Review and special article
Bridging Research and Practice: Models for Dissemination and Implementation Research

https://doi.org/10.1016/j.amepre.2012.05.024Get rights and content

Context

Theories and frameworks (hereafter called models) enhance dissemination and implementation (D&I) research by making the spread of evidence-based interventions more likely. This work organizes and synthesizes these models by (1) developing an inventory of models used in D&I research; (2) synthesizing this information; and (3) providing guidance on how to select a model to inform study design and execution.

Evidence acquisition

This review began with commonly cited models and model developers and used snowball sampling to collect models developed in any year from journal articles, presentations, and books. All models were analyzed and categorized in 2011 based on three author-defined variables: construct flexibility, focus on dissemination and/or implementation activities (D/I), and the socioecologic framework (SEF) level. Five-point scales were used to rate construct flexibility from broad to operational and D/I activities from dissemination-focused to implementation-focused. All SEF levels (system, community, organization, and individual) applicable to a model were also extracted. Models that addressed policy activities were noted.

Evidence synthesis

Sixty-one models were included in this review. Each of the five categories in the construct flexibility and D/I scales had at least four models. Models were distributed across all levels of the SEF; the fewest models (n=8) addressed policy activities. To assist researchers in selecting and utilizing a model throughout the research process, the authors present and explain examples of how models have been used.

Conclusions

These findings may enable researchers to better identify and select models to inform their D&I work.

Section snippets

Context

Vast resources are invested in the development of interventions to prevent and treat disease; however, only a fraction of research products are translated to practice and policy in order to affect population health.1, 2, 3 Dissemination and implementation (D&I) science seeks to understand how to systematically facilitate deployment and utilization of evidence-based approaches to improve the quality and effectiveness of health promotion, health services, and health care.4 Although this

Evidence Acquisition

Dissemination and implementation research is described using several terms, many of which are used interchangeably, for example, knowledge translation, knowledge exchange, and knowledge utilization.16 The diverse range of disciplines contributing models to D&I research leads to a tremendously wide range of sources. These factors prohibited establishing a scope for this review that would comply with traditional systematic review guidelines. Therefore, a narrative approach was determined to be

Evidence Synthesis

From a total of 109 models, 26 were excluded due to a focus on practitioners, rather than researchers; 12 were excluded because they were not applicable to local-level dissemination (communities or organizations); and eight were excluded because they focused on dissemination at the end of a research study rather than D&I research. Two models were identified as duplicates, and combined for inclusion. A total of 61 models were included in this review. A complete list of the models, including all

Discussion

The importance of using models in D&I studies cannot be overstated. Use of models not only makes a study more likely to be successful, but if an existing model is used, this application also contributes to the literature on a particular model and enables continued distillation and better understanding of model constructs.10, 11, 12, 13 This paper presents 61 existing models (as well as information regarding the settings and approaches to which these models are suited) to assist researchers

Acknowledgments

The authors are grateful to numerous model developers who commented on their models and the variables used for classification. The authors also appreciate the feedback of the Washington University Network for Dissemination and Implementation Research (WUNDIR).

This project was funded in part by cooperative agreement number U48/DP001903 from the CDC, Prevention Research Centers Program, and Grant 1R01CA124404-01 from the National Cancer Institute at the NIH. It was also supported in part by the

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    Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.