In Profile: Prof. Geoffrey Curran

In Profile: Prof Geoffrey Curran

Visiting Fulbright Specialist from University of Arkansas for Medical Sciences

by Eoin Brady

 Global

Implementation science is the scientific study of how best to support the uptake implementation and sustainment of evidence-based practices. Prof Geoffrey Curran from University of Arkansas for Medical Sciences (UAMS) is an internationally recognized thought leader in this area. 

Prof Alice Coffey who is the lead of the HRI Health Implementation Science Research Cluster (HIST) here in UL met with Prof Curran in 2019 at the Implementation Science Conference at King’s College London where he was leading a master class.  She invited him to facilitate a seminar for HIST which Prof Curran conducted online in Jan 2021 on the topic of Hybrid Designs. Ultimately this led to a successful co-application for a Fulbright Specialist Program which enabled Prof Curran to come to Ireland for a period of six weeks work with the HIST cluster including an Implementation Science Summer School.  

I met with Prof Curran just before his return to the US after his residency to discover how it went: 

You have been here since June not just for the summer school but consulting with researchers, clinicians, and health and policy administrators. 

The Fulbright grant was a win-win situation. I was lucky too, that, you know, my University was fully supportive of me coming over here, for a couple of months. I mean, I had to keep my keep my day job! So, I did a round of teaching on this topic, consulting with more people from Alice’s HIST cluster, but then also worked with the cluster itself on its sustainability plans and planning for the future.

Can you give me a layman’s definition of what you mean by implementation science? 

Implementation science is the study of how best to support the implementation and sustainment of evidence-based practices or, indeed, any kind of practice or program that works. A lot of this work is actually trying to get people to stop doing certain practices which might have had some evidence base, but now they don't, or it's been replaced by some new intervention or new program or should be. It's this idea of, you know, really how best to help. 

And so that's why it's a science because we hope to generate generalizable knowledge about how to support and help people to do the thing that we know works, but we don't actually apply it enough or deliver it enough. Normally our projects research starts after somebody has tried to implement a clinical practice guideline and it didn't go very well. People thought that with a little education, a little training, it would be adopted and done as part of routine care. And when it doesn’t, our research projects try to understand why? What are the barriers to why something (the thing) did not get delivered well or enough or both? 

Even if everybody thinks the thing is a good idea and everybody knows what to do, it's hard to do. They need prompts. They need reminders, they need coaching, then we try to deploy those kinds of strategies. If the thing is relatively easy to do, but they just don't know about it or don't believe it yet, then maybe our strategies would be focused more on trying to change their attitude about it, trying to change their motivation about it. 

Does implementation science have a wider application than in healthcare settings? 

My work is often in healthcare settings, but it doesn't have to be. It's really about how best to support optimal delivery of programs and interventions in a variety of settings and programs that you know are often quite different. People benefit from implementation science because it is generic. The approaches and the philosophies and theories, models and frameworks that our field uses are generic, and they can apply to anything. 

I know that Alice and her cluster see this as a strength of their group and what's happening here in Limerick. This work can be done not just in in healthcare but in other sectors too: in sports clubs and criminal justice and in schools and in lots of different kinds of places with lots of different kinds of interventions. 

How did your teaching and meetings in UL go? 

I thought it went great. I facilitated a summer school, which was a three-day course and then after that for a series of weeks, I've met with a lot of different faculty members who are, part of the cluster or are health service or community partners working with the cluster. I talked to them about their project ideas, the grants they want to write, the things that they're trying to do and get adopted. And it's been really fun, you know. 

Reading about your work, I know that you are an advocate for mentoring. Why is this important to you? 

Yes. For the past eight, almost nine years now, I've been the head of a centre at my University and one of the main goals is to build capacity. It's sort of the buzzword in our field at the moment; to build capacity in implementation science and so I've taken that to heart. I've been involved in a lot of national and international training programs and mentoring programs. And so, it was attractive for me when Alice came and told me that in Ireland, Implementation Science research was at more of an early stage and could really use some help in trying to build capacity in this field. 

What do you think are the next steps for implementation science in Ireland? 

It’s at an earlier stage than in the US and the funding mechanisms are not there yet to do the larger research studies. I had to adjust some of my messages and my teachings to this reality, to encourage small pilot studies and program evaluations, which are more observational studies of how implementation can work in an Irish context. 

It was not all work while you were here, I gather? 

I have grandparents who were born in Ireland and I am a joint citizen so I was excited to get the opportunity to come over and see more of the country with my family and work with people here, which has been very satisfying. 

I hope we’ll see you again? 

Yes, I hope. I have some paperwork to fill out; an application for me to be considered for a position as a visiting adjunct professor. That would make it easier for me to help Alice and her team grow and develop the HIST cluster.