A mixed-methods analysis to understand the implementation of a multistakeholder research consortium: Environmental influences on child health outcomes (ECHO)

Abstract

Introduction: Large, transdisciplinary research consortia have increasingly been called upon to address complex and challenging health problems. The National Institutes of Health's (NIH) Environmental influences on Child Health Outcomes (ECHO) Program developed multisite collaboration strategies to promote impactful collaborative observational research on child health. Team science and implementation science offer theoretical and methodological structure to answer questions about the strategies that facilitate successful consortia. We sought to characterize the elements and conditions that influence the implementation of a complex, interdisciplinary longitudinal research program, ECHO.

Methods: Informed by the Practical, Robust, Implementation and Sustainability Model, our ethnographic research included semi-structured interviews with internal stakeholders and program evaluation metrics. We conducted template and matrix analysis and triangulated the qualitative and quantitative data to understand the implementation of ECHO.

Results: Between February and May 2022, we conducted 24 virtual interviews with representatives from ECHO components. The main cross-cutting topics that emerged from thematic analysis were collaboration and team science; communication and decision-making; data processes and harmonization; and diversity, equity, and inclusion. Both the qualitative and secondary quantitative evaluation data provided insights into the reach, adoption, implementation, and effectiveness of the program.

Conclusion: A large, multidisciplinary research consortium such as ECHO has produced conceptual, instrumental, capacity building, and connectivity impact for internal and external stakeholders. Facilitators included infrastructure that supported collaboration and learning, alignment of data processes, and harmonization. Opportunities for enhanced impact include multidisciplinary, multimethod communication strategies, and alignment of research priorities.

Keywords: Team science; ethnography; implementation science; qualitative; stakeholder engagement.

Figure 1.

The PRISM framework [12] with details specific to our ECHO program research.

Figure 2.

Organizational structure of the environmental influences on child health outcomes (ECHO) program. HHEAR = human health exposure analysis resource; IDeA =states institutional development award states; NIH = National Institutes of Health; PI = principal investigator; PRO = person-reported outcomes (from LeWinn et al. 2022 [40]).