How to build a good research partnership: A Q&A with Dr. Kevin Volpp on his work with the AHA
CHIBE is highlighting the ways our affiliates have created successful research partnerships. This is the fourth article in a series of stories illustrating effective collaborations. Are you a CHIBE investigator looking for a partner for your research? Contact chibe@pennmedicine.upenn.edu to connect with the CHIBE Steering Committee.
CHIBE Director Dr. Kevin Volpp has partnered with the American Heart Association (AHA) on a unique opportunity to advance “food is medicine” (FIM) interventions that can treat, manage, and prevent diet-related diseases.
Dr. Volpp serves as the scientific lead of the Health Care X FoodTM initiative, which awarded research grants to fund 23 clinical trials in 2023 and 2024 that are focused on a combination of questions related to program design and implementation approaches to build a stronger foundation for the FIM field.
How do research collaborations like this one happen? Learn how in the Q&A below.
How did this partnership come about?
Like many academics, I’ve been a long-time volunteer for the American Heart Association (AHA) and have been involved in a variety of committees, task forces, and writing projects. In the fall of 2022, the CEO of the AHA Nancy Brown reached out to me to see if I would be interested in being the scientific lead for this new initiative.
The initiative sprung out of conversations that the Rockefeller Foundation had initiated with AHA leadership. Rockefeller has had a long abiding interest in food, nutrition, and sustainability. Their leadership started thinking about building evidence on the efficacy of “food is medicine” programs in improving people’s health with an eye toward convincing insurers to pay for programs.
My understanding is that in asking around, they were advised by a lot of people to go to AHA because AHA is well known for getting things done, building rigorous evidence, and having expertise in clinical trials. AHA leadership came to me because of a combination of our expertise in behavioral science, our experience in running trials of cardiovascular risk reduction, and the many projects we have run with patient populations, insurers, employers, state Medicaid plans, and consumer companies. We have worked on a number of projects that have been translated into benefit design.
Why did you want to work on this project?
It’s an opportunity to design a new initiative that could impact the health of tens of millions of people. It is estimated that 40% to 50% of the mortality from diet-related chronic conditions such as heart disease, diabetes, or stroke is related to poor diet. Health systems in the US have never systematically tried to address the role suboptimal diets play in health.
Clinicians, on some level, recognize that this is important, but they generally receive little training in nutrition and on behavior change. Clinicians also don’t have programs to refer people to, by and large.
This is a really interesting opportunity from a behavior change standpoint to think about in terms of creating the kind of programs that clinicians would want to refer people to, that patients would want to sign up for, and that payors would want to pay for since they have been shown to improve people’s health.
There are a number of important questions regarding how to design these programs to maximize cost effectiveness as well as about creating systems that make it easy for clinicians to refer patients to effective FIM programs.
How long did the process take from initially reaching out to you to starting the work together?
There was a lot of strategizing that started pretty quickly. Part of that initially was creating a steering committee that serves as our Board in the initiative and to think through our strategy before we did anything. We wanted to be quite intentional since this was being built from the ground up.
Tell us about the strategy behind this project and what you learned from assessing the existing research on FIM.
When we looked at a lot of the existing research and programs, there are a few observations one could readily make:
First is that a lot of the existing research wasn’t all that rigorous. There have been a lot of 1-arm demonstration projects that are hypothesis-generating, but not all that conclusive in terms of whether a particular program worked. We knew we needed to set up a mechanism to conduct a lot of randomized trials and to more rigorously assess existing programs.
Second, when we looked at a lot of the existing research as well as programming implementation, it was very striking that a lot of benefit dollars are left on the table. In some contexts, half of the dollars people were eligible to receive weren’t used and that really highlighted to me that we need to figure out how to improve on that before doing any longer-term studies.
There is strong interest in long-term studies on the impact of Food Is Medicine programs on cardiovascular outcomes. However, findings that engagement rates are often suboptimal highlight the need for more research in behavioral and implementation science to design programs that drive higher participation and engagement—ultimately improving efficacy before launching longer-term studies. As part of this, we put a big emphasis on human-center design so that teams could do a better job of informing project design based on the lived experience of potential participants.
Third, we realized it made sense to make a lot of small bets before making any big bets. So, rather than jumping to do a small number of large trials, we are now supporting (through a variety mechanisms) 23 teams to conduct randomized trials looking at ways to improve on some of these implementation challenges and engagement challenges.
We will take the findings from those, and then over time, support a smaller number of larger studies, but hopefully we will have de-risked some of the underlying implementation challenges.
What advice would you give someone looking to partner with a major organization?
There are a few key things to keep in mind: the first is that there needs to be mutual benefit where the sponsoring organization has to feel that you are helping them solve an important problem or problems that are priorities for them.
Researchers sometimes make the mistake of thinking that because they have a scientifically interesting idea that they can approach an organization and that enthusiasm will be universally shared. You will likely get more traction if you start by asking the potential collaborating organization what are the problems that they have been struggling to solve? What are some of the questions they would like to have answered? In essence, how can we help? And then look for the intersection between the scientifically interesting questions and what the organization needs.
If the answer to those questions is known, then collaborating on research isn’t as likely to be fruitful; it’s more just providing advice on “here’s what you should do.” But in many cases, particularly in the many health contexts where there is a big need for more effective or cost-effective approaches to improve on the status quo, you can often identify questions that are both scientifically interesting and that are highly relevant to collaborating organizations. Finding the intersection between the needs of organizations and what researchers find scientifically interesting is the sweet spot.
Secondly, I would say a key thing in forming partnerships is to make sure you’re talking to people in the partnering organization who are well placed to commit resources to driving the agenda forward.
Anything else you’d add?
Make sure to invest in building personal relationships with people you like to work more with. Success in collaborations can be enhanced considerably over time if you invest the time to get to know people personally and they value those relationships as well as your expertise.
If you’re interested in more advice on building partnerships, check out CHIBE’s Q&As with Drs. Kit Delgado, Amol Navathe, and Katy Milkman on how they developed successful research partnerships.
Photo: Darnell Barnes