Page 551 - Encyclopedia of Nursing Research

518 n TRANSLATIONAL RESEARCH

it is interpreted in a range of ways (Levine, the ability to control the intervention versus
2007; Newby and Webb, 2010). Translational an inconsistent or convenient application of
T research is often referred to as “bench-to- the intervention, the identification and mea-
bedside” and further explained in several surement of outcomes, the choice of statis-
ways: using new knowledge produced as a tical analyses, and the ability to generalize
part of the science of discovery and applying findings.
that knowledge to improve health and health In an attempt to address methodological
care, or the application of new and unproven issues and to improve translational research
laboratory discoveries to improve health, or methods, glasgow (2009) discussed the need
research that explores and develops potential for translational research designs to consider
treatments and tests the safety and efficacy of four critical research issues that relate to the
those treatments in randomized control trials. ability to generalize findings from transla-
These definitions of translational research tional research:
are referred to as T1 translation (Agency for
Healthcare Research and Quality, 2000). 1. use of a heterogeneous population—
However, a second definition or type of samples must be purposively selected to
translational research, referred to as T2 trans- represent the real world and include rep-
lation (Agency for Healthcare Research and resentativeness of age, gender, ethnicity,
Quality, 2000), investigates how the newly and health literacy that have all been asso-
discovered science can be applied to real- ciated with inequity in health care.
world clinical settings. Even when a drug, 2. use of multiple settings—the research
test, or treatment is found safe and effica- must include a range of settings that repre-
cious in the randomized control trial, further sent a typical practice.
research on the use of that drug or treatment 3. use of comparison—well-designed com-
in a typical clinical practice or setting is nec- parisons that include the current standard
essary. The setting for this type of transla- of care to an alternative rather than pla-
tional research is the organization, clinical cebo or no treatment.
practice, or community, and it requires a dif- 4. use of multiple outcomes—include mul-
ferent set of research skills. Sometimes now tiple outcomes that are relevant to deci-
referred to as implementation science (Titler, sion makers and policy makers including
2004a), this translational research evaluates cost, benefit, quality of life, and impact
interventions in the clinical setting using measures.
information technology, epidemiology, orga-
nizational theory, change theory, adult learn- It is widely recognized that the gap
ing theory, behavioral science, marketing between research findings and practice is a
theory, social cognitive theory, social ecolog- concern for all health care practitioners, and
ical theory, and social influence/communica- many countries are investing in providing
tion theory to further a better understanding resources to increase and support transla-
of organizational variables that affect the tional research (Canadian Institutes of Health
translation of evidence into practice. Research, 2009; Cooksey, 2006; National
Calling both T1 and T2 programs of Institutes of Health, 2009; Woolf, 2008). At a
research “translational research” has been a time when experts warn of the fragmented
source of confusion to many. T1 and T2 face health care system and a widening “chasm” in
different research challenges including the access, quality, and disparities, interventions
recruitment of subjects, homogeneous sam- to close these gaps—the work of T2—may
ples versus diverse samples/populations, do more to improve outcomes than the dis-
rigor of the research methods particularly covery of yet another new imaging device