title: Interventions in organizational and community context: a framework for building evidence on dissemination and implementation in health services research.
abstract: The effective dissemination and implementation of evidence-based health interventions within community settings is an important cornerstone to expanding the availability of quality health and mental health services. Yet it has proven a challenging task for both research and community stakeholders. This paper presents the current framework developed by the UCLA/RAND NIMH Center to address this research-to-practice gap by: (1) providing a theoretically-grounded understanding of the multi-layered nature of community and healthcare contexts and the mechanisms by which new practices and programs diffuse within these settings; (2) distinguishing among key components of the diffusion process-including contextual factors, adoption, implementation, and sustainment of interventions-showing how evaluation of each is necessary to explain the course of dissemination and outcomes for individual and organizational stakeholders; (3) facilitating the identification of new strategies for adapting, disseminating, and implementing relatively complex, evidence-based healthcare and improvement interventions, particularly using a community-based, participatory approach; and (4) enhancing the ability to meaningfully generalize findings across varied interventions and settings to build an evidence base on successful dissemination and implementation strategies.
authors.affiliation: RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, USA. mendel@rand.org
authors.forename: Peter
authors.initials: P
authors.lastname: Mendel
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Meredith
authors.forename: Michael
authors.initials: M
authors.lastname: Schoenbaum
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Sherbourne
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Wells
mesh_terms: D003155:Community Mental Health Centers / Q000458:organization & administration*; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D006302:Health Services Research; D006801:Humans; D033181:Information Dissemination; D014481:United States