T3 Translational Research Core Expands to Support Investigators

Margaret GreyMargaret Grey, Dr. P.H., RN, FAAN, has been implementing her vision since she took over as director of the T3 Translational Research Core in October 2011. 
Margaret Grey, Dr. P.H., RN, FAAN, has been implementing her vision since she took over as director of the T3 Translational Research Core in October 2011.
YCCI’s T3 Translational Research Core has undergone a transformation over the last year under the leadership of Margaret Grey, Dr. P.H., RN, FAAN, dean of the Yale School of Nursing. Grey has worked to implement her vision of working with investigators across the institution to improve health in local communities by promoting research that supports rapid dissemination, implementation, and sustained use of effective interventions to prevent and treat such common health problems as asthma, obesity, diabetes, violence-related trauma, and addictions. Her specific aims include:

• Increasing awareness of, interest in, and participation in translational research at Yale
• Enhancing translational research education and training opportunities for patients, students, scientists, clinicians, and community partners
• Attracting and re-training new investigators from multiple fields to conduct translational research
• Providing community partners with the skills and resources to implement high-quality translational research in community settings
• Fostering the interdisciplinary collaborations required to advance translational research
Patrick O’Connor, Margaret Grey, Rafael Perez-Escamilla, Lois Sadler, Nancy RedekerFrom left: Patrick O’Connor, Margaret Grey, Rafael Perez-Escamilla, Lois Sadler, Nancy Redeker 
From left: Patrick O’Connor, Margaret Grey, Rafael Perez-Escamilla, Lois Sadler, Nancy Redeker
One of Grey’s first initiatives was to restructure the core’s leadership structure by incorporating representatives from the three health schools: Patrick O’Connor, M.D., M.P.H., professor of medicine, and Rafael Perez-Escamilla, Ph.D., professor of epidemiology, joined Lois Sadler, Ph.D., RN, PNP-BC, FAAN, professor of nursing, as associate directors. Together with Grey and Nancy Redeker, Ph.D., RN, FAHA, FAAN, director of NetHaven, they have formed a working group that’s developing ways to expand and develop Yale’s translational research efforts internally at the university and externally in the community. 

“Yale excels in basic science and is doing well in academic clinical research,” said Grey. “Our group is working on how to get uptake of interventions in the community that can make a difference and how to make that happen in the context of primary or ambulatory care practices in the community. At the same time, we need to and will continue to engage the local community in some of this thinking.” 

One area of focus is to create education and training opportunities in community based practice research for patients, students, investigators, clinicians, and community partners. The Robert Wood Johnson (RWJ) Clinical Scholars Program and the YCCI/RWJ Community Research Scholars Program offer opportunities for translating health services research into health care practice and applying the principles of community-based research. In addition, 20 percent of the junior faculty members selected for the YCCI Scholars program presently conduct community-based research in areas that include studying falls among the aging HIV-infected population and testing cognitive strategies to regulate cravings in cocaine-dependent individuals.

Because the core is committed to increasing the number of investigators who can preform community-based and translational research in the community, one of its most importan goals is to create infrastructure to support that research. The School of Nursing and YCCI collaborated to form NetHaven, an interdisciplinary practice-based researc network that represents approximately 800 health care providers (see New Opportunities for NetHaven). The core also offers pilot funding for research aimed at enhancing the adoption of best practices in the community, including research focused on the cost-effectiveness of prevention and treatment strategies. In addition, YCCI has partnered with the Children’s Fund of Connecticut to fund research projects that promote and enhance high-quality health care services for children and families. There are also new grant mechanisms in place, such as funding from the Patient- Centered Outcomes Research Institute (PCORI), that align well with the core’s mission and that Grey encourages investigators to utilize. 

Increasing awareness and participation in translational research at Yale and speeding up the dissemination and uptake of research findings are the heart of the core’s activities. Representatives from the Cultural Ambassadors program in collaboration with Junta for Progressive Action and the African Methodist Episcopal (AME) Zion Church (see Cultural Ambassadors: Collaborating with the Community) are involved in engaging the New Haven community in clinical research. They have also helped the T3 Core with several strategic grant applications that are currently under review, providing input and contributing ideas for specific interventions. “The partnerships with Junta and Ame Zion are really extraordinary,” said Grey.

“It’s a great resource that most of Yale doesn’t know anything about but they are an integral part of our objectives to boost this kind of research and translation within the Yale community.” 

As part of its efforts to involve the community in research, the core has formed the Yale Affiliated Hospitals Program (YAHP), a partnership between Yale and eight hospitals in southern Connecticut designed to improve the quality of health care in the community. Participating hospitals have access to such YCCI resources as education and training, NetHaven, pilot funding opportunities, and protocol support. 

The core’s efforts stem from an awareness of the health challenges facing the community. “Ultimately the collaborative work between the community and YCCI changes health parameters in the area,” said Grey. “If we’re successful in what we set out to do, then we should see some prevention and better control of diseases like type 2 diabetes among people in the community in the next five or 10 years.” 

The T3 Core is a major focus of YCCI; it was one of three topics chosen for the upcoming Strategic Retreat, in which senior leadership from all three health schools will make key decisions on where YCCI is headed and how to accomplish its goals. Although it’s been a relatively short time since Grey became director, she is pleased with the core’s direction. “I believe the new structure we’ve put in place has led to an increased awareness of translational research across the health schools,” she said. “I think we’ve made great progress in our efforts to increase participation in this type of research in the Yale and New Haven communities,” she said.