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: 6.47). 05/2009; 30(1):151-74. DOI: 10.1146/annurev.publhealth.031308.100049
Source: PubMed


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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    • "(i.e., publications and conference presentations), it takes approximately 17 years for just 14% of research to become incorporated into everyday practice (Balas & Boren, 2000; Green, 2009). To address this gap, researchers in implementation science have begun to use innovative hybrid research designs that simultaneously investigate an intervention's effectiveness in the context of real-world implementation (Curran, Bauer, Mittman, Pyne, & Stetler, 2012). "
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    ABSTRACT: Purpose: To provide a resource of pertinent information concerning implementation science for immediate research application in communication sciences and disorders (CSD). Method: Key terminology related to implementation science is reviewed. Practical suggestions for the application of implementation science theories and methodologies are provided, including an overview of hybrid research designs that simultaneously investigate clinical effectiveness and implementation as well as an introduction to approaches for engaging stakeholders in the research process. A detailed example from education is shared to show how implementation science was utilized to move an intervention program for autism into routine practice in the public school system. In particular, the example highlights the value of strong partnership between researchers, policymakers, and frontline practitioners in implementing and sustaining new evidence-based practices. Conclusions: Implementation science is not just a buzzword. This is a new field of study that can make a substantive contribution in CSD by informing research agendas, reducing health and education disparities, improving accountability and quality control, increasing clinician satisfaction and competence, and improving client outcomes.
    Journal of Speech Language and Hearing Research 10/2015; DOI:10.1044/2015_JSLHR-L-15-0302 · 2.07 Impact Factor
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    • "Fixing the communication pipeline between researchers and practitioners requires attention to diffusion and dissemination frameworks. While diffusion denotes the unintentional spread of information about an intervention or policy, dissemination reflects more directional efforts to push this information toward the practice world (Green et al., 2009). Frameworks that focus on diffusion and dissemination are plentiful, with Tabak et al. (2012) describing 50 such frameworks in a recent narrative review. 1 One dominant theme found in diffusion and dissemination frameworks is the role of interpersonal interactions and communication networks. "
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    ABSTRACT: The implementation of effective community interventions can be challenging for many reasons, including financial and time costs, lack of infrastructure, local contextual variations, and barriers to fidelity. But, prior to all of these is the challenge of limited information exchange between the researchers developing interventions and the practitioners implementing them, or the so-called research-practice gap. In this paper, we use network theory and review a dozen small world experiments to understand the research-practice gap, identifying three key lessons: (1) spatial and social distances are related to the severity of the gap, (2) social boundaries may lead to echo chambers and closed loops, and (3) wider gaps reduce the likelihood of successful information exchange. From these lessons, we recommend that researchers and practitioners should rely on the assistances of information brokers who know people they do not know and who are different from themselves.
    09/2015; DOI:10.1016/j.psi.2015.07.006
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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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