Off-hours with Andria Eisman, a Clinical Practitioner-turned Implementation Science Researcher
CHERISH Research Affiliate Andria (Andi) Eisman first connected with the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH) over a site visit to New York City. At the time, she was a 2021 Implementation Research Institute (IRI) Fellow at the Brown School of Social Work at Washington University in St. Louis. She received comprehensive training, mentorship, and guidance to advance her career in implementation science research but was also interested in working with CHERISH to explore the intersection between economics and implementation science.
The initial conversations between the CHERISH investigators and Eisman soon grew into a collaborative effort to teach other researchers the importance of and methods for estimating the costs of interventions in a manner that aligns with implementation science frameworks and informs real-world decision-makers. At Academy Health’s 16th Annual Conference on the Science of Dissemination and Implementation in Health, CHERISH Methodology Core Co-director Sean M. Murphy, Eisman, and colleagues led a foundational workshop on micro-costing of interventions for substance use disorder and related conditions. Building on that session, Murphy, Eisman, and co-presenters Danielle Ryan and CHERISH Research Affiliate Bryan Garner will lead a similar workshop at the 2024 Addiction Health Services Research Conference.
In this Off-hours interview highlighting CHERISH Research Affiliates, Eisman shares why she became interested in implementation science and new research directions combining economic evaluations and implementation science.
Q: As an occupational therapist by training, can you tell us about your decision to dive into academic research?
Before I became a researcher, I worked as an occupational therapist for 13 years. At that time, I treated a lot of traumatic injuries and the ones that impacted me the most were injuries among young people. Very frequently, they were related to substance use. Being on the treatment end, I saw firsthand how much investment was needed for the patients to recover from devastating injuries that deeply impacted their lives and the lives of their families. This experience motivated me to move upstream and focus on prevention. So, I pursued my PhD to work with youth and the institutions that serve them to advance school-based drug use prevention research. I trained as an interventionist at the University of Michigan in health behavior and health education but realized there were great interventions out there that were not being used. This realization spurred my interest in implementation science.
Q: In your field, you’re noticing greater applications of economic methods in implementation science. Can you talk about the significance of this direction?
I love seeing the application of economic methods in implementation science. It’s an exciting area that continues to develop. As a community-based researcher, I have seen many organizations consider the cost of the intervention they want to adopt, but not what it will take to implement and sustain it successfully. Is it any wonder that costs are a key reason for implementation failure? Community organizations see the value in implementation cost analysis and economic evaluation, but it’s up to us to find ways that they can use this information to make data-driven decisions related to resource allocation.
This area is underdeveloped but vital to our objectives as a field to bridge the research-to-practice gap. For example, what are the costs for not just the intervention but the implementation or sustainment? What do implementation outcomes look like and how might they differ from or in addition to clinical outcomes?
Q: Where does one start to learn about cost and economic evaluation in implementation science?
Many researchers don’t get a lot of training on it. So, we recently developed a micro-costing guidebook designed to help implementation researchers and practitioners take the first step of costing their implementation efforts. This guidebook was spearheaded by the ACCORDS (Adult & Child Center for Outcomes Research & Delivery Science) group at the University of Colorado School of Medicine with other contributors like Sean and me. The objective is not to make every implementation science an economic expert but, rather, to understand the methods to foster collaboration between implementation science and health economics researchers.
Q: With your office located near the cultural historic district in Detroit, how do you spend time in the city?
There are lots of new and interesting restaurants, so my family and I periodically visit the area to enjoy the food scene. It’s really amazing and there are so many choices! I have a family of foodies, so they love that aspect of visiting the D. I also like the cultural offerings in the city so close by. On a nice day, I often will go by the Detroit Public Library or the Detroit Institute of Arts. Detroit also has great theatres like the Fox and the Fisher; my family and I have gone to several musicals there. My family are big sports fans. So, they also love the major sports in the city- baseball, basketball, hockey, and football.