The failure of better science to readily produce better services has led to increasing interest in the science and practice of implementation. The results of recent reviews of implementation literature and best practices are summarized in this article. Two frameworks related to implementation stages and core implementation components are described and presented as critical links in the science to service chain. It is posited that careful attention to these frameworks can more rapidly advance research and practice in this complex and fascinating area.

Complex behaviour change interventions are not well described; when they are described, the terminology used is inconsistent. This constrains scientific replication, and limits the subsequent introduction of successful interventions. Implementation Science is introducing a policy of initially encouraging and subsequently requiring the scientific reporting of complex behaviour change interventions. The current state of affairsProgress in tackling today's major health and healthcare problems requires changes in behaviour [1,2]. Population health can be improved by changing behaviour in those who are at risk from ill health, in those with a chronic or acute illness, and in health professionals and others responsible for delivering effective, evidence-based public health and healthcare. In the field of implementation research, thousands of studies have developed and evaluated interventions aimed at bringing the behavior of healthcare professionals into line with evidence-based practice. Systematic reviews of behaviour change interventions have tended to find modest and worthwhile effects but no clear pattern of results favouring any one particular method. Where effects are found, it is often unclear what behaviour change processes are responsible for observed changes. If effective interventions to change behaviours are to be delivered to influence outcomes at population, community, organisational or individual levels [3], the field must produce greater clarity about the functional components of those interventions. These should then be matched to population, setting, and other contextual characteristics [4].

F or the past several decades, considerable scientific and policy interest and research activity have focused on developing evidence-based practices and programs, evidence-informed practices and programs, and other innovations intended to produce better outcomes for exceptional children. Past and current efforts to diffuse, translate, transport, disseminate, mandate, incentivize, and otherwise close the "science-to-service gap" have not been successful in getting the growing list of evidence-based programs routinely into practice. D. L. Fixsen, Naoom, Blase, Friedman, and Wallace ( 2005) defined evidence-based programs as collections of practices that are done within known parameters (philosophy, values, ser-vice delivery structure, and treatment components) and with accountability to the consumers and funders of those practices. … Such programs, for example, may seek to integrate a number of intervention practices (e.g., social skills training, behavioral parent training, cognitive behavior therapy) within a specific service delivery setting (e.g., officebased, family-based, foster home, group home, classroom) and organizational context (e.g., hospital, school, not-for-profit community agency, business) for a given population (e.g., children with severe emotional disturbances, adults with co-occurring disorders, children at risk of developing severe conduct disorders). (p. 26) In an extensive review of the diffusion and dissemination literature, Greenhalgh, Robert,

The "pre-delinquent" behaviors of six boys at Achievement Place, a community based family style behavior modification center for delinquents, were modified using token (points) reinforcement procedures. In Exp. I, point losses contingent on each minute late were effective in producing promptness at the evening meal. During the reversal phase, threats (which were not backed up with point losses) to reinstate the point consequences initially improved promptness but the last two of five threats were ineffective. In Exp. II, point consequences effectively maintained the boys' room-cleaning behavior and, during a fading condition where the percentage of days when the contingency occurred was decreased, the point consequences remained effective for over six months, even when they were delivered on only 8% of the days. Experiment III showed that the boys saved considerable amounts of money when point consequences were available for deposits but saved little money when no points were available. Also, when points were given only for deposits that occurred on specific days the boys deposited their money almost exclusively on those days. In Exp. IV, point consequences contingent on the number of correct answers on a news quiz produced the greatest increase in the percentage of boys who watched the news and, to a lesser extent, increased the percentage of correct answers for the boys who watched the news. The results indicate that "pre-delinquent" behaviors are amenable to modification procedures and that a token reinforcement system provides a practical means of modifying these behaviors.

Evidence-based programs will be useful to the extent they produce benefits to individuals on a socially significant scale. It appears the combination of effective programs and effective implementation methods is required to assure consistent uses of programs and reliable benefits to children and families. To date, focus has been placed primarily on generating evidence and determining degrees of rigor required to qualify practices and programs as “evidence-based.” To be useful to society, the focus needs to shift to defining “programs” and to developing state-level infrastructures for statewide implementation of evidence-based programs and other innovations in human services. In this article, the authors explicate a framework for accomplishing these goals and discuss examples of the framework in use.