Clinical and Translational Science Institute / CTSIBringing better health to more people more quickly!

UCSF Training and Support in

Implementation & Dissemination Science2011-2012

Translating Research Findings into Improved Health. .........................2

UCSF Training and Support in Implementation & Dissemination: An Overview .............................................................................................3

Training Opportunities

Collaboration and Consultation Services

New Developments

IDS Success Stories

Training: IDS Certificate Program .........................................................5

Program Description

Learning Objectives

Course Schedule

Works in Progress Seminars

Field Training

Applying to the Program

Training: Master’s in Clinical Research .................................................7

Program Description

IDS Track

Learning Objectives

Course Schedule

Applying to the Program

Training: PhD Program in Epidemiology & Translational Science ......9

IDS Course Offerings at UCSF ...............................................................10

Additional Training and Research Support at UCSF ............................12

Table of Contents

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Implementation and dissemination science (IDS) is integral to community- and practice-based translational research, which the Institute of Medicine describes as the “translation of results from clinical studies into everyday clinical practice and health decision mak-ing.” The goal of IDS is to ensure that the knowledge and materials produced by health research actually lead to improved population health by: 1) reaching the people for whom they are intended, and 2) being implemented safely, efficiently, equitably, and in a patient-centered manner (see the Institute of Medicine’s report: Crossing the Quality Chasm).

This type of research is particularly important because it is widely acknowledged that recent advances in medical knowledge and treatments are not being fully translated into improved health in the U.S. and other countries. Indeed, many evidence-based interven-tions fail or even have negative consequences when transferred to new settings, largely because their implementation is untested, incomplete, or not suited to local contexts. IDS researchers help reduce barriers to effective translation through an emphasis on interdisciplinary collaboration, mixed methods research, and community engagement.

Implementation research, in particular, addresses how to adapt health interventions to real-world contexts – whether at the level of individuals, organizations, or populations. Research on implementation is informed by the social and behavioral sciences, pub-lic health, public policy, and clinical epidemiology. Implementation research questions

include: which behavior change strategy or policy approach might be most effective in a particular setting? How could a health program designed for use in one community or population be most effectively transferred and adapted to another, and how would engagement with community collaborators enhance this process?

Dissemination is the strategic distribution of research-based knowledge and intervention materials to specific audiences. Dissemination research examines how health-related evidence and interventions are created, promoted, transferred, and interpreted among a variety of populations and stakeholders. For example, why or why not, and through what mechanisms, is an organizational change strategy adopted in a particular health care delivery setting? How would adding a community engagement component to the strategy aid in its adoption?

Translating Research Findings into Improved Health

Social and Behavioral SciencesBusiness AdministrationEnvironmental SciencesEngineeringEconomicsHumanities

DentistryMedicineNursingPharmacyPublic Health

EpidemiologyBiostatisticsHealth Policy

Implementation & Dissemination Science

“Translating research results into everyday clinical practice and health decision making.”

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Training Opportunities

UCSF’s IDS-oriented educational programs include the IDS Certificate Program, the Master’s Program in Clinical Research, and the PhD in Epidemiology and Translational Science. These programs emphasize interdisciplinary collaboration and offer a blend of didactic courses, experiential learning, faculty mentoring, and support for research and grant writing. They appeal to a broad range of health professionals, graduate students, and postdoctoral fellows.

Upon completion of an IDS program, students are able to:

1. Design and implement more effective intervention programs

2. Produce more comprehensive evaluations of interventions

3. Develop better funding proposals

Consultation Services

For those interested in receiving consultations on IDS-related projects – including study design, implementation, evaluation, dissemination, qualitative and mixed methods, behavior change interventions, and interdisciplinary collaborations – please see: http://ctsi.ucsf.edu/consult.

New Developments

- The IDS Program is working with UCSF Profiles to develop a forum through which researchers at UCSF and beyond will be able to identify potential collaborators engaged in IDS-type research and interventions.

- Collaboration with community-based organizations will be enhanced through the introduction of a field training program for IDS Certificate Program participants.

- Plans are underway for a leadership training curriculum to be developed in conjunc-tion with UCSF’s Center for the Health Professions.

IDS Success Stories

Addressing a Transnational Outbreak of Lead Poisoning Using Community-Engaged Strategies

In 2000, Dr. Margaret Handley (UCSF epidemiologist and IDS Program Co-Director) was asked by Dr. Eric Sanford (member of a UCSF practice-based research network and family medicine physician) to collaborate in an investiga-tion of an apparent increase in lead poisoning cases among local children and pregnant women who were patients at a community clinic in Seaside, California. An outbreak investigation followed, integrating both clinic and community en-gagement components. The investigation found that migrants from one area rural Oaxaca, Mexico often had extremely high lead levels, and that the source of lead was homemade foods sent from patients’ community of origin – indicat-ing that exposure was occurring through transnational family networks involving food production and preparation, rather than in Seaside. The initial investigation was followed by a study in the community of origin in Oaxaca. Building trust was particularly important to this part of the investigation because community mem-bers had previously had few positive experiences with medical and government institutions. Community advisors influenced the study design by indicating that a local investigation would be acceptable if participants in California contacted their families in Oaxaca as a recruitment strategy. Bringing together expertise

Relevant Courses

Health Disparities Research

Individual-Centered Implementation Strategies

Community-Engaged Research

UCSF Training and Support in Implementation & Dissemination: An Overview

Pottery with high concentration of lead

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in anthropology, community development, environmental geochemistry, and epidemiology, the study team identified multiple sources of lead in the com-munity. These included cooking pottery that appeared to contain substantially higher levels of lead than other pottery sold in the region, as well as local mine tailings that had contaminated the soil in which local crops are grown. Because there had been no prior contact with public health officials about lead poison-ing, and community members had no way to easily avoid exposure without significant changes to daily farming and cooking practices, education about the problem was insufficient to change behaviors related to lead exposure. Instead, Dr. Handley and the research team developed a collaborative approach that brought researchers and community members together to adapt existing, accepted programs in the community. These included nutrition programs in Oaxaca and educational programs in Seaside for the at-risk population. These interventions were found to be acceptable to community advisors in Oaxaca and they are currently being implemented.

Bringing Patients and Physicians Together to Reduce Unnecessary Use of Antibiotics

When the spread of the antiobiotic-resistant Streptococcus pneumoniae in-creased dramatically in the 1990s, Dr. Ralph Gonzales (UCSF general internist and IDS Co-Director) initiated a research project to reduce the overuse of antibi-otics. Streptococcus pneumoniae is the leading bacterial cause of severe com-munity-acquired infections such as meningitis, pneumonia and sepsis, as well as less severe but common infections such as otitis media and sinusitis. Most previous interventions to reduce antibiotic use focused separately on providers or patients, and most reported minimal-to-no impact on antibiotic prescribing. In collaboration with Kaiser Permanente-Colorado, Dr. Gonzales conducted pa-tient telephone surveys and analyzed physician prescribing practices, in order to identify factors contributing to expectations for antibiotic treatment of coughs and colds and reasons for antibiotic overuse. This formative research resulted in an intervention strategy based on a social ecological framework, and with both patient and provider components. The goal of the intervention was to reduce patient expectations for antibiotics for cough and cold illnesses, and to increase providers’ confidence and self-efficacy in not prescribing antibiotics when they are not appropriate. The patient education component addressed the common misperception that green phlegm or mucous indicates a need for antibiotics, and taught that typical cough duration is two-three weeks for people with bronchitis. Key educational messages were delivered with refrigerator magnets, telephone advice nurse scripts, printed brochures in clinic waiting rooms, and simple post-ers in medical exam rooms. Provider components included audit-and-feedback of the clinic’s antibiotic prescription rates for cough and cold illnesses, and an educational seminar in which physicians were provided with three key reasons to discuss with patients - via the examination room poster - why antibiotics are not appropriate treatment for acute bronchitis. The intervention was associ-ated with a 40% decline in antibiotic use for acute bronchitis, compared with no change in prescription rates among clinics that received provider education alone, or that received nothing. Subsequent studies in a variety of other settings (such as private practices, urgent care clinics and emergency departments)

have reinforced the importance of patient education in improving physi-cian antibiotic prescribing behavior. Adaptations of the patient educational materials have been disseminated locally and nationally through a variety of channels, including state departments of public health, Centers for Disease Control (CDC), and quality improvement organizations affiliated with Kaiser Permanente. The findings from this research have also in-formed the development and dissemination of clinical practice guidelines for the appropriate use of antibiotics for acute respiratory tract infections in adults by the CDC, the American College of Physicians, the American

Academy of Family Physicians, and the Infectious Diseases Society of America.

Individual Centered Implementation Strategies

Translating Evidence into Policy

Epidemiologic Methods

Clinical Trials

Community-Engaged Research

Biostatistical Methods for Clinical Research IV

Business providing transport of goods between Oaxaca and California

Advertisement cautioning patients against using antibiotics for the common cold

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This one-year, part-time program offers a series of courses and experiential learning activities focused on applied methods of implementation and dissemination, particularly as they relate to developing more effective interventions. The program is designed for people from a broad range of professions who are currently engaged in the develop-ment, implementation, and evaluation of programs to promote and improve health and health care quality, including clinical and public health researchers, quality improvement officers, community-based clinic staff, public health and public policy practitioners, and clinicians. Those interested in developing skills relevant to their existing work may be particularly interested in the program.

To accommodate busy working professionals, classes meet weekly on Thursdays. Class size is kept small so that course material may be tailored to individual research interests and to facilitate productive interaction between faculty and participants.

Learning Objectives

1. Design and Implement More Effective Intervention Programs, through a) identifying community, patient, clinician and organizational factors that serve as barriers and facilitators to translating research results into every-day practice, policy and public health; and b) using this knowledge to tailor interventions to diverse settings and populations.

2. Design More Comprehensive Evaluations of Interventions, through applying the basics of process and outcome evaluation, and by identifying the appropriate qualitative and quantitative measures of effect.

3. Develop Better Funding Proposals, by making a compel-ling case for translational research and educational programs, and by integrating conceptual frameworks, theory and research results into the intervention design and/or evaluation of your program.

Training: IDS Certificate Program

“I developed new theoretical design skills, and better project implementation and evaluations tools that complement the MPH degree that I received ten years ago.

I feel that in whatever capacity that I work, whether it’s academic research, health care administration, public health agencies, or a medical clinic, that I am better able to formulate interventions that will translate to better practice and health policy.”

- IDS Certificate Program participant

Rep. Henry Waxman and IDS Course Director Andy Bindman work on federal

health reform on Capitol Hill

Course Schedule for 2011-2012

Timeline: Courses begin Spring Quarter 2011 and follow UCSF’s 10-week quarter system for one calendar year (with a break during the summer quarter).

Where/when: Classes are held on Thursdays at UCSF China Basin in San Francisco, next to AT&T Park.

Requirements: Four core courses* and Works in Progress seminar. Elective courses are optional.

*Students choose either of these two courses as the fourth required course.

Works in Progress (WIP) Seminars

Moderated by IDS Program Directors Dr. Ralph Gonzales and Dr. Margaret Handley, WIP Seminars provide a forum for participants to present research projects for critical review and feedback from their peers and faculty members. Projects at all stages of development are presented, including grant proposals, data collection and analysis methods, prelimi-nary results, manuscript drafts, and dissemination strategies. The seminar environment is relaxed and supportive, enabling participants to both learn from and teach their peers.

Field Training (beginning Summer 2012)

Field training will give participants an opportunity to put into practice the theories and skills taught in the program’s courses. During Summer Quarter 2012, all Certificate Program participants will pursue a field project of their choice in a local community-based organization, hospital, health department, or other setting in which health care is delivered or health research is conducted. Each project will be closely guided and mentored by IDS faculty and staff.

Applying to the Program

Applications for the 2011-2012 IDS Certificate Program are due February 28, 2011. Courses begin in April 2011.

Applicants should have a master’s degree in public health or clinical research, or the equivalent.

For more information about tuition, prerequisites, and how to apply, please see the program web site at: http://www.epibiostat.ucsf.edu/courses/implementation_research.html. Or contact the IDS Program Coordinator, Sara Ackerman at ids@ucsf.edu.

***The IDS Certificate Program is co-sponsored by the UCSF Clinical & Translational Science Institute (CTSI), the UCSF Program in Implementation & Dissemination Science, and the UCSF Department of Epidemiology & Biostatistics.

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Thursdays Spring 2011Summer

2011Fall 2011 Winter 2012

8:45am-10:15am Translating Evidence into Practiceno

coursesIndividual-Centered Implementation Strategies

10:30am-12:00pmWorks in Progress Seminar (biweekly)

Delivery System-Centered Implementation Strategies*

1pm-2:30pm Community-Engaged ResearchWorks in Progress Seminar (biweekly)

3:15pm-4:45pm Translating Evidence into Policy*

Several full-tuition scholarships will be awarded to IDS Certificate Program applicants in 2011

“The program has given me the knowledge and skills to better position myself to apply for an R01-type grant application.”

- IDS Certificate Program participant

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Training: Master’s in Clinical ResearchThe Master’s Degree Program in Clinical Research is a rigorous, two-year course of study that focuses on advanced epidemiologic and biostatistical methods and specialized topics such as qualitative research, medical informatics, molecular methods in clinical research, and decision and cost-effectiveness analysis. The program is intended for advanced pre-doctoral fellows and faculty members who wish to master clinical research methods and pursue independent research careers.

IDS Track

Master’s Degree Program scholars have the option of electing a specialized track in IDS, which offers most of the same methods and analysis courses as those required for the standard master’s program, in addition to a series of IDS-specific electives. The IDS track is relevant for scholars interested in developing contacts with a diverse network of faculty conducting IDS-oriented research at UCSF, nationally, and internationally, and for those who want to pursue a research career focused on:

• Developing and evaluating practice-based or community-based health interventions, in the U.S. or in a global health context

• Forming collaborations with community partners to co-develop interventions, or to improve the relevance and content of existing research and interventions

• Implementing and evaluating quality improvement and health promotion programs from the perspective of providers, patients, health care organizations, public health programs, or communities

• Developing, implementing and evaluating policies that affect practice-based or community-based health programs

IDS track scholars also receive career mentoring and individual feedback on research projects from faculty representing a wide range of disciplines and UCSF departments, including: health policy; anthropology, history, and social medicine; family and community medicine; epidemiology and biostatistics; internal medicine; global health; social and behavioral sciences; and obstetrics, gynecology and reproductive science.

All scholars also participate in the Master’s seminars held every quarter. These seminars provide a forum for scholars to present their research for critical review and feedback from faculty members and their peers. The seminar environment is relaxed and supportive, enabling scholars to both learn from and teach their peers.

Learning Objectives

Before completion of the program, all students enrolled in the Master’s in Clinical Research program are expected to:

1. Acquire mastery of a broad set of clinical research methods.

2. Plan and implement one or more clinical research projects.

3. Present research findings at a national meeting.

4. Write a comprehensive literature review and publish one or more first-authored peer-reviewed original research papers.

5. Obtain experience in the instruction of clinical research methods.

6. Design and Implement More Effective Intervention Programs (IDS track)

7. Design More Comprehensive Evaluations of Interventions (IDS track)

8. Develop Better Funding Proposals (IDS track)

Master’s program graduates and faculty, 2010

“The lectures were extremely informative; they integrated theory with real-world application. [The professor] was very active in learning about our individual projects and tailored the lectures to meet our needs.”

- System-Centered Implementation

Strategies student

Master’s in Clinical Research IDS Track Required Courses 2010-2011

YEAR 1Summer

Designing Clinical Research (Epi 202)

Building a Career in Clinical Research (Epi 227)

Responsible Conduct of Research (Epi 201)

Introduction to Statistical Computing in Clinical Research (Biostat 212)

Fall

Epidemiologic Methods (Epi 203)

Clinical Epidemiology (Epi 204)

Biostatistical Methods for Clinical Research I (Biostat 200)

Master’s Seminar I (Epi 220)

Winter

Clinical Trials (Epi 205)

Biostatistical Methods for Clinical Research II (Biostat 208)

Master’s Seminar I (Epi 220)

Spring

Systematic Reviews/Meta-Analysis (Epi 214)

Biostatistical Methods for Clinical Research III (Biostat 209)

Publishing and Presenting Clinical Research (Epi 212)

Master’s Seminar I (Epi 220)

Translating Evidence into Practice (Epi 245)

Translating Practice into Evidence: Community-Engaged Research (Epi 248)

YEAR 2Fall

Biostatistical Methods for Clinical Research IV (Biostat 210)

Master’s Seminar II (Epi 221)

Individual-Centered Implementation Strategies (Epi 246) ^

Winter

Master’s Seminar II (Epi 221)

Qualitative Research Methods (Epi 240) *

Decision and Cost-Effectiveness Analysis (Epi 213) *

Medical Informatics (Epi 206) *

Translating Evidence into Policy (Epi 249) ^

System-Centered Implementation Strategies (Epi 247) ^

Spring

Master’s Seminar II (Epi 221)

Clinical Performance and Health Outcomes Measurement (Epi 211) *

Health Disparities Research Methods (Epi 222) ^

* At least one course from this group is required and can be taken in Year 1 or 2.^ At least two courses from this group are required and can be taken in Year 1 or 2.

Courses meet Tuesdays and Thursdays at UCSF’s China Basin campus http://www.epibiostat.ucsf.edu/courses/ChinaBasinLocation.html 185 Berry St., San Francisco (next to AT&T Park)

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“One of the best courses I have ever taken at UCSF…more fellows and faculty should be taking this course!”

- Individual-Centered Implementation

Strategies student

In 2010, UCSF’s Department of Epidemiology & Biostatistics and CTSI launched the PhD program in Epidemiology & Translational Science. The program is designed to provide students with rigorous training in epidemiologic and biostatistical methods along with opportunities for practical experience in a wide variety of applied areas to enhance their didactic training. Because of its location in a school of medicine on a health sciences campus, the number and diversity of opportunities for such training in clinical, basic and population science areas are numerous. Students in the PhD program are encouraged to pursue IDS-oriented coursework. Learn more at http://www.epibiostat.ucsf.edu/courses/doctoral.html.

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Training: PhD Program in Epidemiology & Translational Science

Applications due March 21, 2011

For more information about the Master’s in Clinical Research, including application mate-rials, please see http://www.epibiostat.ucsf.edu/courses/masters.html.

***The Master’s in Clinical Research is sponsored by the Training in Clinical Research (TICR) Program, which offers multiple educational opportunities for scholars at various stages in their careers. Learn more at http://www.epibiostat.ucsf.edu/courses/post.html). The TICR Program is co-sponsored by UCSF’s Clinical & Translational Science Institute (CTSI) and the Department of Epidemiology & Biostatistics.

Training in Clinical Research Master’s program students

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IDS Course Offerings at UCSF

SPRING QUARTER

Clinical Performance and Health Outcomes Measurement (Epi 211)Course Director: Andy Auerbach, MD

Instruction in types of questions that can be addressed with large administrative and clinical databases; gaining access to these databases; determining validity of information; risk adjustment; linking datasets; and building registries.

Health Disparities Research Methods (Epi 222) Course Director: Eliseo Pérez-Stable, MD

Instruction in the meaning of race, ethnicity, social class, and culture, and how these constructs affect the conduct and interpretation of clinical research.

Translating Evidence into Practice: Theory and Design (Epi 245) Course Director: Ralph Gonzales, MD, MSPH

An introduction to the different target audiences and approaches needed to translate biomedical evidence into practice. The course is the gateway for scholars who plan for additional study within this discipline but also suffices as cross-exposure for scholars from other disciplines. In addition to didactic work, scholars are guided through the creation of a research protocol aimed towards translating their particular choice of evidence into practice.

Translating Practice into Evidence: Community-Engaged Research (Epi 248) Course Director: Kevin Grumbach, MD

Introduces the principles and applied methods of community-engaged research, including defining the community and partnership models for identifying relevant research questions, developing and implementing study designs, interpreting and disseminating findings, and scaling-up studies for translational implementation research.

FALL QUARTER

Translating Evidence into Practice: Individual-Centered Implementation Strategies (Epi 246) Course Director: Margaret Handley, PhD, MPH

Instruction in developing interventions for individual health behavior change, including behavior change strategies at the individual, interpersonal, and system/community level; developing practical frameworks to integrate principles of behavior change theory; evidence for effective tools; and practical implementation strategies in the design of health interventions.

Community health workers in Sub-Saharan Africa involved in a UCSF-affiliated IDS project

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WINTER QUARTER

Medical Informatics (Epi 206) Course Director: Ida Sim, MD, PhD

Instruction in the core concepts of medical informatics: vocabularies, interchange stan-dards, decision support systems, and how computers are used to manage information in health care and to support clinical research.

Decision and Cost-Effectiveness Analysis in Medicine (Epi 213) Course Directors: James Kahn, MD, MPH and Aaron Caughey, MD, MPP, MPH

Instruction in creating decision trees and other analytic models; obtaining appropriate probabilities, utilities and costs; and completing analyses using customized software.

Qualitative Research Methods (Epi 240) Course Director: Dan Dohan, PhD

Introduces basic qualitative research methods used in clinical settings: question design and interviewing techniques; focus group analysis; ethnographic fieldwork, notes and narrative analysis; and audio and video data collection and analysis.

Translating Evidence into Practice: System-Centered Implementation Strategies (Epi 247) Course Director: Laura Schmidt, PhD, MSW, MPH

Instruction in translational tools at health care system level to promote the adoption of evidence-based medicine by the public and providers through mechanisms that influence health care delivery systems.

Translating Evidence into Policy: Framing Research to Influence Policy (Epi 249) Course Director: Andy Bindman, MD

Instruction in the policy process and strategies for collecting and disseminating research findings to inform and influence that process. The course will be taught through a series of lectures and interactive sessions during which students will have an opportunity to apply the strategies to their own work.

Community health clinic in Oaxaca, Mexico

Patient and physician at SF General Hospital

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Additional Training and Research Support at UCSF

An extensive list of UCSF-based research training and career advancement opportunities is available at http://ctsi.ucsf.edu/training/browse-ucsf-opportunities.

CTSI’s Community Engagement & Health Policy Program sponsors IDS-related training and consultation services for community-engaged research projects at http://ctsi.ucsf.edu/about/programs/ce-services.

Current NIH funding opportunities for IDS-related research projects are described in de-tail on the CTSI web site at http://ctsi.ucsf.edu/funding/t2.

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IDS Program Directors

Ralph Gonzales, MD, MSPHralphg@medicine.ucsf.edu

Margaret Handley, PhD, MPHhandleym@medsfgh.ucsf.edu

IDS Program Coordinator

Sara Ackerman, PhD, MPHsara.ackerman@ucsf.edu

For more information, contact the Program in Implementation & Dissemination Science:

Phone: (415) 514-6286Email: ids@ucsf.eduWebsite: http://ctsi.ucsf.edu/training/ids

*****************************************************************

Writing and Editing

Sara Ackerman, PhD, MPH, IDS Program CoordinatorRalph Gonzales, MD, MSPH, IDS Program DirectorMargaret Handley, PhD, MPH, IDS Program Director

Special thanks to:

Chris Ireland Katja Reuter

Design

UCSF Documents, Media & Mail

We invite you download the online version of this brochure at: http://ctsi.ucsf.edu/files/ids_program_manual.pdf

IDS Program staff Ralph Gonzales, Sara Ackerman, and Margaret Handley

IDS FacultyAndrew Auerbach, MD, MPH, Associate Professor of Medicine (Division of Hospital Medicine); Director of Research, Division of Hospital Medicine

Andrew B. Bindman*, MD, Professor of Medicine (Division of General Internal Medicine-SFGH); Phil R Lee Institute for Health Policy Studies; and Epidemiology & Biostatistics; Chief, Division of General Internal Medicine—San Francisco General Hospital

Daniel Dohan*, PhD, Associate Professor, Phil R. Lee Institute of Health Policy Studies (IHPS) and Anthropology, History and Social Medicine; IHPS Associate Director for Training and Development

Ellen Goldstein*, MA, Academic Coordinator, Department of Family and Community Medicine; Program Manager, CTSI Community Engagement Program

Ralph Gonzales*, MD, MSPH, Professor of Medicine (Division of General Internal Medicine-Parnassus-Mt Zion) and Epidemiology and Biostatistics; Associate Director, CTSI KL2 Career Development Program

Lawrence W. Green*, DrPH, Adjunct Professor, Department of Epidemiology and Biostatistics and Helen Diller Family Comprehensive Cancer Center

Kevin Grumbach, MD, Professor of Family and Community Medicine; Chair, Department of Family and Community Medicine; Co-Director, CTSI Community Engagement and Health Policy Program; Director, UCSF Center for California Workforce Studies

Margaret Handley*, PhD, MPH, Assistant Professor of Epidemiology and Biostatistics; and Medicine (Division of General Internal Medicine-SFGH)

James G Kahn*, MD,MPH, Professor, Phil R. Lee Institute of Health Policy Studies and Epidemiology and Biostatistics

Sunita Mutha*, MD, Professor of Clinical Medicine, Division of General Internal Medicine and Center for the Health Professions

Anna Napoles, PhD, MPH, Associate Professor of Medicine (Division of General Internal Medicine-Laurel Heights)

Eliseo J. Pérez-Stable*, MD, Professor of Medicine; Chief, Division of General Internal Medicine—Parnassus-Mt Zion; Director, Medical Effectiveness Research Center for Diverse Populations; Associate Director for Health Care Disparities, Helen Diller Family Comprehensive Cancer Center

Laura Schmidt*, PhD, MSW, MPH, Associate Professor, Phil R. Lee Institute of Health Policy Studies and Anthropology, History and Social Medicine

Ida Sim*, MD, PhD, Associate Professor of Medicine (Division of General Internal Medicine-Parnassus-Mt Zion); Director, Center for Clinical and Translational Informatics

* IDS Program Steering Committee members.

Additional Steering Committee members

Janet Myers, PhD, MPH, Associate Professor of Medicine, Center for AIDS Prevention Studies

George Rutherford, MD, Director, Institute for Global Health; Head, Division of Preventive Medicine and Public Health; Vice Chair, Department of Epidemiology and Biostatistics

George Sawaya, MD, Professor, Department of Obstetrics, Gynecology and Reproductive Sciences and Department of Epidemiology and Biostatistics

This publication was supported by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.