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Our Dynamic Process Framework

While research on arts/design/humanities approaches to health typically focuses on discovery of what works, how it works and for whom (i.e., is “designed to prove”) and program evaluations tend to focus more on determining what is valuable and can guide decision-making (i.e., are “designed to improve”), CHC recognizes growing overlap between the two areas as the field of implementation and dissemination science advances.

At the same time, such work can also create conflicts for partners from distinct disciplines, interprofessional practice teams, review groups, and funders. Disciplinary jargon, divergent standards for evidence, competing project goals, and unfamiliar methodologies can magnify differences in ways of seeing and doing, thereby producing “ a tension that more often ends in compromise than collaboration” (Fancourt & Joss, 2015, p. 2).

Recognizing this tension as a source of creativity and productivity, the CHC hub is testing and refining a dynamic, collaborative process framework drawing from multiple research and program evaluation approaches (see Figure 1). The approaches include components from public health implementation and translation models such as Reach Effectiveness Adoption Implementation Maintenance (RE-AIM), Knowledge to Action, Pragmatic Dissemination & Implementation (e.g., Battaglia & Glasgow, 2018; Layde et al., 2012; Milat & Li, 2017), Health-Arts Framework (Davies et al., 2014), Arts in Health Programming (Fancourt & Joss, 2015), and program evaluation frameworks from public health (CDC, 2018).

Flexible by design, each CHC project begins by determining overall goals and objectives of the partners through dynamic dialogues incorporating practice-based evidence and evidence-based practice/treatments, where practitioners’ voices are equally valued in the identification of outcomes; tools for assessment; intervention components and modes of delivery; and implementation and dissemination (Coon & Evans, 2009). It recognizes that “users” (health care systems, community-based organizations, researchers, artists, students) come to CHC with varied experience in building interprofessional partnerships, designing research, working with artists and designers, developing intervention programs, conducting evaluations, and carrying out implementation and dissemination activities.

As such, the CHC hub may assist with any part(s) of the process (e.g., project outcomes and related evaluation tools) or the process overall (as it will for this application’s keystone and pipeline projects). The CHC framework is also a dynamic, iterative and reflective process that allows for modifications (alterations or additions) to research design components across time. We engage partners in guided discussions to assess their needs and actively involve them in the process throughout the period of collaboration.

CHC seeks feedback from users about its collaborative process framework through both qualitative (focus groups and focused interviews, formative evaluation techniques) and quantitative means (anonymous survey data) to investigate outcomes and outputs. Our overarching research questions for the dynamic process framework are:

  • What are users’ perceptions of benefit from working with CHC and its framework?
  • How do these perceptions vary by parts of the process?
  • What are facilitators and barriers to participation?

With each CHC project, we expect to refine the framework and related products (e.g., webinars, checklists, workshops) to offer as deliverables for dissemination as the CHC research hub matures.