Diffusion Theory and Knowledge Dissemination, Utilization, and Integration in Public Health

Helen Diller Comprehensive Cancer Center, and Department of Epidemiology and Biostatistics, School of Medicine University of California, San Francisco, California 94143-0981, USA.
Annual Review of Public Health (Impact Factor: 6.63). 05/2009; 30(1):151-74. DOI: 10.1146/annurev.publhealth.031308.100049
Source: PubMed

ABSTRACT Legislators and their scientific beneficiaries express growing concerns that the fruits of their investment in health research are not reaching the public, policy makers, and practitioners with evidence-based practices. Practitioners and the public lament the lack of relevance and fit of evidence that reaches them and barriers to their implementation of it. Much has been written about this gap in medicine, much less in public health. We review the concepts that have guided or misguided public health in their attempts to bridge science and practice through dissemination and implementation. Beginning with diffusion theory, which inspired much of public health's work on dissemination, we compare diffusion, dissemination, and implementation with related notions that have served other fields in bridging science and practice. Finally, we suggest ways to blend diffusion with other theory and evidence in guiding a more decentralized approach to dissemination and implementation in public health, including changes in the ways we produce the science itself.

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Available from: Lawrence W Green, Aug 14, 2015
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    • "Dissemination has been defined as " an active approach of spreading evidence-based interventions to the target audience via determined channels using planned strategies " [10]. There is a need to speed up the pipeline from discovery to application (e.g., discovery of a new smoking cessation technique to widespread use across clinical and public health settings) [7]. Potential solutions to bring research to practice include involving stakeholders [11] [12] [13] [14] [15] [16] in the research process (e.g., design, data gathering, and analysis) and/or evaluation process (also referred to as practice-based research [17]) and "
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    DESCRIPTION: Objectives. In public health and clinical settings insufficient dissemination of evidence-based practices limits the reach of new discoveries to broad populations. This study aimed to describe characteristics of the dissemination process by researchers across three countries (Brazil, United Kingdom, and United States), explore how designing for dissemination practices has been used, and analyze factors associated with dissemination. Methods. A similar online survey was used to query researchers across the three countries; data were pooled to draw cross-country conclusions. Findings. This study identified similarities and differences between countries. Importance of dissemination to nonresearcher audiences was widely recognized as important; however, traditional academic venues were the main dissemination method. Several factors were associated with self-rated dissemination effort in the pooled sample, but these predictive factors (e.g., support and resources for dissemination) had low prevalence. Less than one-third of researchers rated their level of effort for dissemination as excellent. Respondents reported limited support and resources to make it easier for researchers who might want to disseminate their findings. Conclusion. Though intentions show the importance of dissemination, researchers across countries lack supports to increase dissemination efforts. Additional resources and training in designing for dissemination along with improved partnerships could help bridge the research-practice gap.
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    • "One of the main areas of investigation has been (and is still) focused on the study of its correlates and determinants. Among the many proposed causal explanations of research mobilisation, there is the 'credibility' hypothesis, which posits that the mobilisation and utilisation of research evidence depends, at least in part, on the credibility of its source: the knowledge producer (Cousins and Leithwood, 1993; Green et al, 2009). The argument implicitly goes like this: knowledge exchange shares characteristics with market transactions, since knowledge users (for example, policy makers) behave like consumers of market products in that they grant importance to the trustworthiness of the knowledge producers, especially when knowledge asymmetry is high – that is, when a social actor has more knowledge than another in a given situation, likely giving him an advantage. "
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    ABSTRACT: This study provides an empirical test of the assumption that the credibility of the messenger is one of the factors that influence knowledge mobilisation among policy makers. This general hypothesis was tested using a database of 321 social scientists from the province of Quebec that combines survey and bibliometric data. A regression model was used to study the association between indicators of faculty members' credibility and the number of times they have presented research evidence to public or partly government-owned organisations over an 18-month period. Overall, empirical results provide new evidence supporting the credibility hypothesis.
    Evidence & Policy A Journal of Research Debate and Practice 01/2014; 10(1). DOI:10.1332/174426413X662699
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    • "Clinical research findings and clinical practice guidelines that have promise to improve health move very slowly from the research setting into clinical practice, and many of these interventions never reach those who could benefit. It is estimated that it takes an average of 17 years to translate 14% of original research into benefit for patients and an average of 9 years for interventions recommended as evidence-based practices to be fully adopted [1] [2]. "
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    ABSTRACT: Dissemination and implementation (D&I) research is a growing area of science focused on overcoming the science-practice gap by targeting the distribution of information and adoption of interventions to public health and clinical practice settings. This study examined D&I research projects funded under specific program announcements by the US National Institutes of Health (NIH) from 2005 to 2012. The authors described the projects' D&I strategies, funding by NIH Institute, focus, characteristics of the principal investigators (PIs) and their organizations, and other aspects of study design and setting. Results showed 46 R01s, 6 R03s, and 24 R21s funded totaling $79.2 million. The top funders were the National Cancer Institute and the National Institute of Mental Health, together providing 61% of funding. The majority of PIs were affiliated with Schools of Medicine or large, nonprofit research organizations and think tanks. Only 4% of projects were to PIs with appointments at Schools of Nursing, with 7% of the funding. The most commonly funded projects across all of the studies focused on cancer control and screening, substance abuse prevention and treatment, and mental health services. Typically implemented in community and organizational settings, D&I research provides an excellent opportunity for team science, including nurse scientists and interdisciplinary collaborators.
    03/2013; 2013:909606. DOI:10.1155/2013/909606
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