Thirty years of BASICS: Dissemination and implementation progress and challenges.

This chapter highlights just a sample of the many rich areas for dissemination and implementation research that will assist us in shortening the gap between discovery and practice, thus beginning to realize the benefits of research for patients, families, and communities. Greater emphasis on implementation in challenging settings, including lower and middle-income countries and underresourced communities in higher income countries will add to the lessons we must learn to fully reap the benefit of our advances in dissemination and implementation research methods. Moreover, collaboration and multidisciplinary approaches to dissemination and implementation research will help to make efforts more consistent and more effective moving forward. Thus, we will be better able to identify knowledge gaps that need to be addressed in future dissemination and implementation research, ultimately informing the practice and policies of clinical care and public health services.

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Dissemination and Implementation in Social Service Settings

10.1093/oso/9780190683214.003.0022 ◽

2017 ◽

Cited By ~ 1

Author(s):

J. Curtis McMillen ◽

Danielle R. Adams

Keyword(s):

Health Disparities ◽

Social Services ◽

Social Service ◽

Careful Consideration ◽

Lessons Learned ◽

Health Interventions ◽

Dissemination And Implementation ◽

The Social ◽

Implementation Models ◽

Complex Settings

Social service settings offer numerous complexities in their staffing, consumers, and payer mix that require careful consideration in designing dissemination and implementation efforts. However, social services’ unique access to vulnerable populations with health problems may prove vital in efforts to improve the health status of many of our citizens and reduce health disparities. While a number of well-developed, blended dissemination and implementation models are being used in social service settings, they all require additional documentation, research, and field experience. Nonetheless, the lessons learned in the social services may help organizations in other sectors better implement health interventions with complex consumers in complex settings.

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Adaptation in Dissemination and Implementation Science

10.1093/oso/9780190683214.003.0017 ◽

2017 ◽

Cited By ~ 19

Author(s):

Ana A. Baumann ◽

Leopoldo J. Cabassa ◽

Shannon Wiltsey Stirman

Keyword(s):

Implementation Science ◽

Implementation Research ◽

Implementation Strategies ◽

Dissemination And Implementation ◽

Research And Practice ◽

Implementation Outcomes ◽

Dissemination And Implementation Science ◽

Dissemination And Implementation Research

This chapter focuses on adaptations in the context of dissemination and implementation research and practice. Consistent with the existing literature, the authors recommend that adaptations be proactively and iteratively determined, strongly informed by a variety of stakeholders, and that efforts be made to carefully describe and document the nature of the adaptations and evaluate their impact on desired service, health, and implementation outcomes. While this chapter focuses on adaptations to interventions and the context of practice, the authors also note that adaptations may need to be made to implementation strategies. Following the call by Proctor and colleagues for further precision in defining and operationalizing implementation strategies, and based on evidence that scholars are not necessarily reporting what and how they are adapting the interventions, scholars are urged to define and evaluate the adaptations they are making not only to the interventions and context of practice but also to the implementation strategies.

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Fidelity and Its Relationship to Implementation Effectiveness, Adaptation, and Dissemination

10.1093/oso/9780190683214.003.0016 ◽

2017 ◽

Cited By ~ 2

Author(s):

Jennifer D. Allen ◽

Rachel C. Shelton ◽

Karen M. Emmons ◽

Laura A. Linnan

Keyword(s):

Public Health ◽

Treatment Strategies ◽

Implementation Fidelity ◽

Population Level ◽

The United States ◽

Dissemination And Implementation ◽

Evidence Based ◽

Health Gains ◽

Significant Public Health ◽

Research Continuum

There is substantial variability in the implementation of evidence-based interventions across the United States, which leads to inconsistent access to evidence-based prevention and treatment strategies at a population level. Increased dissemination and implementation of evidence-based interventions could result in significant public health gains. While the availability of evidence-based interventions is increasing, study of implementation, adaptation, and dissemination has only recently gained attention in public health. To date, insufficient attention has been given to the issue of fidelity. Consideration of fidelity is necessary to balance the need for internal and external validity across the research continuum. There is also a need for a more robust literature to increase knowledge about factors that influence fidelity, strategies for maximizing fidelity, methods for measuring and analyzing fidelity, and examining sources of variability in implementation fidelity.

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Measurement Issues in Dissemination and Implementation Research

10.1093/oso/9780190683214.003.0014 ◽

2017 ◽

Cited By ~ 5

Author(s):

Cara C. Lewis ◽

Enola K. Proctor ◽

Ross C. Brownson

Keyword(s):

Health Care ◽

Implementation Research ◽

Health Care Access ◽

Healthcare Research ◽

Dissemination And Implementation ◽

Measurement Issues ◽

Care Access ◽

Dissemination And Implementation Science ◽

Dissemination And Implementation Research ◽

Access And Quality

The National Institutes of Health, the Agency for Healthcare Research and Quality, the CDC, and a number of private foundations have expressed the need for advancing the science of dissemination and implementation. Interest in dissemination and implementation research is present in many countries. Improving health care requires not only effective programs and interventions, but also effective strategies to move them into community based settings of care. But before discrete strategies can be tested for effectiveness, comparative effectiveness, or cost effectiveness, context and outcome constructs must be identified and defined in such a way that enables their manipulation and measurement. Measurement is underdeveloped, with few psychometrically strong measures and very little attention paid to their pragmatic nature. A variety of tools are needed to capture health care access and quality, and no measurement issues are more pressing than those for dissemination and implementation science.

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The Role of Organizational Processes in Dissemination and Implementation Research

10.1093/oso/9780190683214.003.0008 ◽

2017 ◽

Cited By ~ 2

Author(s):

Gregory A. Aarons ◽

Joanna C. Moullin ◽

Mark G. Ehrhart

Keyword(s):

Health Care ◽

Organizational Development ◽

Organizational Factors ◽

Dissemination And Implementation ◽

Evidence Based ◽

Organizational Strategies ◽

Evidence Based Practices ◽

Effective Dissemination ◽

Dissemination And Implementation Research ◽

Ebp Implementation

Both organizational characteristics and specific organizational strategies are important for the effective dissemination and implementation of evidence-based practices (EBPs) in health and allied health care settings, as well as mental health, alcohol/drug treatment, and social service settings. One of the primary goals of this chapter is to support implementers and leaders within organizations in attending to and shaping the context in which implementation takes place in order to increase the likelihood of implementation success and long-term sustainment. The chapter summarizes some of the most critical organizational factors and strategies likely to impact successful evidence-based practice implementation. There are myriad approaches to supporting organizational development and change—this chapter focuses on issues supported by relevant scientific literatures, particularly those germane to EBP implementation in health care and related settings.

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The Role of Economic Evaluation in Dissemination and Implementation Research

10.1093/oso/9780190683214.003.0006 ◽

2017 ◽

Cited By ~ 2

Author(s):

Ramesh Raghavan

Keyword(s):

Service Providers ◽

Implementation Strategies ◽

Cost Effective ◽

Point Of View ◽

Dissemination And Implementation ◽

Economic Point ◽

Open Questions ◽

Public Health Organizations ◽

Quality Health ◽

Dissemination And Implementation Research

This chapter presents an overview of how D&I research can be evaluated from an economic point of view. Dissemination and implementation imposes costs upon knowledge purveyors, provider organizations, public health organizations, and payers (including governments). However, whether these added costs will result in improved service delivery and, perhaps more importantly, client outcomes and improvements in population health remain as open questions. If emerging studies reveal that defined implementation strategies are more cost effective than “usual” implementation, then policymakers and service providers will need to resource these added costs of implementation in order to assure the success and sustainability of high-quality health services over the long term.

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