Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors

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Abstract

Implementation science is a quickly growing discipline. Lessons learned from business and medical settings are being applied but it is unclear how well they translate to settings with different historical origins and customs (e.g., public mental health, social service, alcohol/drug sectors). The purpose of this paper is to propose a multi-level, four phase model of the implementation process (i.e., Exploration, Adoption/Preparation, Implementation, Sustainment), derived from extant literature, and apply it to public sector services. We highlight features of the model likely to be particularly important in each phase, while considering the outer and inner contexts (i.e., levels) of public sector service systems.

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Most cited references 47

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Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity.

Nina Wallerstein, Bonnie Duran (2010)

Community-based participatory research (CBPR) has emerged in the last decades as a transformative research paradigm that bridges the gap between science and practice through community engagement and social action to increase health equity. CBPR expands the potential for the translational sciences to develop, implement, and disseminate effective interventions across diverse communities through strategies to redress power imbalances; facilitate mutual benefit among community and academic partners; and promote reciprocal knowledge translation, incorporating community theories into the research. We identify the barriers and challenges within the intervention and implementation sciences, discuss how CBPR can address these challenges, provide an illustrative research example, and discuss next steps to advance the translational science of CBPR.

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Changing provider behavior: an overview of systematic reviews of interventions.

J. M. Grimshaw, L Shirran, R. Thomas … (2001)

Increasing recognition of the failure to translate research findings into practice has led to greater awareness of the importance of using active dissemination and implementation strategies. Although there is a growing body of research evidence about the effectiveness of different strategies, this is not easily accessible to policy makers and professionals. To identify, appraise, and synthesize systematic reviews of professional educational or quality assurance interventions to improve quality of care. An overview was made of systematic reviews of professional behavior change interventions published between 1966 and 1998. Forty-one reviews were identified covering a wide range of interventions and behaviors. In general, passive approaches are generally ineffective and unlikely to result in behavior change. Most other interventions are effective under some circumstances; none are effective under all circumstances. Promising approaches include educational outreach (for prescribing) and reminders. Multifaceted interventions targeting different barriers to change are more likely to be effective than single interventions. Although the current evidence base is incomplete, it provides valuable insights into the likely effectiveness of different interventions. Future quality improvement or educational activities should be informed by the findings of systematic reviews of professional behavior change interventions.

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A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice.

Adrianne C Feldstein, Russell E. Glasgow (2008)

Although numerous studies address the efficacy and effectiveness of health interventions, less research addresses successfully implementing and sustaining interventions. As long as efficacy and effectiveness trials are considered complete without considering implementation in nonresearch settings, the public health potential of the original investments will not be realized. A barrier to progress is the absence of a practical, robust model to help identify the factors that need to be considered and addressed and how to measure success. A conceptual framework for improving practice is needed to integrate the key features for successful program design, predictors of implementation and diffusion, and appropriate outcome measures. A comprehensive model for translating research into practice was developed using concepts from the areas of quality improvement, chronic care, the diffusion of innovations, and measures of the population-based effectiveness of translation. PRISM--the Practical, Robust Implementation and Sustainability Model--evaluates how the health care program or intervention interacts with the recipients to influence program adoption, implementation, maintenance, reach, and effectiveness. The PRISM model provides a new tool for researchers and health care decision makers that integrates existing concepts relevant to translating research into practice.

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Author and article information

Contributors

: gaarons@ucsd.edu

: hurlburt@usc.edu

: Sarah.Horwitz@stanford.edu

Journal

Journal ID (nlm-ta): Adm Policy Ment Health

Title: Administration and Policy in Mental Health

Publisher: Springer US (Boston )

ISSN (Print): 0894-587X

ISSN (Electronic): 1573-3289

Publication date (Electronic): 14 December 2010

Publication date PMC-release: 14 December 2010

Publication date (Print): January 2011

Volume: 38

Issue: 1

Pages: 4-23

Affiliations

[1 ]University of California, 9500 Gilman Dr. (0812), La Jolla, CA 92093-0812 USA

[2 ]Department of Pediatrics and the Centers for Health Policy and Primary Care and Outcomes Research, Stanford University, Stanford, CA USA

[3 ]University of Southern California, Los Angeles, CA USA

[4 ]Child and Adolescent Services Research Center at Rady Children’s Hospital, San Diego, CA USA

Article

Publisher ID: 327

DOI: 10.1007/s10488-010-0327-7

PMC ID: 3025110

PubMed ID: 21197565

SO-VID: 5935a32a-5f07-4b38-849b-cc474822b906

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ScienceOpen disciplines: Social policy & Welfare

Keywords: mental health,alcohol/drug,sustainability,implementation,organization,adoption,child welfare,public sector,sustainment,social service,dissemination

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ScienceOpen disciplines: Social policy & Welfare

Keywords: mental health, alcohol/drug, sustainability, implementation, organization, adoption, child welfare, public sector, sustainment, social service, dissemination

Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors

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Emerald: Healthier Lives

Most cited references 47

Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity.

Changing provider behavior: an overview of systematic reviews of interventions.

A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice.

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