​Three members of the Brown School faculty have been named among the most highly cited researchers in the sciences by the Institute for Scientific Information in 2020. 

Ross Brownson, Byron Powell, and Enola Proctor were among 55 faculty from Washington University named to the list, which recognizes researchers worldwide who have demonstrated significant and broad influence, reflected in their publication of multiple papers that have been frequently cited by their peers. Their papers rank in the top 1% for their fields and year in Web of Science. Washington University ranks 10th in the world for its number of highly-cited researchers. For 2020, about 6,100 researchers made the overall list.

Brownson, the Stephen H. and Susan U. Lipstein Distinguished Professor and director of the Prevention Research Center, is a leading expert in chronic disease prevention and applied epidemiology. Powell is an assistant professor whose research focuses on efforts to improve the quality of behavioral health and social services. Proctor is a professor and pioneer in the field of dissemination & implementation science who directs the Implementation Research Institute, a training program in implementation science funded by the National Institute for Mental Health.

A series of public discussions sponsored by the Brown School and the Center for Health Economics and Policy has resulted in a white paper that recommends major changes in Missouri’s Medicaid system to enhance access to high-quality care while containing rising costs. Recommendations for Missouri Medicaid Transformation is based on input by stakeholders who gathered in person, and later virtually through the Clark-Fox Policy Institute in workshops led by the Center, a part of the Institute for Public Health.

The recommendations include:

• Expanding Primary Healthcare Homes to include more Medicaid enrollees.
• Replacing fee-for-service payments to hospitals with global budgets.
• Moving more Medicaid enrollees into managed care organizations.
• Streamlining eligibility, funding and communication across programs.

“This work represents our Center’s fifth installation in a string of events to steer a discussion of how Missouri’s health care system can be transformed to enhance access to high quality care, improve outcomes, while also helping contain costs,” said Timothy McBride, co-director of the Center and Bernard Becker Professor at the Brown School. “It can give the state access to a range of voices on these crucial issues.” The project was led by Abigail Barker, research assistant professor at the Brown School; and Lauren Kempton, an MSW/MPH  student at the Brown School and lead author of the report.

The workshops convened a diverse group of individuals and organizations, including health-care providers, urban and rural hospitals, long-term care facilities, researchers and policymakers.

“Bringing together stakeholders to craft policy solutions to our knottiest social problems is what the Clark-Fox Policy Institute is all about,” said Atia Thurman, associate director of the institute. “Our discussions reflected a wide range of opinions, but all of the participants shared a common goal: Making our Medicaid system work better for the people who need it the most.”

Cancer is the second leading cause of death overall in the United States. While university-based research is yielding an abundance of new discoveries related to cancer treatment, research findings often take 10 to 20 years before they are incorporated into clinical or public health practice.

The science of dissemination and implementation (D&I) has emerged to address the gap between research and practice. 

A team of researchers at Washington University in St. Louis has been an international leader in developing the science of D&I research. A recent mentored training program is helping to expand that knowledge base well beyond the university.

“The Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) program was the first of its kind in cancer prevention and control, and we have some impressive findings showing its impact in a variety of ways, including an increase in skills, grants, publications, networking and even some practice changes,” said Ross Brownson, the Steven H. and Susan U. Lipstein Distinguished Professor and director of the Prevention Research Center at Washington University.

Brownson directed the training program, which was funded by the National Cancer Institute from 2014-2020. As an example of a real-world impact, one fellow helped to secure funding through their state health agency responsible for overseeing the Medicaid health program to provide technical assistance and support to 15 coordinated care organizations (CCOs), including education on evidence-based interventions and best practices for their uptake. Early results show increases in cancer screening rates across these CCOs, Brownson said.

Making international connections

Postdoctoral and early-career cancer researchers with full-time appointments in a research setting and interests in D&I research were enrolled. Between 2014 and 2017, 58 fellows representing the United States, Australia and Canada were trained.

The fellows participated in two summer institutes (five-day trainings) in St. Louis each June. Trainings primarily focused on competencies for D&I research and in-person mentoring and interactive sessions to work on and receive feedback related to research proposals and or other projects in progress.

“MT-DIRC was absolutely pivotal in my career. The mentored approach to training in dissemination and implementation in cancer was critical in helping me to situate my expertise in the context of the intersection of these fields, identifying my unique contribution,” said program fellow Sarah Birken, associate professor in the Division of Implementation Science at Wake Forest School of Medicine.

“Participating in MT-DIRC also gave me a network of scholars with expertise that complements mine, offering us long-sustained collaborations.”

“A colleague recently said to me that in this decade, implementation science will transform healthcare services. And I think she is right!”

“The MT-DIRC program has been pivotal in my career development,” said Nicole Rankin, assistant professor in implementation science in the School of Public Health at the University of Sydney in Australia.

“It has enabled me to develop expertise in implementation science that would otherwise not have been possible because of that deep immersion through the summer institutes and having dedicated time to devote to the program from my workplace,” said Rankin, who also directs the implementation science program at Sydney Health Partners.

“The mentoring aspect was a vital ingredient of success as I had someone to check in with each month and my mentor was so generous with her time,” Rankin said. “It was also incredibly helpful to have my co-mentees to bounce ideas off and learn from their experiences.

“The broader network of mentors and mentees has also been career-changing, as I’ve made international connections I would otherwise not have had,” she added. “More than anything else, the MT-DIRC program gave me the confidence to pursue a career in implementation science and it helped me to form a vision of what might be possible in the Australian setting. A colleague recently said to me that in this decade, implementation science will transform healthcare services. And I think she is right!”

Thirteen D&I research faculty members from various institutions served as mentors to program participants. Five Washington University faculty members from the Brown School, the School of Medicine and the Siteman Cancer Center were involved. A series of recent academic papers in Academic Medicine, BMC Medical Education and Implementation Science, among others, showed the success of the mentorship program.