ICE/Centres Meeting
January 20-21, 2005
Toronto, Ontario
ICE Team Representatives:
| Baker, Ross University of Toronto ross.baker@utoronto.ca |
Macarthur, Colin Bloorview MacMillan cmcarthur@bloorviewmacmillan.on.ca |
| Battista, Renaldo (PI) Université de Montréal renaldo.battista@umontreal.ca |
Maclure, Malcom (PI) University of Victoria Malcolm.maclure@gems4.gov.bc.ca |
| Bavinton, Holly University of British Columbia hbavinton@cw.bc.ca |
Neis, Barbara (PI) Memorial University of Newfoundland bneis@mun.ca |
| Beaulne, Ginette Institut national de santé publique gbeaulne@santépub-mtl.qc.ca |
Parent, Robert Université de Sherbrooke rparent@adm.usherb.ca |
| Blancquaert, Ingeborg Agence d'évaluation des technologies et des modes d'intervention en santé Ingeborg.blancquaert@aetmis.gouv.qc.ca |
Ronsky, Janet University of Calgary jlronsky@ucalgary.ca |
| Boon, Heather University of Toronto Heather.boon@utoronto.ca |
Raina, Parminder (PI) McMaster University praina@mcmaster.ca |
| Cassels, Alan University of Victoria alan@alancassles.com |
State, Stephen University of Western Ontario sstate@uwo.ca |
| Edwards, Geoffrey Université Laval Geoffrey.edwards@scg.ulaval.ca |
Straus, Sharon (PI) University of Toronto Sharon.straus@utoronto.ca |
| Gibson, Jennifer University of Toronto Jennifer.gibson@utoronto.ca |
Tetroe, Jacqueline University of Ottawa jtetroe@ohri.ca |
| Gocool, Iona University of Toronto iona.gocool@utoronto.ca |
Tousignant, Pierre (PI) Institut national de santé publique ptousi@santepub-mtl.qc.ca |
| Grimsaw, Jeremy (PI) University of Ottawa jgrimshaw@ohri.ca |
Verhoef, Marja University of Calgary mverhoef@ucalgary.ca |
| Howley, Heather University of Ottawa hhowley@uottawa.ca |
Wilson, Brenda (PI) University of Ottawa bwilson@uottawa.ca |
| Kapiriri, Lydia University of Toronto Lydia.kapiriri@utoronto.ca |
Wilson, David University of British Columbia dawilson@interchange.ubc.ca |
| Lee, Shoo (PI) University of British Columbia shool@interchange.ubc.ca |
Vingilis, Evelyn (PI) University of Western Ontario evingili@uwo.ca |
ICE/Centres Partners:
| Beckett, Barbara Institute of Neurosciences, Mental Health and Addiction bbeckett@cihr-irsc.gc.ca |
Paradis, Gilles Fonds de recherche en santé du Québec gilles.paradis@staff.mcgill.ca |
| Bélanger, Brigitte Public Health Agency of Canada Brigitte_Belanger@phac-aspc.gc.ca |
Robertson, Stephanie Institute of Genetics srobertson@cihr-irsc.gc.ca |
| Desjardins, Louise Institute of Muskuloskeletal Health and Arthritis ldesjardins@cihr-irsc.gc.ca |
Saulnier, Marcel Canadian Medical Association marcel.saulnier@cma.ca |
| Hewitt, Allyson Safe Kids Canada allyson.hewitt@sickkids.ca |
Smith, Michael Health Canada Michael_J_Smith@hc-sc.gc.ca |
| Keelor, Sean Ministry of Health and Long Term Care Sean.Keelor@moh.gov.on.ca |
Thomas, Ginette CIHR Rural and Northern Health Strategic Initiative gthomas@cihr-irsc.gc.ca] |
| Liboiron, Renée l'Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) RENLIB@irsst.qc.ca |
CIHR Staff and Invited Guests:
| Barer, Morris Scientific Director Institute of Health Services and Policy Research mbarer@ihspr.ubc.ca |
Hedden, Lindsay Special Projects Officer Institute of Health Services and Policy Research lhedden@ihspr.ubc.ca |
| Champagne, François Chair, Institute Advisory Board Institute of Health Services and Policy Research francois.champagne@umontreal.ca |
Kishchuk, Nathalie Evaluation Consultant nkishchuk@sympatico.ca |
| Di Ruggiero, Erica Associate Director Institute of Population and Public Health e.diruggiero@utoronto.ca |
Larsen, Craig Institute Manager Institute of Health Services and Policy Research clarsen@ihspr.ubc.ca |
| Frank, John Scientific Director Institute of Population and Public Health j.frank@utoronto.ca |
Martens, Patricia Acting Director Manitoba Centre for Health Policy University of Manitoba Pat_Martens@cpe.umanitoba.ca |
| Gagnon, Michelle Assistant Director, Partnerships and Knowledge Translation Institute of Health Services and Policy Research & Population and Public Health mgagnon@cihr-irsc.gc.ca |
Ndaba, Vera Financial/Events Officer Institute of Population and Public Health v.ndaba@utoronto.ca |
| Gasparini, Toni Head, Research Capacity Development Canadian Institutes of Health Research tgasparini@cihr-irsc.gc.ca |
O'Rourke, Michèle Associate, Strategic Initiatives Institute of Health Services and Policy Research & Population and Public Health morourke@cihr-irsc.gc.ca |
| Gaudreau, Kim Project Officer Institute of Health Services and Policy Research & Population and Public Health kgaudreau@cihr-irsc.gc.ca |
Savoie, Jean-Yves Chair, Institute Advisory Board Institute of Population and Public Health jsavoie002@sympatico.ca |
| Greco, Lori Knowledge Translation Branch lgreco@cihr-irsc.gc.ca |
Snell, Richard Deputy Director, Knowledge Creation Programs Canadian Institutes of Health Research rsnell@cihr-irsc.gc.ca |
| Goering, Paula Member, Institute Advisory Board Institute of Health Services and Policy Research Paula_Goering@camh.net |
1.0 Welcome and Introduction
Drs. Champagne and Savoie welcomed everyone to the inaugural meeting of Centres for Research Development and Interdisciplinary Capacity Enhancement Teams (ICE). They signalled the importance of the Centres and ICE teams to IPPH and IHSPR, as a key strategy to build population and public health (PPH) research and health services and policy research (HSPR) and knowledge exchange capacity. They further commented on how the Centres and Teams were on the forefront of charting and supporting innovative and interdisciplinary PPH and HSP research and facilitating its application to inform policies, programs, and practices.
2.0. Setting the Stage: How do the Centres and ICE Teams fit in the big picture?
Drs. John Frank and Morris Barer provided an overview. The following is a summary of the slides presented.
The objectives of the presentation were as follows:
History
Community Alliances for Health Research
Interdisciplinary Health Research Teams
Capacity for Applied and Developmental Research and Evaluation (CADRE)
CIHR Group Program
Strategic Training Programs in Health Research
New & Emerging Teams also emerged in 2001, an IA/INMD concept intended to:
2001 - Strategic Plan for IHSPR
From NETs to ICE
Mission Statement
Need for Centres
IPPH's Strategic Research Priorities
Centres for Research Development
Current Context for Centres
Changing PPH landscape
National Collaborating Centres
Each National Collaborating Centre will draw on regional expertise and complement the contributions of other organizations in the pan-Canadian public health system, including
the Public Health Agency of Canada, the provinces and territories, academia and on governmental organizations
May 2004, Health Canada Press Release.
The first six centres will work on priority areas of
interest as follows:
Proposed Collaborating Centre Functions
The Way Forward -- Role of Institute of Population & Public Health
CIHR Blueprint (2003)
Five key areas where CIHR will focus from 2003-2008:
1. Strengthen Canada's health research community.
2. Address emerging health challenges and develop national platforms and initiatives.
3. Develop and support a balanced research agenda that includes research on disease mechanisms, disease prevention and cure, and health promotion.
4. Harness research to improve the health status of vulnerable populations.
5. Support health innovations that contribute to a more productive health system and prosperous economy.
The Future:
Better, Simpler CIHR
Diagnosis:
Treatment:
First Steps
Teams Grant
Emerging Teams (name?)
What's to become of ICE and Centres?
Options:
The presentation was followed by a question and answer period.
Dr. Morris Barer, Scientific Director, Institute of Health Services and Policy Research (IHSPR) and Dr. John Frank, Scientific Director, Institute of Population and Public Health (IPPH) helped to set the stage for the discussions by providing a presentation about CIHR - past, present and future. A copy of the presentation is attached. The presentation was followed by a question and answer period, which is summarized below.
One participant asked whether there was a plan to convert ICE/Centres into standing competitions. It was noted that this would likely occur through CIHR's Simpler, Better CIHR exercise (refer to slide 27); however, it is possible that IHSPR could run another ICE competition in the future. While CIHR has already moved towards one consolidated tool, in the case of Large Team Grants, this new model is recognized to be missing elements when compared to the Centre or ICE tools. One participant commented that a six-year rather than five-year grant for ICE teams would have been preferable, given the significant amount of time required for start-up.
Identifying the outcomes of the Centre and ICE initiatives was highlighted as a key objective of the Institutes, and a necessary precursor to any subsequent competition for either funding tool. There is also a need to use qualitative methods for capturing the work of the Centres and ICEs. Given the duration of these grants (i.e. Centres have six years of funding and ICEs have five), it is unclear where CIHR stands and what funding options exist for the future. The Institutes are hopeful that there will be more options in the future to address emerging needs. Questions were raised about what collaboration with the Collaborating Centres for Public Health and Public Health Agency of Canada would look like, and the role of the IPPH in facilitating these connections (see slide 22). One individual asked about how cross-cutting themes (e.g. injury prevention) fit into the picture. It was noted that cross-cutters have been classified into first and second tier, and that Large Team and New Emerging Team (NET) grants would work well to address the second tier initiatives, subject to the availability of funding.
There was some discussion about what strategies could be employed for educating and influencing the general public about our work. While the Institutes' ability to do this is limited given minimal staffing, more proactive approaches to getting our messages across via the media were recommended.
Some questioned what CIHR was doing to link with provincial funders to support strategic initiatives and strengthen infrastructure. IHSPR does have some provincial funders as partners on selected ICE teams. These arrangements need to be negotiated in advance so provinces do not feel as though they are picking up "second rate" research and that they feel truly engaged in the funding initiative. Some wondered what CIHR was doing to strengthen public health 'receptor capacity' to create a demand for evidence. IPPH has been very concerned about strengthening public health capacity in Canada. We need to involve policy makers and practitioners in Summer Institutes, training programs, and other activities. Unfortunately, academia in Canada had not been very welcoming. The best in the field are not being attracted to take on careers in the public service. This is one of the greatest challenges. At least in the area of pillar 3, CADRE investments are heavily oriented to partner involvement in merit review, training etc. Also, there are selected group of institutes now building knowledge translation casebooks to share successful and unsuccessful stories with decision-makers and trainees.
3.0 ICE Teams Breakout Session
3.1 Roundtable introductions:
Heather Boon facilitated the first segment of the ICE Teams concurrent meeting. To begin the session, she asked all of the ICE Team representatives to introduce themselves to the group and to give a brief description of their work and what they hoped to accomplish over the course of the day.
3.2 Discussion of Pre-Survey Themes
Heather asked the group to list the ICE Team "Bests" and "Challenges". Following a lengthy discussion, the lists below represent a synthesis of what was expressed by the group:
Bests:
Challenges:
The themes listed in the challenges column were identified as priorities to discuss as a group in order to develop practical strategies, and action items to address them and move forward.
3.3 Discussion/Action planning on priority themes
3.3.1 Communication
Communication challenges emerged as a priority, both in the pre-survey and in the group discussion. Thus, the group elected to discuss this theme first.
The participants decided that the scope of communication first needed to be defined and the following groups were identified as being part of the communication process:
Everyone agreed that one of the main communication goals is to create incentives for people to collaborate and to participate.
a) Description of communication within the ICE Team:
ICE Teams need to be attractive and visible in order to draw other researchers to join the network; thus the value-added of joining the network must be evident. ICE Teams must also be able to demonstrate how their area fits within the larger discipline, for example, convincing politicians that Health Services and Genetics is an important topic.
While the majority of the core ICE Teams are made-up of researchers, some Teams are mainly composed of co-principal Investigators, while others are mainly driven by trainees.
All of the Teams expressed communication difficulties related to geographical barriers, making it difficult to hold face-to-face meetings. Face to face meetings are important to gain a common understanding of what every member is contributing to the team, which is necessary to establishing trust. The key is getting people together and creating a space to learn from each other. Thus, the core Team needs to be in a proactive environment where members are intimately linked and can explore ways of creating synergies.
Most ICE Teams agreed that it was important to focus on internal team building first and that overtime, a natural shift toward external collaborations will occur. Such a shift could focus on building receptor capacity and gaining community support by showing what the research has accomplished and what it can do.
Building capacity and training students was considered by the participants to be feasible; however, retaining trainees in the field was considered a challenge, mostly due to the lack of sustainable funding opportunities.
Finally, developing a common language, an identify, and getting people motivated to apply for funds were identified as key priorities.
b) Strategies for internal communication:
Technology (lotus notes, IBM, videoconferencing, intranet site...), was identified as a key strategy to facilitate information sharing and communication. However, it is important to make sure that the technology is user friendly and that not too much time need to be devoted to it. One type of technology suggested by IRSST was the "learning history" tool. This is a business research tool, developed at Harvard to help teams keep track of their projects as they progress.
For example, it can record the history of key investigator interviews and allow for comments to be added to the interview results. It can also identify changes in cultures and allows for information sharing.
Some groups were able to manage their communication with regular meetings via teleconference. They noted that making relevant information accessible was key (i.e. sharing information ahead of time like presentation materials and placing literature referred to on web site) Others found that videoconferencing worked best, in combination with face-to-face meetings. The Team based at Laval University is able to borrow videoconferencing equipment from the University. Nonetheless, all Teams agreed that face to face meetings are essential to establishing links and that funding should allow for this type of interaction. Some Teams found it helpful to tag on their face-to-face meetings with other events, to save on travel costs.
One Team adopted a "bottom-up approach" whereby trainees are brought together to work in the same physical location for a few months, which increases linkages and facilitates learning, regardless of their backgrounds.
Many groups rely heavily on their coordinator for communication. The coordinator, for example, will send regular e-mail notification on various items (i.e. job opportunities, events, publications.) and will keep the team updated and engaged.
Some Teams organized Seminar Series, whereby everyone talks about the research they are conducting, while other Teams organized semi-annual retreats to share information.
c) Strategies for external communication:
The creation of an advisory committee, which meets approximately twice a year to hear what the Team is doing, was identified as an important strategy to facilitate external communication. A similar strategy was the establishment of an executive committee, composed of researchers and policy-makers from various organizations and levels, which meets on a monthly basis, via teleconference, in-order to foster a decision-making process that is transparent and regular.
Four ICE Teams reported hosting annual symposiums in order to foster external connections with NGOs, ministries, collaborators and junior researchers that may be interested in joining the Team. These events allow for profiling and networking over and above presentations and can also facilitate linkages between ICE Teams. The core Team's expenses were covered by the ICE budget and planned for from the beginning. Additional funds needed to be leveraged from other sources.
Shoo Lee suggested that Deputy Ministers and practitioners be involved in the research project(s) from the very beginning. Thus, the ICE Team must work at three levels: 1) at the practitioner level to change guidelines, 2) at the professional body level to change policies and at the regional health authority level to create a mutual learning environment (i.e. get the authorities to approach the Team for advice on policies...). This model has been successful for knowledge transfer and in gaining credibility. It is however, very time consuming, but in the end is worthwhile in terms of leveraging funds and informing health authorities on policies and how to implement them. It is important to understand what the policy makers are facing and to learn how to speak their language in order to develop common interests and linkages.
Some Teams have partnered with other training centres to co-fund trainees and share resources.
One Team developed a website to engage stakeholders and to build a network. For example, this site can be used to administer surveys on priorities across Canada and to solicit feedback.
Regardless of the strategies used, all the Teams agreed that creating collaborations required a significant time investment and that there was largely no way around it.
3.3.2 KT versus Scientific Research
a) Defining the problem:
The group felt that we needed to capture KT more broadly; and that it should include processes related to large team building.
The tension between KT and scientific productivity exists due to the disconnect between the objectives of the ICE program and academic rewards. For example, a key aspect of the ICE program is to enhance capacity of non full-time researchers1 to improve their own systems with respect to policies and this objective does not translate into CIHR applications.
Since ICE involves 1) capacity building, 2) KT and 3) network building, it is difficult to master all of these components at the same time and thus, the Teams felt like they won't be accurately captured during the evaluation due to the lack of time and resources. For example, it takes a lot of time to get a network up and running and KT will be levered once the ICE Teams are fully functional and won't necessary occur during the life of the ICE grant. Shoo Lee admitted that it took his team five years to see KT come into effect with his neo-natal research team. Today, this team produces about 200 publications per year.
The process of obtaining research results, implementing them and influencing policy is quite lengthy. Also, many research projects are not conducive to KT and therefore, we need to be strategic when deciding when/where KT should be a key focus.
Some Teams think that KT is a key activity part of the ICE team's strategy from the very beginning, related to most activities. For example, it is critical to involve partners in setting research priorities. KT was seen by these Teams as an interactive process rather than a linear process.
Some participants felt that the KT definition varied depending on the context. KT does not need to be disciplinary and it goes beyond the research produced by the team, it addresses an existing policy problem and looks at how research can solve it. For example, research syntheses transform existing research into a new product.
Since KT is difficult to define, the group felt that the KT outcomes needed to be defined carefully in the context of the evaluation process. And since researchers are not KT experts, working assumptions and models should be made explicit.
b) Strategies:
One Team explained how they used the CIHR funds to cover the cost of academic activities and that they leveraged funds (i.e. from ministries) to support other relevant activities, such as KT, as a strategy to balance both types of activities.
One participant felt that it was up to the principal investigator to approach the dean and to propose that ICE relevant work be counted in the academic realm.
Some suggested that ICE trainees could perform tasks that have dual purposes, in order to come to terms with competing objectives. For example, students could conduct research syntheses that would serve as a product for policy partners and also to address research gaps. On a related note, another way to address the competing academic and KT objectives is to report on existing global research gaps via syntheses, rather that on individual projects emerging from the ICE Team.
Some teams suggested that KT be addressed via priority setting exercises with researchers and decision-makers from the beginning of the project.
Some felt that the tension is necessary and must rather be managed at the three following levels:
It was mentioned that the new PHSI competition and the new HSPR journal would help bridge these tensions.
As a collective, the group felt that it was partly their responsibility to change evaluation criteria at the University department level. They identified this problem as intrinsic as they are attached to scientific fibres. They recognized the need to build a critical mass of researchers who will be able to apply the right criteria as they seem to fail at it.
It was suggested that a shared activity to tackle this issue could emerge from the ICE Teams in the form of a call for action. However, since CHSRF has started work on this in the form of tips for peer reviewers and since CIHR is also working on this (i.e. modifying application forms to capture interdisciplinary activities, KT activities and modifying peer review criteria...), it was suggested that the ICE Teams could feed into these processes rather than initiating a separate effort. On behalf of CIHR, Lori Greco welcomed feedback from the participants. Some initial feedback included taking a look at the Netherlands model, which focuses on relevance and to expand the definition on the "information requested" page.
3.3.3 Sustainability
Funding from CIHR enables the Teams to attract trainees to do research in a particular field and hopefully, they will become young researchers in that field. However, to achieve this, funding outside of the academic channels must be continuous. For example, we should make connections between what is accomplished through ICE and the regular New Investigator awards at CIHR, to help maintain learned skills.
Moreover, since researchers tend to disappear and since projects seem to unravel before the end of the grant's term, it is important for the Teams to start planning and gaining buy in, from the very beginning in order to ensure ongoing work in the area, beyond the term of the grant.
Funding can be obtained from various levels to support a program. CIHR can provide the initial necessary resources to get the program up and running, then, funds can be obtained from the ministries of health and other levels of government. It is therefore critical for ICE Teams to be able to demonstrate value-added and benefits to secure additional funding. However, we must not assume that everything needs to be sustained and we must be critical about which parts of the program need to be pursued and if other parts need to be re-thought, re-focused or dropped.
It was suggested that ICE Teams that share commonalities could potentially get together to apply for CIHR Team Grants or Emerging Team (ET) Grants for continued funding. In essence, we need to look beyond the ICE tool.
Since CIHR is currently developing a suite of new tools through the Better Simpler initiative, it will be important to ensure that the ICE features be incorporated in the Team and/or the Emerging Team (ET) tools. For example, the criterion that encourages teams that have never worked together before is key to maintain since this is where innovation occurs. In sum, the main ICE features to maintain in the new tools are 1) new teams, 2) KT and 3) training. Morris provided a brief update on the Better Simpler initiative and how the Institutes' funds would still be used toward targeted priorities.
3.4 Linking between ICE Teams
The facilitator opened this part of the session by asking the people in the room how many had discussed common interests with other ICE Teams during the meeting so far. The response was overwhelming, as the majority had done so. Thus, the meeting itself proved to be a good opportunity to forge linkages.
In order to facilitate further linkages, it was suggested that learning more about each other's work would help. For example, at the next meeting, poster presentations would be helpful. Such information would foster linkages between Teams with common topic interests (first order linkages) and may also foster linkages among Teams with broader common interests (second order linkages).
It was mentioned that linkages would be explored as a natural evolution but that it was still a bit early to do so. Thus, it would be beneficial if CIHR organized another meeting in about a year, which would focus on linkages. This meeting could also include Centres as possible linkages between ICE and Centres could be formed.
Summary
Communications:
Barriers: 1) language, 2) geography, 3) time commitment
KT and Scientific Merit:
Good ideas were suggested to merge the competing objectives (i.e. synthesis)
Sustainability:
Two levels: 1) tool (maintain ICE, or ICE - like features in tools) and 2) of the current ICE Teams (i.e. Team grant).
Linkages:
CIHR meetings and natural evolution
1. 0 Overview and general reactions
A presentation of the key components of the evaluation framework and of messages heard during the consultations with ICE and Centre Principal Investigators elicited lively discussion. While overall the logic model and its links to the performance measurement and evaluation strategies seemed clear, issues were raised by the participants about several aspects of the proposed strategies:
2. 0 Team presentations
The presentations made by two teams also raised issues about evaluation:
3.0 Broader issues raised, resolved and remaining
The presentations and ensuing open discussion prompted further discussion and response among participants and with the Institute's Scientific Directors. Issues raised in this session included:
Participants were encouraged to submit further reflection and comments to Natalie Kishchuk, (514) 694-8995, nkishchuk@sympatico.ca.
