Accelerating solutions to complex problems in health policy and practice: An implementation science approach to applied doctoral dissertations in health administration

The Doctoral Program in Health Leadership at the University of North Carolina at Chapel Hill has since 2005 prepared mid- to senior-level practitioners for highest-level positions in organizations working domestically and internationally to improve the public's health. The three-year, cohort-based distance program confers a DrPH in Health Administration. Coursework is completed in the first two years; dissertation in year three. Since program inception, 40 doctoral dissertations have been successfully defended. Another 48 students are at varying stages of dissertation development.

Dissertations are characterized by several distinguishing features. In each case, students identify a substantial and complex organizational or policy problem, preferably within the organization in which they work. They use a scholarly and systematic approach to devise a strategy that brings to bear concepts in implementation science, including leadership principles, to create a plan to guide organizational or policy change. These applied dissertations culminate in the creation of plans that, if implemented, would improve the public's health.

Analysis of completed dissertations reveals several important differences and commonalities in content areas, research aims, study designs and methods, time to completion, and approaches to the plans for change. Future plans include additional support, long term monitoring and evaluation of plans for change implemented by graduates over time. Our experiences may be helpful in informing other schools' efforts to design practice-based doctoral programs in health leadership as well as academic components of nascent programs in implementation science.