If we keep on doing what we have been doing, we are going to keep on getting what we have been getting. Concerns about the gap between science and practice are longstanding. There is a need for new approaches to supplement the existing approaches of research to practice models and the evolving community-centered models for bridging this gap. In this article, we present the Interactive Systems Framework for Dissemination and Implementation (ISF) that uses aspects of research to practice models and of community-centered models. The framework presents three systems: the Prevention Synthesis and Translation System (which distills information about innovations and translates it into user-friendly formats); the Prevention Support System (which provides training, technical assistance or other support to users in the field); and the Prevention Delivery System (which implements innovations in the world of practice). The framework is intended to be used by different types of stakeholders (e.g., funders, practitioners, researchers) who can use it to see prevention not only through the lens of their own needs and perspectives, but also as a way to better understand the needs of other stakeholders and systems. It provides a heuristic for understanding the needs, barriers, and resources of the different systems, as well as a structure for summarizing existing research and for illuminating priority areas for new research and action.
Implementation science is growing in importance among funders, researchers, and practitioners as an approach to bridging the gap between science and practice. We addressed three goals to contribute to the understanding of the complex and dynamic nature of implementation. Our first goal was to provide a conceptual overview of the process of implementation by synthesizing information from 25 implementation frameworks. The synthesis extends prior work by focusing on specific actions (i.e., the "how to") that can be employed to foster high quality implementation. The synthesis identified 14 critical steps that were used to construct the Quality Implementation Framework (QIF). These steps comprise four QIF phases: Initial Considerations Regarding the Host Setting, Creating a Structure for Implementation, Ongoing Structure Once Implementation Begins, and Improving Future Applications. Our second goal was to summarize research support for each of the 14 QIF steps and to offer suggestions to direct future research efforts. Our third goal was to outline practical implications of our findings for improving future implementation efforts in the world of practice. The QIF's critical steps can serve as a useful blueprint for future research and practice. Applying the collective guidance synthesized by the QIF to the Interactive Systems Framework for Dissemination and Implementation (ISF) emphasizes that accountability for quality implementation does not rest with the practitioner Delivery System alone. Instead, all three ISF systems are mutually accountable for quality implementation.
The high prevalence of drug abuse, delinquency, youth violence, and other youth problems creates a need to identify and disseminate effective prevention strategies. General principles gleaned from effective interventions may help prevention practitioners select, modify, or create more effective programs. Using a review-of-reviews approach across 4 areas (substance abuse, risky sexual behavior, school failure, and juvenile delinquency and violence), the authors identified 9 characteristics that were consistently associated with effective prevention programs: Programs were comprehensive, included varied teaching methods, provided sufficient dosage, were theory driven, provided opportunities for positive relationships, were appropriately timed, were socioculturally relevant, included outcome evaluation, and involved well-trained staff. This synthesis can inform the planning and implementation of problem-specific prevention interventions, provide a rationale for multi-problem prevention programs, and serve as a basis for further research.
There are many challenges when an innovation (i.e., a program, process, or policy that is new to an organization) is actively introduced into an organization. One critical component for successful implementation is the organization’s readiness for the innovation. In this article, we propose a practical implementation science heuristic, abbreviated as R= MC2. We propose that organizational readiness involves: 1) the motivation to implement an innovation, 2) the general capacities of an organization, and 3) the innovation-specific capacities needed for a particular innovation. Each of these components can be assessed independently and be used formatively. The heuristic can be used by organizations to assess readiness to implement and by training and technical assistance providers to help build organizational readiness. We present an illustration of the heuristic by showing how behavioral health organizations differ in readiness to implement a peer specialist initiative. Implications for research and practice of organizational readiness are discussed.
An individual or organization that sets out to implement an innovation (e.g., a new technology, program, or policy) generally requires support. In the Interactive Systems Framework for Dissemination and Implementation, a Support System should work with Delivery Systems (national, state and/or local entities such as health and human service organizations, community-based organizations, schools) to enhance their capacity for quality implementation of innovations. The literature on the Support System [corrected] has been underresearched and under-developedThis article begins to conceptualize theory, research, and action for an evidence-based system for innovation support (EBSIS). EBSIS describes key priorities for strengthening the science and practice of support. The major goal of EBSIS is to enhance the research and practice of support in order to build capacity in the Delivery System for implementing innovations with quality, and thereby, help the Delivery System achieve outcomes. EBSIS is guided by a logic model that includes four key support components: tools, training, technical assistance, and quality assurance/quality improvement. EBSIS uses the Getting To Outcomes approach to accountability to aid the identification and synthesis of concepts, tools, and evidence for support. We conclude with some discussion of the current status of EBSIS and possible next steps, including the development of collaborative researcher-practitioner-funder-consumer partnerships to accelerate accumulation of knowledge on the Support System.
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