, MO: Elsevier. (2011). Knowledge translation is defined as a process that includes synthesis, dissemination, exchange and ethically sound application of knowledge to improve health, provide more effective health services and products and strengthen the healthcare system. Tinc PJ, Gadomski A, Sorensen JA, Weinehall L, Jenkins P, Lindvall K. Khoury MJ, Gwinn M, Ioannidis JPA [2010]. The field of investigation focused on understanding the scientific and operational principles underlying each step of the translational process. NIEHS has a goal to ensure job opportunities and career enhancements programs for both our work force and our community. doi:10.1016/j.cnur.2014.05.001, Titler, M.G. In contrast, EBP is the conscientious and judicious use of current best evidence in conjunction with clinical expertise, patient values, and circumstances to guide healthcare decisions (Straus, Richardson, Glasziou, Richardson, & Haynes, 2011; Titler, 2014). Lack of a common language makes it difficult for researchers to learn from each others studies; to collaborate across geographic boundaries and disciplines; and to search for and synthesize scientific findings (Colquhoun et al., 2014). c. empirical research. There are multiple implementation strategies that have been tested and/or used for promoting adoption of EBPs. Kirk, M.A., Kelley, C., Yankey, N., Birken, S.A., Abadie, B., Damschroder, L. (2016). Today, RE-AIM is used in the planning stages for implementation in diverse areas of healthcare (e.g., health promotion, disease prevention, disease management) and settings (e.g., communities, hospitals, primary care, schools) as well as reporting results of implementing EBPs. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Such pronouncements receive wide publicity in the general news media. Testing is carried out using cell or animal models of disease; samples of human or animal tissues; or computer-assisted simulations of drug, device or diagnostic interactions within living systems. The emergence of translational epidemiology: from scientific discovery to population health impact. doi:10.1186/1748-5908-4-29, McCormack, B., Rycroft-Malone, J., DeCorby, K., Hutchinson, A.M., Bucknall, T., Kent, B., Schultz, A., Wilson, V. (2013). In contrast, NIOSH defines the phrase translation research to refer to the study of the process of moving research-to-practice-to-impact and the methods, barriers and facilitators, context, and issues encountered in this process. Stephenson CM, Stephenson MR. Evidence-based practice (previously called research utilization) was advanced by several initiatives, including the: diversity of terminology impedes efforts to synthesize, advance, and apply findings from translation science. doi:10.1111/j.1365-2648.2012.06053.x, Helfrich, C.D., Damschroder, L.J., Hagedorn, H.J., Daggett, G.S., Sahay, A., Ritchie, M., Stetler, C.B. The NIEHS Translational Research Framework involves a series of rings that represent five primary categories of translational research. Here, we have used phosphoproteomics to obtain more insight into such changes, which revealed that CHIKV infection induces . Translation research has different levels; Translations to humans include transferring knowledge from fundamental to clinical research (Curtis & DeMaio 2017). Implementation Science, 11(1), 141. doi:10.1186/s13012-016-0506-3, May, C.R., Mair, F., Finch, T., MacFarlane, A., Dowrick, C., Treweek, S., Victor, M. (2009). For example, if scores for hiring staff that value EBP are low, an organization may want to examine hiring practices and interview questions used in selection of staff. Translation research findings add great value to occupational safety and health research by helping us understand how science can better achieve practical benefits and what factors stand in the way of scientific work leading to useful outcomes. (2015). This concept is often summarized by the phrases bench-to-bedside and bedside-to-community research. doi:10.1002/chp.47, Grimshaw, J.M., Eccles, M.P., Lavis, J.N., Hill, S.J., & Squires, J.E. Which of the following is an example of being a producer of research? doi:10.1186/1748-5908-7-15, Armstrong, R., Waters, E., Dobbins, M., Anderson, L., Moore, L., Petticrew, M., Swinburn, B. Development of a new standard laboratory protocol for estimating field attenuation of hearing protection devices. The final level of control of gene expression in eukaryotes is post-translational regulation. BLS occupational hearing loss report for 2007. Basic research involves scientific exploration that can reveal fundamental mechanisms of biology, disease or behavior. (2016, May 2). Translational research is also referred to interchangeably as translational medical or translation science. In the revised i-PARIHS framework, successful implementation is primarily specified in terms of the achievement of implementation goals and results from the facilitation of an innovation with the recipients in their (local, organizational and health system) context. This is the stage, where treatments and interventions are being developed. Translation science is a relatively new area of investigation and nurse scientists are setting directions in this field. There are three levels of translational research, starting with T1, which involves the beginning research or development of an intervention, including the lab research, observational research and phase I and II clinical trials (Translational Research, n.d.). One example of post-translational regulation is enzyme inhibition. Varieties of Translational Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Existing studies have pointed to the multiple meanings of translational research in ongoing academic and policy debatesand to the way in which this concept is tied to a range of varying . Reducing commercial fishing deck hazards with engineering solutions for winch design. Translational research - often used interchangeably with translational medicine or translational science or bench to bedside - is an effort to build on basic scientific research to create new therapies, medical procedures, or diagnostics. The Iowa model of evidence-based practice to promote quality care. This is T4 translational research. Disseminating the results of nursing research. Implementation Science, 10(162). defines, distinguishes and explores the promise of translation, translational research and translational science. Utilization of the behavior change wheel framework to develop a model to improve cardiometabolic screening for people with severe mental illness. (2018). Implementation Science, 10, 2739. Implementation Science, 8(107). Towards a common terminology: A simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. Evidence-Based Practice for Nursing and Health Care Quality Improvement. Estabrooks, C.A., Derksen, L., Winther, C., Lavis, J.N., Scott, S.D., Wallin, L., & Profetto-McGrath, J. The spectrum is not linear or unidirectional; each stage builds upon and informs the others. The CTSA program at NIH: Opportunities for advancing clinical and translational research. Unit leadership and climates for evidence-based practice implementation in acute care: A cross-sectional descriptive study. 522). T0 Research: basic biomedical research, including preclinical and animal studies, not including interventions with human subjects; T1 Research: translation to humans, including proof of concept studies, Phase 1 clinical trials, and focus on new methods of diagnosis, treatment, and prevention in highly-controlled settings; Reed WR, Kwitowski AJ, Helfrich WJ, Cecala AB, Joy GJ. T2- testing the efficacy and effectiveness of these treatments and interventions. Much of the current work in dissemination and implementation science would fit within this ring. Cookies used to make website functionality more relevant to you. What can management theories offer evidence-based practice? doi: https://doi.org/10.1186/1748-5908-8-22, Colquhoun, H., Leeman, J., Michie, S., Lokker, C., Bragge, P., Hempel, S., Grimshaw, J. The translational spectrum is customarily divided into four phases: T1: Translation to humans T2: Translation to patients T3: Translation to practice T4: Translation to population health The spectrum metaphor highlights the fact that these distinctions are not always hard and fast. Answer: d. translational research. (2018). Titler, M.G. All information these cookies collect is aggregated and therefore anonymous. CHIKV replication strongly depends on resources of the host cell, which undergoes many changes during infection. Implementation Science 7(33). Nursing Outlook, 29(3), 164169. BMC Health Services Research, 17(1), 68. doi:10.1186/s12913-017-2029-2, https://doi.org/10.3912/OJIN.Vol23No02Man01. doi:10.1186/s13012-015-0320-3, Squires, D., & Anderson, C. (2015). London: Harrison & Sons. Download or play NIEHS Health Chat's with a wide range of experts and topics. Worldviews on Evidence-Based Nursing, 4(3), 126145. This Funding Opportunity Announcement (FOA) invites applications for Edward R. Roybal Centers for Translational Research in the Behavioral and Social Sciences of Aging. Topic 1 Participation Description: NA Topic 1: Quality Research and Theoretical Frameworks. This expanded framework integrates concepts from previous frameworks, and provides a space for environmental health science. Nightingale, F. (1863a). Occup Health Sci (2017) 1: 29. The role of organizational context in moderating the effect of research use on pain outcomes in hospitalized children: A cross sectional study. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Translational research includes two areas of translation. According to this model (see Figure 1), adoption of EBPs is influenced by four key areas: Successful implementation requires strategies to address each of these four areas (Titler, 2010; Titler et al., 2016). These seminal projects provided a strong foundation for evidence-based practice (EBP). Translational research involves moving knowledge gained from the basic sciences to its application in clinical and community settings. Issues regarding implementation strategies in translation science include lack of agreement about naming of the implementation intervention and/or strategy (ontology); inconsistencies in the descriptions of interventions and their content; lack of an agreed upon classification system or taxonomy of implementation interventions; lack of clarity regarding the target of the intervention (e.g., organization, clinicians, teams of practitioners, or some combination thereof); description of the intervention dose; and selection and measurement of the primary end-points for determining effectiveness (Alexander & Hearld, 2012; Bornbaum, Kornas, Peirson, & Rosella 2015; Colquhoun et al., 2014; Grimshaw et al., 2012; Lokker et al., 2015; Martinez, Lewis, & Weiner, 2014; Titler & Shuman, 2017). In G. LoBiondo-Wood, J. Haber, & M.G. doi:10.1186/s13012-017-0656-y, Bornbaum, C.C., Kornas, K., Peirson, L., & Rosella, L.C. doi:10.1177/0193945910388984. 2. Through translation research, NIOSH studies the process, drivers, and barriers for turning knowledge into practical applications that create these improvements for the safety and health of workers. NIEHS offers a broad range of job opportunities, career enhancement programs, and research training grants and programs in environmental health sciences and administration. Although this new field of research has not received much attention in occupational safety and health, it can have a valuable impact on workers everywhere. Education of clinicians about the EBPs is necessary but not sufficient to change practice and didactic continuing education alone does little to change practice behaviors. She has served on national committees including the National Advisory Council for AHRQ, and the Committee on Standards for Developing Trustworthy Clinical Practice Guidelines for the Institute of Medicine. doi:10.1016/j.apnr.2015.12.004. Implementation Science, 12(77). Using your own ideas, give examples of each term.b. Decide on methods for keeping senior leaders informed throughout implementation. doi:10.1186/s13012-015-0367-1, Richter, A., von Thiele Schwarz, U., Lornudd, C., Lundmark, R., Mosson, R., & Hasson, H. (2016). This field of investigation continues to provide multiple opportunities for nurse scientists and practicing clinicians to address application of evidence in practice to improve care delivery, patient outcomes, and population health. doi:10.1186/1748-5908-7-38. Knowledge translation is a term primarily used in Canadian implementation research and is defined by the Canadian Institutes for Health Research (CIHR) as a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system (CIHR, 2017, para. Michie, S., Atkins, L., & West, R. (2014). doi:10.1186/s13012-015-0351-9, Brownson, R.C., Chriqui, J.F., & Stamatakis, K.A. The research-to-practice process starts with research and ends with useful innovations. Titler, M.G., Conlon, P., Reynolds, M.A., Ripley, R., Tsodikov, A., Wilson, D.S., & Montie, M. (2016). At the hub/center of the BCW is a behavior system involving 3 essential conditions: capability, opportunity, and motivation. (2013). Implementation consists of five domains such as strategies and outcomes, and setting refers to the specific physical location in which the intervention is put into practice. During this stage, scientists develop model interventions tofurther understand the basis of a disease or disorder and find ways to treat it. A review of policy dissemination and implementation research funded by the National Institutes of Health, 20072014. Here comes the Helmet-CAM: A recent advance in technology can improve how mine operators investigate and assess respirable dust. Observation on the evidence contained in the statistical reports submitted by her to the Royal Commission on the sanitary state of the army in India. Use the browser controls to adjust the font size, or print this page. doi:10.1186/s13012-015-0242-0, Pfadenhauer, L.M., Gerhardus, A., Mozygemba, K., Lysdahl, K.B., Booth, A., Hofmann, B., Rehfuess, E. (2017). Description Objectives: 1. This project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant Number UL1 TR002319. Implementation Science, 11(2). What are the main distinctions among translational research, translational medicine, and translational epidemiology? Former NCATS Director Christopher P. Austin, M.D.,defines, distinguishes and explores the promise of translation, translational research and translational science. The NCATS website states that: 2023 University of Arkansas for Medical Sciences, University of Arkansas for Medical Sciences, CTSA Multi-Institutional Pilot Award Program, Winthrop P. Rockefeller Cancer Institute Rural Research Award Program, KL2 Mentored Research Career Development Scholar Awards Program, (STARs) Program Strategies for Training and Advancing under-represented Researchers, Community Based Participatory Research (CBPR) Scholars Program, Community Partners Educated as Arkansas Research Leaders (CPEARL) Program, Biostatistics, Epidemiology and Research Design (BERD) Consultation, Comprehensive Informatics Resource Center (CIRC), Research Support/Clinical Trials Innovation Unit (CTIU), Translational Research Innovations and Partners (TRIP) Program, Graduate Certificate in Implementation Science, Masters Program in Clinical and Translational Sciences (MS-CTS), Arkansas Community Researcher Training (ArCRT), National Center for Advancing Translational Sciences, Encourages and promotes multidisciplinary collaboration among laboratory and clinical researchers, Incorporates the desires of the general public, with communities being engaged to determine their needs for health innovation, Identifies and supports the adoption of best medical and health practices.