About

Clayton Brown is a documentary and narrative filmmaker interested in exploring the stories that emerge when people pursuing their passions collide with the practicalities and realities of American culture, politics, and society. His work includes several documentary features, such as The Atom Smashers, about America’s search for the Higgs boson, which won the Pariscience Audacity award and was broadcast on Independent Lens; The Believers, about the controversial 1989 announcement of Cold Fusion, which won the Gold Hugo for Best Documentary at the Chicago International Film Festival and Best Documentary at the Maryland International Film Festival; and We Believe in Dinosaurs, about the building of a life-sized Noah’s Ark by the Creation Museum in Kentucky, which premiered at the San Francisco Film Festival, won Best Documentary at the St. Louis International Film Festival, and has a 91% “fresh” rating on Rotten Tomatoes. His documentary work has been covered in various media outlets and has been screened at numerous festivals. Brown is in production on two new documentary features, Duneland and We The People Ride, focusing on environmental issues in East Chicago and stories along the US/Mexico border, respectively. His fiction work includes science fiction, supernatural, and historical science themes, with films such as Galileo’s Grave and Pere Marquette, which involves practical and digital special effects.

Research topics

• Medicine
• Psychiatry
• Computer Science
• Psychology
• Political Science
• Internal medicine
• Clinical psychology
• Gynecology
• Medical education
• Geography
• Knowledge management
• Applied psychology
• Oncology
• Family medicine
• Business
• Process management
• Nursing

Selected publications

• Rollout trial designs in implementation research are often necessary and sometimes preferred

  Implementation Science · 2025-02-24 · 10 citations

  articleOpen accessSenior author

  BACKGROUND: Rollout designs, which include stepped wedge designs, are defined by staggered implementation of new or alternative programs or services. Critiques of stepped wedge and other rollout designs have raised concerns regarding the confounding of true implementation or program effects with unrelated, global changes in service delivery, with some recommending they only be used when traditional parallel-group designs are not practicable. However, rollout designs may sometimes be more suitable than traditional parallel group designs for ethical, scientific, or practical reasons. RESULTS: As investigators involved in several recent rollout trials, we define and provide rationale for and examples of stepped wedge and the larger class of rollout designs, in which all participating units receive a new program or service implementation. Staged implementation in a rollout design may be necessary when denying, rather than delaying, implementation of a known effective service is ethically unacceptable. Scientifically, stepped wedge has increased statistical power relative to an equivalent parallel group design, and some rollout designs have the capability to compare different phases of implementation and sustainment. A rollout design may be practically necessary either because of limited resources and other logistical challenges or community requirements that no site serve as a control. Examples of completed and ongoing rollout trials illustrate how these ethical, scientific, and practical considerations influenced trial designs. CONCLUSIONS: Stepped wedge and other rollout trial designs may be well suited to evaluation of implementation strategies or policy changes. In implementation trials, rollout designs may be necessary for practical reasons, may be required for ethical reasons, and may be preferred for scientific reasons. We summarize when such rollout designs have advantages and drawbacks.

  PublisherOA PDFDOI

• Impact of the Sources of Strength Peer Leader Program on Suicide Attempt Rates in 40 High Schools: A Cluster Randomized Controlled Trial

  School Mental Health · 2025-09-05 · 1 citations

  articleOpen access

  Universal interventions are essential to reduce suicide rates. This study describes a hybrid effectiveness-implementation cluster RCT of Sources of Strength, a program that prepares diverse student peer leaders to disseminate a healthy coping framework. Forty predominantly small-town and rural high schools (four serving American Indian Nations and federal reservations) were randomized to Sources of Strength for 2 years or wait-list. Of 21,053 students, 17,280 participated in ≥ 1 of four waves. Students reported on suicide attempts and theory-informed mediators. Sources of Strength did not reduce suicide attempts overall, and impact differed by implementation quality and grade. Sources of Strength increased communication and help-seeking from adults in year 1, with findings supporting an indirect program effect reducing suicide attempts through increased adult help with emotions. However, declining implementation adherence in year 2, particularly in messaging activities, coincided with loss of impact. Program benefits were not found for 9th graders. In schools with poor adherence including deviation from peer leader selection guidelines, 9th graders showed increased new suicide attempts vs. controls. From this and other trials combined—including a recent trial showing program impact reducing suicide attempts among 9th–11th graders—we conclude that Sources of Strength implemented with strong adherence can reduce suicide attempts through its theoretical pathway of increased protective adult relationships. However, implementation drift eliminates those benefits. Poor adherence to messaging and peer leader selection may accelerate negative peer influences and increase risk particularly for younger students. Findings underscore the critical importance of maintaining fidelity in peer-based prevention programs. Trial registration at ClinicalTrials.gov #NCT02043093, 01/23/2014.

  PublisherOA PDFDOI

• What scientific inferences can be made with randomized implementation rollout trials

  Implementation Science · 2025-12-11 · 1 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Randomized rollout trial designs, including stepped wedge designs, are commonly used to examine how well an evidence-based intervention or package is being implemented in community or healthcare settings. The multitude of implementation research questions and specific hypotheses suggest the need for diverse randomized rollout implementation trial designs, assignment principles and procedureds, and statistical modeling. METHODS: We separate key research questions and identify mixed effect models for randomized implementation rollout trials involving 1) a single implementation strategy that tests how this strategy varies over time and/or resources that are allocated, 2) comparison of two distinct implementation strategies, and 3) three distinct strategies or components tested in a single trial. Appropriate rollout designs, optimal assignment methods, and other design and analysis considerations are discussed for trials of up to three distinct implementation strategies. RESULTS: To examine improvement in implementation outcomes we present a Fixed-Length Staggered Rollout Trial Design to examine how well a sustainment period continues to produce outcomes, The Rollout Implementation Optimization (ROIO) methodology illustrates testing for quality improvement. For comparing an existing to new strategy, we focus on a Stepped Wedge design, and for comparing two new strategies we describe a Head-to-Head Rollout trial design. To test for synergy between two components, we introduce a Head-to-Head Rollout trial design, and for testing an existing strategy to a new one followed by a sustainment period, we recommend using a Three-Phase Sequential Rollout Implementation trial design. Modeling choices are described, including options for specifying random effects that capture variations in site and clustering. We discuss comparisons of superiority versus non-inferiority testing and multiple contrasts. To support uses of these six designs and analyses, we provide computational code. CONCLUSIONS: The large class of randomized rollout implementation trial designs provides rich opportunities to address research questions posed by implementation scientists. Balance in assigning sites to cohorts is important before random assignment to time of transition to a new implementation occurs. Specific hypotheses are tested with mixed effects models where fixed effects include comparisons of implementation conditions and random effects that account for variation in sites and clustering.

  PublisherDOI

• Developing a Multi-Criteria Decision Analysis Tool to Support the Adoption of Evidence-Based Child Maltreatment Prevention Programs

  UNC Libraries · 2025-12-19

  articleOpen access1st authorCorresponding
  PublisherDOI

• Impact of collaborative care model treatment for depression and anxiety on cardiovascular risk factors using electronic health record data

  Journal of Affective Disorders · 2025-06-18 · 3 citations

  article
  PublisherDOI

• Comparing Implementation and Effectiveness Outcomes for Two Implementation Strategies of the Keep It Up! Digital HIV Prevention Program: A Type 3 Hybrid Effectiveness-Implementation Trial

  AIDS and Behavior · 2025-08-19 · 3 citations

  articleOpen access

  This study sought to compare implementation and effectiveness outcomes for two delivery strategies of a digital HIV prevention intervention: community-based organization (CBO) versus direct-to-consumer (DTC). A type III hybrid effectiveness-implementation trial compared two implementation strategies of Keep It Up! (KIU! ) for young men who have sex with men (YMSM) (n = 2124). Data were collected at baseline and 12-weeks in 2019-2023. DTC enrolled more participants, but CBO recruited more Black (11.7% vs. 21.7%) and Latino YMSM (27.3% vs. 32.9%). CBO enrollees were at higher HIV risk based on condomless anal sex (p < .05) and rectal Gonorrhea rates (p < .01). Although pre-exposure prophylaxis (PrEP) use with adherence was 1.94 times higher at follow-up vs. baseline (p < .0001) across arms, PrEP increase was 1.60 times higher in CBO vs. DTC (p < .0001). CBO delivery averted more HIV infections per 100 people-years than DTC (1.65 vs. 0.62), but the cost of averting an HIV infection was higher in CBO than DTC ($983,029 vs. $173,313). Although CBOs were able to reach participants at higher HIV risk, the DTC strategy was estimated to cost less per infection averted and below established thresholds for cost savings. Findings must be interpreted within the context of data collection during the COVID-19 epidemic. More information about KIU! can be found at https://kiu.northwestern.edu/ .Trial registration: NCT03896776 (date of registration: 04/01/2019).

  PublisherOA PDFDOI

• Implementation climate and clinic personnel attitudes in primary care towards a mental health and drug use preventive intervention for hispanic families: preliminary findings

  Frontiers in Health Services · 2025-09-10

  articleOpen access

  Despite the availability of preventive interventions to address mental health and drug use among Hispanic adolescents, few are implemented in real-world settings. Favorable attitudes towards evidence-based practices and a better implementation climate can facilitate the successful execution of interventions in real-word settings to ameliorate health disparities among Hispanic youth. The purpose of this study was to investigate how implementation climate influences attitudes toward a mental health and drug use preventive intervention for Hispanic families at the individual and clinic level. Participants included 73 clinic personnel from 18 primary care clinics that were part of an effectiveness-implementation hybrid Type 1 study in South Florida. Clinic personnel completed the Implementation Climate Scale and Evidence-based Practice Attitude Scale. Using hierarchal linear modeling, we examined: (1) whether individual differences in implementation climate were associated with individual attitudes towards an evidence-based practice within clinics, and (2) whether clinic-level differences in mean implementation climate were associated with clinic-level differences in attitudes towards an evidence-based practice. At the individual level, there was a significant positive relationship between individual implementation climate and attitudes toward the evidence-based practice. Implementation climate varied significantly among individuals. At the clinic level, clinics with higher average implementation climate did not show significantly different average attitudes towards the mental health and drug use preventive intervention. Understanding implementation climate and attitudes toward evidence-based practices can inform tailored implementation strategies for the unique needs of primary care settings to address drug use and mental health disparities among Hispanic youth.

  PublisherOA PDFDOI

• Simplifying the Quantum World: Demonstrations for Young Learners in an Informal Setting

  Apollo (University of Cambridge) · 2025-07-21

  article

  Publication status: Published

  Publisher

• Association of Hospitalization, Critical Illness, and Infection with Brain Structure in Older Adults

  UNC Libraries · 2024-03-23

  articleOpen access

  Objectives: To examine the association between hospitalization, critical illness, and infection occurring during middle- and late-life and structural brain abnormalities in older adults. Design: Prospective cohort study. Setting: Atherosclerosis Risk in Communities (ARIC) Study. Participants: A community sample of adults who were 44 to 66 years of age at study baseline. Measurements: Active surveillance of local hospitals and annual participant contact were used to gather hospitalization information (including International Classification of Diseases, Ninth Revision, codes) on all participants over a 24-year surveillance period. Subsequently, a subset of participants underwent 3-Tesla brain magnetic resonance imaging (MRI) to quantify total and regional brain volumes, white matter hyperintensity (WMH) volume, and white matter microstructural integrity (fractional anisotropy (FA) and mean diffusivity (MD) as measured using diffusion tensor imaging (DTI)). Results: Of the 1,689 participants included (mean age at MRI 76±5), 72% were hospitalized, 14% had a major infection, and 4% had a critical illness during the surveillance period. Using covariate-adjusted regression, hospitalization was associated with 0.12–standard deviation (SD) greater WMH volume (95% confidence interval (CI)=0.00–0.24) and poorer white matter microstructural integrity (0.17-SD lower FA, 95% CI=–0.27 to –0.06; 0.16-SD greater MD, 95% CI=0.07–0.25) than no hospitalization. There was a dose-dependent relationship between number of hospitalizations, smaller brain volumes, and lower white matter integrity (p-trends ≤.048). In hospitalized participants, critical illness was associated with smaller Alzheimer's disease (AD) signature region (–1.64 cm3, 95% CI=–3.16 to –0.12); major infection was associated with smaller AD signature region (–1.28 cm3, 95% CI=–2.21 to –0.35) and larger ventricular volume (3.79 cm3, 95% CI= 0.81–6.77). Conclusions: Whereas all-cause hospitalization was primarily associated with lower white matter integrity, critical illness and major infection were associated with smaller brain volume, particularly within regions implicated in AD.

  PublisherDOI

• Model-driven decision support: A community-based meta-implementation strategy to predict population impact

  Annals of Epidemiology · 2024-05-14 · 2 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

Recent grants

• NIH Grant R01MH040859

  NIH · $10.0M · 2016

• C-DIAS RP 1: A community-driven modeling approach for identifying and implementing evidence-based interventions and implementation strategies to reduce overdose deaths.

  NIH · $22.3M · 2022–2027

• HD2A Research Adoption Support Center (RASC)

  NIH · $25.7M · 2022–2027

• Center for Prevention Implementation Methodology for Drug Abuse and HIV (Ce-PIM) - Admin Core

  NIH · $6.6M · 2022

• Synthesis of Trials to Prevent Suicide Risk Behavior in Sexual and Gender Minorities

  NIH · $2.0M · 2018–2023

Frequent coauthors

• Christopher J. Gordon

  Woolcock Institute of Medical Research

  1100 shared

• K. Robinson

  University of Nottingham

  996 shared

• Helen M. Dewey

  University of Melbourne

  796 shared

• Julie Bernhardt

  University of Melbourne

  792 shared

• L. D. Smith

  UCL Biomedical Research Centre

  784 shared

• C Charnley

  Western Health

  776 shared

• David James

  University of Nottingham

  776 shared

• Nick Wilson

  Edinburgh Royal Infirmary

  776 shared

Education

• Ph D, Statistics

  University of Chicago

  1983

Awards & honors

• Pariscience Audacity award
• Gold Hugo for Best Documentary at the Chicago International…
• Best Documentary at the Maryland International Film Festival
• Chicago IFP Production Fund