Interventions in organizational and community context: a framework for building evidence on dissemination and implementation in health services research.
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.
Mendel
Peter
P
RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, USA. mendel@rand.org
Meredith
Lisa S
LS
Schoenbaum
Michael
M
Sherbourne
Cathy D
CD
Wells
Kenneth B
KB
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