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Implementation Research to Address the United States Health Disadvantage: Report of a National Heart, Lung, and Blood Institute Workshop

Authors:

Michael M. Engelgau ,

Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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K.M. Venkat Narayan,

Department of Global Health, Emory University, Atlanta, GA, US
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Majid Ezzati,

Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London; Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, School of Public Health, Imperial College London, London; World Health Organisation Collaborating Centre on Noncommunicable Disease Surveillance and Epidemiology, Imperial College London, London, GB
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Luis A. Salicrup,

Center for Global Health, National Cancer Institute, National Institutes of Health, Bethesda, MD, US
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Deshiree Belis,

Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Laudan Y. Aron,

Center on Labor, Human Services, and Population, The Urban Institute, Washington, DC, US
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Robert Beaglehole,

University of Auckland, Auckland, NZ
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Alain Beaudet,

Canadian Institutes of Health Research, Ottawa, Ontario, CA
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Peter A. Briss,

National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, US
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David A. Chambers,

Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, US
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Marion Devaux,

Organization for Economic Cooperation and Development, Paris, FR
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Kevin Fiscella,

Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, US
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Michael Gottlieb,

Foundation for the National Institutes of Health, Bethesda, MD, US
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Unto Hakkinen,

Centre for Health and Social Economics, National Institute for Health and Welfare, Helsinki, FI
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Rain Henderson,

Clinton Health Matters Initiative, Clinton Foundation, New York, NY, US
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Anselm J. Hennis,

Department of Noncommunicable Disease and Mental Health, Pan American Health Organization, Washington, DC, US
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Judith S. Hochman,

Department of Medicine, Division of Cardiology, New York University School of Medicine, New York, NY, US
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Stephen Jan,

The George Institute for Global Health, Sydney; University of Sydney, Sydney, New South Wales, AU
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Walter J. Koroshetz,

National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, US
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Johan P. Mackenbach,

Department of Public Health, Erasmus Medical Center, Rotterdam, NL
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M.G. Marmot,

Institute of Health Equity and Department of Epidemiology and Public Health, University College London, London, GB
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Pekka Martikainen,

Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, FI
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Mark McClellan,

Duke-Robert J. Margolis, MD, Center for Health Policy, Duke University, Washington, DC, US
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David Meyers,

Agency for Healthcare Research and Quality, Rockville, MD, US
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Polly E. Parsons,

Department of Medicine, University of Vermont College of Medicine, Burlington, VT, US
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Clas Rehnberg,

Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institute, Stockholm, SE
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Darshak Sanghavi,

Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Baltimore, MD, US
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Stephen Sidney,

Kaiser Permanente Northern California, Oakland, CA, US
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Anna Maria Siega-Riz,

Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, US
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Sharon Straus,

Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario; Knowledge Translation Program, St. Michael’s Hospital, Toronto, Ontario, CA
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Steven H. Woolf,

Center on Society and Health, Virginia Commonwealth University, Richmond, VA, US
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Stephanie Constant,

Office of Scientific Review, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Tony L. Creazzo,

Office of Scientific Review, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Janet M. de Jesus,

Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Nara Gavini,

Division of Extramural Science Programs, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, US
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Norma B. Lerner,

Division of Blood Diseases and Resources, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Helena O. Mishoe,

Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Cheryl Nelson,

Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Emmanuel Peprah,

Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Antonello Punturieri,

Division of Lung Diseases, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Uchechukwu Sampson,

Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Rachael L. Tracy,

Indian Health Service, Rockville, MD, US
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George A. Mensah

Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, US
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Abstract

Four decades ago, U.S. life expectancy was within the same range as other high-income peer countries. However, during the past decades, the United States has fared worse in many key health domains resulting in shorter life expectancy and poorer health—a health disadvantage. The National Heart, Lung, and Blood Institute convened a panel of national and international health experts and stakeholders for a Think Tank meeting to explore the U.S. health disadvantage and to seek specific recommendations for implementation research opportunities for heart, lung, blood, and sleep disorders. Recommendations for National Heart, Lung, and Blood Institute consideration were made in several areas including understanding the drivers of the disadvantage, identifying potential solutions, creating strategic partnerships with common goals, and finally enhancing and fostering a research workforce for implementation research. Key recommendations included exploring why the United States is doing better for health indicators in a few areas compared with peer countries; targeting populations across the entire socioeconomic spectrum with interventions at all levels in order to prevent missing a substantial proportion of the disadvantage; assuring partnership have high-level goals that can create systemic change through collective impact; and finally, increasing opportunities for implementation research training to meet the current needs. Connecting with the research community at large and building on ongoing research efforts will be an important strategy. Broad partnerships and collaboration across the social, political, economic, and private sectors and all civil society will be critical—not only for implementation research but also for implementing the findings to have the desired population impact. Developing the relevant knowledge to tackle the U.S. health disadvantage is the necessary first step to improve U.S. health outcomes.

Highlights

  • This is a summary of a NHLBI/National Institutes of Health—sponsored Think Tank meeting of global and U.S. health experts that provides recommendations for an implementation research agenda that tackles the U.S. health disadvantage.
  • The health disadvantage is characterized by shorter and less healthy lives among the U.S. population compared with the populations of peer countries of similar wealth and development.
  • Key areas considered were understanding the drivers of the disadvantage, identifying potential solutions, creating strategic partnerships with common goals, and finally, enhancing and fostering a research workforce for implementation research.
How to Cite: Engelgau MM, Narayan KMV, Ezzati M, Salicrup LA, Belis D, Aron LY, et al.. Implementation Research to Address the United States Health Disadvantage: Report of a National Heart, Lung, and Blood Institute Workshop. Global Heart. 2018;13(2):65–72. DOI: http://doi.org/10.1016/j.gheart.2018.03.003
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Published on 01 Jun 2018.

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