Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition.

Kaiser Permanente Colorado, USA.
American Journal of Public Health (Impact Factor: 4.23). 09/2003; 93(8):1261-7. DOI: 10.2105/AJPH.93.8.1261
Source: PubMed

ABSTRACT The gap between research and practice is well documented. We address one of the underlying reasons for this gap: the assumption that effectiveness research naturally and logically follows from successful efficacy research. These 2 research traditions have evolved different methods and values; consequently, there are inherent differences between the characteristics of a successful efficacy intervention versus those of an effectiveness one. Moderating factors that limit robustness across settings, populations, and intervention staff need to be addressed in efficacy studies, as well as in effectiveness trials. Greater attention needs to be paid to documenting intervention reach, adoption, implementation, and maintenance. Recommendations are offered to help close the gap between efficacy and effectiveness research and to guide evaluation and possible adoption of new programs.

1 Bookmark
  • Source
    Journal of Science and Medicine in Sport 12/2013; 16:e47-e48. DOI:10.1016/j.jsams.2013.10.114 · 3.08 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Translating evidence-based interventions into community practice is vital to health promotion. This study used the RE-AIM framework to evaluate the larger dissemination of the ManUp intervention, an intervention which utilized interactive web-based technologies to improve the physical activity and nutrition behaviors of residents in Central Queensland, Australia. Data were collected for each RE-AIM measure (Reach, Effectiveness, Adoption, Implementation, Maintenance) using (i) computer-assisted telephone interview survey (N = 312) with adults (18 years and over) from Central Queensland, (ii) interviews with key stakeholders from local organizations (n = 12) and (iii) examination of project-related statistics and findings. In terms of Reach, 47% of participants were aware of the intervention; Effectiveness, there were no significant differences between physical activity and healthy nutrition levels in those aware and unaware; Adoption, 73 participants registered for the intervention and 25% of organizations adopted some part of the intervention; Implementation, 26% of participants initially logged onto the website, 29 and 17% started the web-based physical activity and nutrition challenges, 33% of organizations implemented the intervention, 42% considered implementation and 25% reported difficulties; Maintenance, an average of 0.57 logins and 1.35 entries per week during the 12 week dissemination and 0.27 logins and 0.63 entries per week during the 9-month follow-up were achieved, 22 and 0% of participants completed the web-based physical activity and nutrition challenges and 33.3% of organizations intended to continue utilizing components of the intervention. While this intervention demonstrated good reach, effectiveness, adoption and implementation warrant further investigation. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email:
    Health Promotion International 02/2015; DOI:10.1093/heapro/dav005 · 1.94 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Centers for Disease Control and Prevention conducted a systematic screening and assessment process to identify promising practices implemented by grantees of the National Breast and Cervical Cancer Early Detection Program and its partners that were appropriate for rigorous evaluation. The systematic screening and assessment (SSA) process was conducted from September 2010 through March 2012 and included five steps: (1) nominations of promising practices; (2) a first rating by subject matter experts; (3) field-based evaluability assessments; (4) a second rating by experts; and (5) use of results. Nominations were sought in three program areas including health education and promotion, quality assurance and quality improvement, and case management/patient navigation. A total of 98 practices were nominated of which 54 % were eligible for the first review by the experts. Fifteen practices were selected for evaluability assessment with ten forwarded for the second review by the experts. Three practices were ultimately recommended for rigorous evaluation, and one evaluation was conducted. Most nominated practices were based on evidence-based strategies rather than representing new, innovative activities. Issues were identified through the process including inconsistent implementation and lack of implementation fidelity. While the SSA was successful in identifying several programs for evaluation, the process also revealed important shortcomings in program implementation. Training and technical assistance could help address these issues and support improved programming.
    Cancer Causes and Control 02/2015; DOI:10.1007/s10552-015-0538-z · 2.96 Impact Factor


Available from