Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

NCCMT Spotlight Webinar - The Consolidated Framework for Implementation Research (CFIR): Application and Tools

1,118 views

Published on

The Consolidated Framework for Implementation Research (CFIR) is used to guide the adaptation and plan for the implementation of public health interventions. The tool is appropriate for individuals and groups involved in planning and implementing existing interventions. To see the summary statement of this tool developed by NCCMT, click here: http://www.nccmt.ca/registry/view/eng/210.html

NCCMT is one of six NCCs for Public Health in Canada. More on the NCCs at www.nccph.ca. Production of this webinar has been made possible through a financial contribution from the Public Health Agency of Canada. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.

Published in: Healthcare
  • Have you ever heard of taking paid surveys on the internet before? We have one right now that pays $50, and takes less than 10 minutes! If you want to take it, here is your personal link ♥♥♥ https://tinyurl.com/realmoneystreams2019
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Be the first to like this

NCCMT Spotlight Webinar - The Consolidated Framework for Implementation Research (CFIR): Application and Tools

  1. 1. Follow us @nccmt Suivez-nous @ccnmo Funded by the Public Health Agency of Canada | Affiliated with McMaster University Production of this presentation has been made possible through a financial contribution from the Public Health Agency of Canada. The views expressed here do not necessarily reflect the views of the Public Health Agency of Canada.. The Consolidated Framework for Implementation Research (CFIR): Application and Tools Presenter: Laura J. Damschroder, MS, MPH November 12, 2015 1:00 – 2:30 PM ET
  2. 2. Follow us @nccmt Suivez-nous @ccnmo Use Q&A to post comments / questions during the webinar • ‘Send’ questions to All (not privately to ‘Host’) Connection issues • Recommend using a wired Internet connection (vs. wireless), • WebEx 24/7 help line • 1-866-229-3239 Housekeeping 2 Q&A Participant Side Panel in WebEx
  3. 3. Poll Question #1 Where are you from? 1. BC 2. AB 3. SK 4. MB 5. ON 6. QC 7. NB 8. NS 9. PEI 10. NL 11. YK 11. NWT 12. NU 13. Outside Canada 3
  4. 4. Follow us @nccmt Suivez-nous @ccnmo Your profession? Put a √ on your answer (or RSVP via email) / Epidemiologist Management (director, supervisor, etc.) Allied health professionals (nurse, dietician, dental hygenist, etc.) Librarian Physician / Dentist Other 4
  5. 5. Follow us @nccmt Suivez-nous @ccnmo The Consolidated Framework for Implementation Research (CFIR): Application and Tools http://www.nccmt.ca/registry/view/eng/210.html Episode 20 5
  6. 6. NCC Infectious Diseases Winnipeg, MB NCC Methods and Tools Hamilton, ON NCC Healthy Public Policy Montreal, QC NCC Determinants of Health Antigonish, NS NCC Aboriginal Health Prince George, BC NCC Environmental Health Vancouver, BC 6
  7. 7. Follow us @nccmt Suivez-nous @ccnmo National Collaborating Centre for Methods and Tools • dedicated to improving access to, and use of, methods and tools that support moving research evidence into decisions related to public health practice, programs, and policy in Canada. 7
  8. 8. Poll Question #2 What sector are you from? 1. Public Health Practitioner 2. Health Practitioner (Other) 3. Education 4. Research 5. Provincial/Territorial/Government/Ministry 6. Municipality 7. Policy Analyst (NGO, etc.) 8. Other 8
  9. 9. Follow us @nccmt Suivez-nous @ccnmo Laura J. Damschroder, MS, MPH Research Scientist Ann Arbor Veteran’s Affairs, Center for Clinical Management Research and HSR&D Center of Excellence Presenter 9
  10. 10. Registry of Methods and Tools Online Learning Opportunities WorkshopsMultimedia Public Health+ Networking and Outreach NCCMT Products and Services 10
  11. 11. The Consolidated Framework for Implementation Research (CFIR): Application and Tools Laura J. Damschroder, MS, MPH November 12, 2015 National Centre for Methods and Tools (NCCMT) Webinar Series McMaster University The views expressed in this presentation are my own and do not reflect the position or policy of the Department of Veterans Affairs or the United States government
  12. 12. Poll Question #3 Have you heard of the CFIR? A. What is the CFIR? B. I am familiar with the CFIR C. I have thought about using the CFIR in my work D. None of the above 12
  13. 13. Goals for Implementation Research Case study: Application of the CFIR Building the knowledge-base Implementation Strategies Outline Roadmap for implementation science
  14. 14. • Science – Collaborative, systematic knowledge building • Praxis – Tools and processes for practitioners – Identify effective strategies • Tailored to context – Contribute to culture of learning healthcare system Dual Goals for Implementation ResearchIS Goals
  15. 15. Power of Theory • Organizing framework for research studies • Build scientific knowledge base • Context, mechanisms of action • Generalize through theory • Syntheses • Provides common terms & definitions • Efficient way to systematically build collective knowledge Colquhoun, H., Leeman, J., Michie, S., Lokker, C., Bragge, P., Hempel, S., … Grimshaw, J. (2014). Towards a common terminology: a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. Implementation Science, 9, 51. Foy R, Ovretveit J, Shekelle PG, et al. The role of theory in research to develop and evaluate the implementation of patient safety practices. Quality & safety in health care. Feb 11 2011. IS Goals
  16. 16. Poll Question #4 Which of the following best describes your work? A. Developing and testing innovations B. Developing and testing implementation approaches C. Implement innovations D. All of the above E. Other 16
  17. 17. Innovations to Improve Patient Care 17 • “Active Ingredients” • Adaptability Innovation Science Goal: Improved health & well being of patients Colquhoun, H., Leeman, J., Michie, S., Lokker, C., Bragge, P., Hempel, S., … Grimshaw, J. (2014). Towards a common terminology: a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. Implementation Science, 9, 51. Establishing “internal validity” is priority Control or ignore CONTEXT
  18. 18. Weight Loss Program Innovation • ASPIRE Comparative Effectiveness Trial – High fidelity coaching  more weight loss • VA DPP Comparative Effectiveness Trial – DPP higher fidelity to ASPIRE-ID’d domains of coaching • Affirmed by patient ratings of delivery – National MOVE! program guidance updated • http://www.move.va.gov/GrpSessions.asp 18
  19. 19. Innovations to Improve Patient Care 19 • “Active Ingredients” • Adaptability Innovation: Improved health & well being of patients RCTs along do not provide sufficient information
  20. 20. Preparing for and Explaining Implementation 20 • Barriers & Facilitators • Why did/will it work? Implementation Science Goal: Drawing on knowledge about how an innovation will achieve expected benefits and the causes, effects, and factors that determine its success (or failure) in clinical practice Grol, et al. (2007). Planning and studying improvement in patient care: The use of theoretical perspectives. Milbank Quarterly, 85(1), 93–138. Establishing “external validity” is priority Embrace and understand CONTEXT …in all its wicked complexity
  21. 21. Use of theory in implementation Assess targeted Innovation and Context Sales A, Smith J, Curran G, Kochevar L. Models, strategies, and tools. Theory in implementing evidence-based findings into health care practice. J. Gen. Intern. Med. Feb 2006;21 Suppl 2:S43-49. Bartholomew, L. K., Parcel, G. S., & Kok, G. (1998). Intervention mapping: a process for developing theory- and evidence- based health education programs. Health Educ Behav, 25(5), 545-563. Use theory to guide assessment
  22. 22. Case Study VA MOVE! Weight Management Program 22 CFIR
  23. 23. Highly Variable Implementation MOVE!® 23 Number of Visits Reported by Study Site 1 & 2 Years Since Dissemination 0 10 20 30 40 50 60 70 FY 2007 FY 2008 #Visits/1000Veterans CFIR
  24. 24. Outcomes 24Proctor, E., H. Silmere, R. Raghavan, P. Hovmand, G. Aarons, A. Bunger, R. Griffey, and M. Hensley, Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health, 2011. 38(2): p. 65-76.
  25. 25. Assess targeted EBP change and context French SD, Green SE, O'Connor DA, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. Apr 24 2012;7(1):38. Who needs to do what differently? Which barriers & facilitators need to be addressed? Applying Theory
  26. 26. Consolidated Framework for Implementation Research (CFIR) • A comprehensive framework to promote consistent use of constructs, terminology, and definitions – Five Domains – 39 Constructs 26 Damschroder L, Aron D, Keith R, Kirsh S, Alexander J, Lowery J: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. 2009, 4:50. CFIR
  27. 27. OUTER CONTEXT INNER CONTEXT PRACTITIONER INNOVATION PROCESS SLIDE CREDIT: ©Dr. Melanie Barwick, SickKids / U Toronto, Canada 2015 Consolidated Framework for Implementation Research LOCAL REALITY CFIR
  28. 28. CFIR Consolidated Framework for Implementation Research Damschroder L, Aron D, Keith R, Kirsh S, Alexander J, Lowery J: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. 2009, 4:50.
  29. 29. Poll Question #4 What types of data do you typically rely on in your work? A. Qualitative data e.g., interview transcripts, field notes B. Quantitative data e.g., surveys C. A lot of both D. Neither 29
  30. 30. Understanding Context • Qualitative Data – Interviews – Artifact data (e.g., P&Ps, journals, meeting notes) – Quantitative ratings 30
  31. 31. 31 www.CFIRGuide.org
  32. 32. 32
  33. 33. 33
  34. 34. 34
  35. 35. 35
  36. 36. Understanding Context • Qualitative Data – Interviews – Artifact data (e.g., P&Ps, journals, meeting notes) – Quantitative ratings • Quantitative Measures – Not well developed • Martinez, R., C. Lewis, and B. Weiner, Instrumentation issues in implementation science. Implementation Science, 2014. 9(1): p. 118 – Synthesis of measures – Chaudoir, S.R., A.G. Dugan, and C.H. Barr, Measuring factors affecting implementation of health innovations: A systematic review of structural, organizational, provider, patient, and innovation level measures. Implement Sci, 2013. 8(1): p. 22. – Assessment of measures – work in progress – REGISTRATION IS FREE BUT NECESSARY: http://www.societyforimplementationresearchcollaboration.org/sirc-projects/sirc-instrument- project/measures-collection/ – Lewis, C., C. Stanick, R. Martinez, B. Weiner, M. Kim, M. Barwick, and K. Comtois, The Society for Implementation Research Collaboration Instrument Review Project: A methodology to promote rigorous evaluation. Implementation Science, 2015. 10(1): p. 2. 36
  37. 37. Quantitative Measures http://cfirguide.org/quant.html CFIR 7th Annual D&I Conference December 2014
  38. 38. Inner Setting: Networks & Communications • HIGH IMPLEMENTATION SITES: – Both sites had a high degree of “teamness” – Meet regularly • LOW IMPLEMENTATION SITES – Did not have regular team meetings – Lack of effective communication • Patients confused about the program Damschroder, L.J. and J.C. Lowery, Evaluation of a large-scale weight management program using the consolidated framework for implementation research (CFIR). Implement Sci, 2013. 8: p. 51. CFIR
  39. 39. Data Collection, Coding, Rating • Coded qualitative data using CFIR as “codebook” • Rated strength and valence of each construct – Scale: -2 to +2 – By transcript – Rolled up ratings by sites • Blinded to site outcomes CFIR
  40. 40. Qualitative Data: Construct Ratings 40 Implementation Effectiveness: Low High I. INTERVENTION CHARACTERISTICS Relative advantage -2 1 2 2 II. OUTER SETTING Patient needs & resources -2 0 2 2 External Policy & Incentives -1 -2 0 1 III. INNER SETTING Networks and communications -2 -2 2 2 Implementation Climate Tension for change 0 0 1 1 Relative priority -1 -2 1 2 Goals and feedback -2 -1 1 2 Learning climate N/A -1 1 2 Readiness for Implementation Leadership Engagement -2 -1 2 2 Available resources -2 -2 1 -1 V. PROCESS Planning -1 N/A 1 1 Executing -2 1 2 2 Reflecting & Evaluating -1 -2 1 2 CFIR Goals and feedback
  41. 41. Number of Referrals per 1000 Veterans by Site Variable referral rates Follow-up Interviews CFIR
  42. 42. Site ID V03-3 V02-6 V03-4 V05-1 V01-2 V03-1 V01-4 V Referral Rate 2.0094 2.3236 2.5855 5.9953 6.0434 6.8834 7.7227 1 Structural Characteristics -2 -2 -2 -1 0 -1 -1 Networks & Communications -1 1 . . . -1 -1 Compatibility 1 -1 1 1 -1 1 -1 Referral rate & Construct Ratings by SiteCFIR
  43. 43. Compatibility • Correlation: 0.55 (p=0.08) 0 5 10 15 V03-3 V02-6 V03-4 V05-1 V01-2 V03-1 V01-4 V01-3 V02-2 V01-6 V02-3 Referred/1000 -2 -1 0 1 2 CFIR
  44. 44. Compatibility • Negative Rating – e.g., – Only providers could refer to TLC in some sites • Our nurses are specifically forbidden to write orders …everything that gets written has to be written by a physician[…] this has formed a really labor intensive situation for practitioners, so they are super rebelling against anything else coming down. [MOVE! Coordinator, V02-6] CFIR
  45. 45. Compatibility • Positive rating – e.g., – Perceived compatibility with clinical initiatives • …this …really helps the patient to have ownership for their processes and their living, and it definitely blends very nicely with the health coaching CFIR
  46. 46. BUILDING ON FINDINGS ACROSS STUDIES Knowledge
  47. 47. Comparing Findings Across Studies 47 Study: MOVE! TeleMOVE TLC Structural Characteristics Networks & Communications Tension for Change Compatibility Relative Priority Goals & Feedback Learning Climate Leadership Engagement Available Resources Strongly Distinguishes Weakly Distinguishes Not assessed
  48. 48. Knowledge
  49. 49. Causal complexity: Set Relations vs. Correlations: • Equifinality: Various (combinations of) conditions can lead to the same outcome. • Conjunctural causation: Conditions do not necessarily exert their impact on the outcome in isolation from one another, but sometimes have to be combined in order to reveal causal patterns. • Asymmetrical causation: The occurrence and non- occurrence of social phenomena require separate analysis – the presence versus absence of conditions might play crucially different roles in bringing about the outcome. 49 Knowledge
  50. 50. Qualitative Comparative Analysis • Case-oriented analysis – Rather than variable-oriented • Based on set theory and Boolean algebra • Appropriate when – The phenomenon of interest is best understood in terms of set relations – Evaluate configurations of conditions across cases • Describe causal complexity related to an outcome • Number of cases does not matter 50 Knowledge
  51. 51. Use QCA to Reveal Combinations of CFIR Constructs  Success Studies Cases 7 53 • Behavioral Change Programs – Group-based weight management – Phone-based coaching for lifestyle change – Technology-enabled weight management program • TeleRetinopathy Program • Specialty Care – SCAN-ECHO – Specialty Care Neighborhood – E-Consults
  52. 52. What We Learned • Causal complexity confirmed • Different pathways lead to success • Analytical limitations – Solutions sets depended on the cases included – Must KNOW your data – link with qualitative data • A priori theories • Triangulate through different analyses, theories Knowledge
  53. 53. Preparing for and Explaining Implementation 53 • Barriers & Facilitators • Why did/will it work? Implementation: Theories about how an innovation will achieve expected benefits and the causes, effects, and factors that determine its success (or failure) Grol, et al. (2007). Planning and studying improvement in patient care: The use of theoretical perspectives. Milbank Quarterly, 85(1), 93–138. Insufficient reporting of contextual factors
  54. 54. Assess targeted EBP change and context French SD, Green SE, O'Connor DA, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. Apr 24 2012;7(1):38. Develop tailored implementation strategy Who needs to do what differently? Which barriers & facilitators need to be addressed? What strategies could be used to address barriers & facilitators? Applying Theory
  55. 55. Implementation Strategy Construct Issue/Barrier Change Strategies Goals & Feedback 55 Powell, Byron J., Thomas J. Waltz, Matthew J. Chinman, Laura J. Damschroder, Jeffrey L. Smith, Monica M. Matthieu, Enola K. Proctor, and JoAnn E. Kirchner. "A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project." Implementation Science 10, no. 1 (2015): 21. •It is challenging to track patients’ weight and other measures over time. Often staff lack time and ability to analyze these data and develop cogent business cases needed to support the program. • Clearly align program data with org goals & communicate CFIR • Develop tools for quality monitoring1 • Audit and provide feedback1 • Anecdotal success stories help to bring data “alive” for leaders and other stakeholders. Strategies
  56. 56. Expert Recommendations for Implementing Change (ERIC) • A mixed methods approach to establish expert consensus on a common nomenclature for implementation strategy terms and definitions Strategies
  57. 57. Engage consumers Train and educate stakeholders Change infrastructure Develop stakeholder interrelationships Provide interactive assistance Utilize financial strategies Use evaluative and iterative strategies Adapt & tailor to context Support clinicians 73 strategies clustered into 9 groups 1 2 3 28 3442 49 66&70 9 10 11 12 13 22 44 4 5 14 18 23 61 26 27 46 56 37 39 41 50 62 69 6 7 17 40 47 52 64 48 51 63 67 68 24 25 36 38 45 65 72 35 57 8 33 53 54 58 21 30 32 59 15 1629 60 19 20 31 43 55 71 73 SLIDE CREDIT: Dr. Byron Powell, University North Carolina, USA. 2015 Strategies
  58. 58. E.g., Provide Interactive Assistance 1 2 3 28 3442 49 66&70 9 10 11 12 13 22 44 4 5 14 18 23 61 26 27 46 56 37 39 41 50 62 69 6 7 17 40 47 52 64 48 51 63 67 68 24 25 36 38 45 65 72 35 57 8 33 53 54 58 21 30 32 59 15 1629 60 19 20 31 43 55 71 73 8 Centralize technical assistance 53 Provide local clinical supervision 33 Facilitation 54 Provide local technical assistance SLIDE CREDIT: Dr. Byron Powell, University North Carolina, USA. 2015 Strategies
  59. 59. Tailoring to Context • Which strategies best address specific barriers as aligned with constructs from the CFIR? ERIC Strategies • Build a coalition • Identify and prepare champions • Involve patients and family members • Inform local opinion leaders • Conduct educational meetings • Use mass media • Visit other sites • Conduct educational meetings • Conduct local consensus discussions • Conduct educational outreach visits • Capture and share local knowledge • Tailor strategies • Conduct local needs assessment • Alter incentive/allowance structures • Conduct cyclical small tests of change • Develop a formal implementation blueprint • Identify early adopters • Promote adaptability CFIR Constructs I. INTERVENTION CHARACTERISTICS A Intervention Source B Evidence Strength & Quality C Relative advantage D Adaptability E Trialability F Complexity G Design Quality and Packaging H Cost II. OUTER SETTING A Patient Needs & Resources B Cosmopolitanism C Peer Pressure D External Policy & Incentives III. INNER SETTING A Structural Characteristics B Networks & Communications Strategies
  60. 60. Survey of Implementation Experts Audit and provide feedback Select and rank up to 7 strategies that best address barriers related to Goals and Feedback: ♦ Goals are not clearly communicated or acted upon, nor do stakeholders receive feedback that is aligned with goals. ♦ Strategies
  61. 61. www.CFIRguide.org Strategies
  62. 62. Tailor an Intervention Strategy Select a domain
  63. 63. Tailor an Intervention Strategy Techniques Select a construct Learn more about the construct in the wiki, or click Techniques
  64. 64. Tailor an Intervention Strategy Audit and provide feedback Obtain and use patient/consumer and family feedback Facilitate relay of clinical data to providers Process: Reflecting & Evaluating Select techniques you want to include for each construct…
  65. 65. Tailor an Intervention Strategy Repeat steps until all relevant constructs have been addressed, then click “Create Tailored Implementation Strategy” Create Tailored Implementation Strategy 0
  66. 66. Tailor an Intervention Strategy Reflecting & Evaluating • Facilitate relay of clinical data to providers Structural Characteristics • Create new clinical teams • Make billing easier • Change service sites Leadership Engagement • Provide clinical supervision Evidence Strength & Quality • Provide on-going consultation Process Inner Setting The tool will generate a document that lists the techniques you chose which can then be used as a basis for a documented tailored Implementation Strategy Innovation Characteristics
  67. 67. Assess targeted EBP change and context French SD, Green SE, O'Connor DA, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. Apr 24 2012;7(1):38. Develop tailored implementation strategy Who needs to do what differently? Which barriers & facilitators need to be addressed? What techniques could be used to address barriers & facilitators? How can change (progress) be measured and understood? Applying Theory
  68. 68. Applying Theory 68 Execute tailored implementation strategy Assess targeted EBP change and context Develop tailored implementation strategy Concurrent monitoring and refinement Theory-informed
  69. 69. Applying Theory 69 Execute tailored implementation strategy Assess targeted EBP change and context Develop tailored implementation strategy Evaluate effectiveness of implementation strategy Proctor E., et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm. Policy Ment Health 2011;38:65-76
  70. 70. Achieving Optimal Outcomes 70 Clinical Innovation Adapted from: Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health and Mental Health Services Research, 36(1), 24-34. Roadmap
  71. 71. Applying Theory 7171 Assess fit of findings with initial theory Execute tailored implementation strategy Evaluate effectiveness of implementation strategy Assess targeted EBP change and context Develop tailored implementation strategy
  72. 72. Applying Theory 72 Assess fit of findings with initial theory Execute tailored implementation strategy Evaluate effectiveness of implementation strategy Assess targeted EBP change and context Develop tailored implementation strategy Add to the knowledge-base
  73. 73. Example Critique of CFIR
  74. 74. Roadmap for Implementation Science • Foundation: Common Terminology & Constructs • Assess Context – Quantitative & Qualitative • Targeted innovations – Intervention mapping (http://www.interventionmapping.com) – Adaptations (http://www.biomedcentral.com/content/pdf/1748-5908-8-65.pdf ) • Implementation Strategies – Strategy Taxonomy (e.g., http://www.implementationscience.com/content/10/1/21/abstract) – Tailored to context (forthcoming) • Generate Testable Theories Roadmap
  75. 75. Packaging for the (real) world • Guidance for planning successful implementations – Context assessment tools • Implementation Strategies – “How to” execute strategies – Tailored to context • “Learning” repositories – Collective learning Roadmap
  76. 76. 76 What works where and why? Contact: Laura.Damschroder@va.gov
  77. 77. Poll Question #5 What are your next steps? I plan to … A. access the CFIR Tool. B. read the NCCMT summary of the CFIR Tool. C. consider using the CFIR Tool. D. tell a colleague about the CFIR Tool. 77
  78. 78. Follow us @nccmt Suivez-nous @ccnmo • Use Q&A to post comments and/or questions • ‘Send’ questions to All (not privately to ‘Host’) Q&A Participant Side Panel in WebExYour Comments/Questions 78
  79. 79. Your Feedback is Important Please take a few minutes to share your thoughts on today’s webinar. Your comments and suggestions help to improve the resources we offer and plan future webinars. The short survey is available at: https://nccmt.co1.qualtrics.com/SE/?SID=SV_8H AZ4HrWTZsPszP 79
  80. 80. After Today The PowerPoint presentation (in English and French) and English audio recording will be made available. These resources are available at: PowerPoint: http://www.slideshare.net/NCCMT/ Audio Recording: https://www.youtube.com/user/nccmt/videos 80
  81. 81. Join us for our next webinar NCCMT’s Applicability & Transferability Tool December 9, 2015 from 1:00 – 2:30pm EST The Applicability and Transferability of Evidence Tool (A&T Tool) is designed to help public health managers and planners decide whether the evidence you find can be used in your local setting. Register at: https://health-evidence.webex.com 81
  82. 82. Follow us @nccmt Suivez-nous @ccnmo Funded by the Public Health Agency of Canada | Affiliated with McMaster University The views expressed here do not necessarily reflect the views of the Public Health Agency of Canada. For more information about the National Collaborating Centre for Methods and Tools: NCCMT website www.nccmt.ca Contact: nccmt@mcmaster.ca

×