Team Grants: Transforming Health with Integrated Care (THINC) -Implementation Science (IST)

1. Purpose

THINC Implementation Science Team (IST) Grants will inform the implementation, evaluation, adaptation and/or spread/scale (share) of evidence-informed integrated care policies and interventions that encompass intersectoral collaborations within and/or beyond the formal health care delivery system in order to advance the Quadruple Aim and health equity for Canadians. For the purpose of this funding opportunity, evidence-informed integrated care policies and interventions are defined as policies, programs, services, and models of funding or care delivery that (a) are implemented with the primary goal of integrating care and (b) have been piloted or tested in a setting or population and show promise (i.e., published evidence) for spread and scale through local adaptation in a different context, population, or jurisdiction (Note: This funding opportunity does not support the development of new or pilot interventions).

THINC ISTs must address six (6) core elements in their design and approach (see detailed info on CIHR website)

2. Objectives

The specific objective(s) of this funding opportunity are to:

• Identify evidence-informed, actionable solutions: Generate actionable evidence on promising integrated care policies and/or delivery system interventions that can advance any/all of the Quadruple Aim goals and health equity;
• Advance the field of implementation science: Advance the evidence base on how to implement, evaluate, adapt, and spread (share) evidence-informed, equitable integrated care policies and interventions across different health system and population contexts;
• Build capacity: Develop human and organizational capacity for actionable evidence on implementation, evaluation, and/or spread and scale (share) of integrated care policies and interventions;
• Spark collaborations: Build strong interdisciplinary, multi-sectoral collaborations and partnerships among researchers, policy makers, decision makers, healthcare providers, patients and public communities interested in advancing transformative integrated care; and
• Foster knowledge mobilization and impact: Foster knowledge mobilization activities throughout the research process to inform the local adaptation, implementation and adoption of integrated care policies and interventions at the community and/or population level.

3. Research areas

This funding opportunity will support research projects aimed to improve the implementation, evaluation, adaptation and/or spread/scale (share) of evidence-informed integrated care policies and interventions that advance any/all of the Quadruple Aim goals and health equity for one or more priority populations.

Priority populations include people with complex health needs (e.g., individuals with multimorbidity, individuals with mental health needs and/or substance use); those currently or at risk of experiencing poor health outcomes based on social economic factors (e.g., ethnic background, gender, disability, age, rural and remote location, homelessness, immigration status, socioeconomic status) and/or those identifying with historically underrepresented populations (e.g., women, children and youth, racialized communities, people living with disabilities, members of LGBTQIA/2S communities, Indigenous Peoples).

This funding opportunity will support projects relevant to the following research areas:

• Health Services and Policy: Improving the implementation, evaluation, adaptation and/or spread/scale (share) of evidence-informed integrated care policies and interventions that substantively involve primary health care and that advance any/all of the Quadruple Aims and health equity for one or more priority population;
• Rural, Remote and Northern Communities: Integration of primary health care and other sectors within and/or beyond health care that addresses the unique needs and contexts of rural, remote and/or northern communities;
• Indigenous Integrated Care: Indigenous-led models of meaningful and culturally safe integrated care that reflect traditional and/or community models of Indigenous health and health care, strengthen individual and collective trust and relationships (e.g., patient, provider, community), and emphasize wellness, strength, and resilience of Indigenous Peoples;
• Aging in the Right Place: Integration of health care, social services and policies to support older adults to remain and live independently in their residence of choice as long as is desired, and seamlessly transition to needed levels of care (including long-term care), as dependence and care needs evolve;
• Gender-Affirming Health: Integration of safe, inclusive, respectful, and culturally competent gender-affirming health care for lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, and Two-Spirit (LGBTQIA/2S) communities across all healthcare settings to ensure LGBTQIA/2S populations achieve the highest possible level of health;
• Transforming Health and Well-Being for Children and Youth: Integrated health, education, and/or social services and policies to create a healthier, stronger and more equitable future for children and youth in all their diversity;
• Genomics in Routine Care: Integrated care that transforms the diagnostic, treatment and management paradigm for rare/inherited disease patients by incorporating genetic testing (including genomics, such as whole-genome sequencing [WGS], whole-exome sequencing [WES], panels) earlier in the care pathway and optimizing post-diagnostic treatment and support care pathways;
• Care of Patients Covered within the IMHA mandate: Integrated care models that improve outcomes of people who have diagnoses related to any elements of the broad IMHA mandate: the musculoskeletal system (including myalgic encephalomyelitis), arthritis, skin and dental conditions;
• Multimorbidity: Integrated care that improves the experience, prevention, treatment, management and outcomes for people with multimorbidity (where multimorbidity must include at least one of the following six disease/disorder areas relevant to the ICRH mandate [circulatory, respiratory, critical care, stroke, blood and blood vessels and sleep], along with at least one other chronic condition within or related to the mandate of ICRH or beyond (e.g., diabetes, dementia, obesity). Applications that include an EDI and/or Indigenous health and wellness focus are encouraged; and
• Interdisciplinary Approaches to Equitable, Diverse and Inclusive Integrated Care: Incorporating social science and humanities methodologies to improve our understanding of the living environment/conditions and socio-economic and psycho-social context of underrepresented or historically excluded groups and/or Indigenous Peoples, and how to implement equitable, diverse and inclusive integrated care systems/models of care that address their unique health needs and improves outcomes. Applications must include social science and humanities researchers on the team.

All projects must explicitly incorporate implementation science, patient-oriented research, and learning health system approaches.

Funds Available

CIHR and partner(s) financial contributions for this initiative are subject to availability of funds. Should CIHR or partner(s) funding levels not be available or are decreased due to unforeseen circumstances, CIHR and partner(s) reserve the right to reduce, defer or suspend financial contributions to grants received as a result of this funding opportunity.

4. Québec researchers egibility to the program

In addition to complying with all CIHR rules for this program, eligible Quebec researchers wishing to apply must comply with  FRQ Common General Rules. Here are a few highlights of the eligibility:

Composition of the core leadership team (excerpt from the conditions of CIHR eligibility)

The core leadership team must include each of the following among its NPA, PKU(s), Principal Applicant(s) (PA), and Knowledge User(s) (KU), who together will comprise the team’s quadripartite leadership responsible for co-leading the team and funded activities.

Note: An individual can represent no more than one (1) role:

1. Researcher: A scientific lead with expertise in integrated care and/or implementation science (must be an independent researcher). The NPA is the scientific lead when they are an independent researcher (1a.);
   • Teams with a senior researcher as the scientific lead must also include an early or mid-career researcher within its core leadership team.
2. Decision-maker: A health system decision maker or policy maker holding an active leadership position at a health system organization that will be involved in the implementation of the intervention and have the authority to make decisions about implementing, evaluating and/or scaling the intervention. If this individual is not the NPA, they must be listed as a PKU;
   • The decision maker must have expertise in the relevant research area and knowledge of the intervention being investigated.
3. Provider: A currently practicing health care provider with experience in integrated care and using research to inform practice; or
4. PWLE: A patient/family/caregiver/person/community representative with lived or living experience of integrated and/or fragmented care.

See full CIHR rules for more details

5. Documents

ATTENTION: No form or document is to be sent to the FRQS as part of this collaborative program. All additional requests and documents for the program must be submitted to CIHR according to their procedure on ResearchNet portal.

Additional information will be requested for Quebec researchers selected during the FRQS award procedure.

N.B. : Eligibility for the program will be jointly coordinated between the CIHR and the FRQS for all Quebec researchers wishing to apply.