Outlook: Newsletter of the Society of Behavorial Medicine

Spring 2020

What is Dissemination & Implementation Science?: An Introduction and Key Resources in the Field

Rachel C. Shelton, ScD, MPH; SBM Member Delegate


It has been well-documented that there is a tremendous gap between research (e.g. what we know works in terms of evidence-based programs, interventions, practices, policies, guidelines) and practice (e.g. what is actually routinely delivered in real-world community and clinical settings). There have been numerous examples that have documented the efficacy or effectiveness of an ‘innovation’ (e.g. evidence-based practices or programs or EBIs) does not lead to or guarantee its uptake in widespread, routine use.  It has been estimated that it takes an average of 17 years for 14% of original (i.e., discovery) research to be translated and integrated into clinical practice among physicians, and it is likely even longer in community-based and lower-resource settings. NIH and other funding agencies globally have recognized the need for research to advance understanding of how to actively enhance the adoption, implementation, reach, and impact of scientific discoveries and interventions in real-world settings.

Dissemination and implementation (D&I) research is the scientific study of methods and strategies to promote the adoption and integration of proven evidence-based treatments, programs and practices into routine use in diverse real-world settings and populations. D&I science has grown rapidly as a field over the past 10-15 years, with a substantial increase in implementation science related submissions and publications, increasing D&I funding, and numerous opportunities for D&I training and job opportunities. The Society of Behavioral Medicine is home to many scientists and practitioners who have helped rigorously develop, evaluate, and build the evidence-base base for numerous programs and practices. As such, D&I research is a natural partner and extension of behavioral science, and an opportunity to consider how we can more actively facilitate the adoption and use of behavioral science innovations, practices, and interventions.

As a field, D&I science has had a focus on and made advancements in: 1) understanding multi-level aspects of context (e.g. policy, organizational, provider/implementer, individual factors) that influence the adoption and use of EBIs across diverse real-world settings, often guided by conceptual frameworks like the Diffusion of Innovations and the Consolidated Framework for Implementation Research; 2) development of a recognized set of D&I study designs (e.g. stepped wedge designs; mixed-methods) and D&I outcomes as a key focus for study (e.g. adoption, fidelity, sustainability, cost, acceptability), often guided by evaluation frameworks like the RE-AIM Framework; and 3) identification and testing of implementation strategies to actively facilitate the implementation of EBIs within specific clinical and community settings, often guided by the ERIC taxonomy.  Bi-directional learning and engagement with stakeholders is a central, foundational part of D&I science, to ensure that researchers are designing with dissemination and ultimately sustainability in mind from the start, and are inclusive of stakeholder perspectives of what is feasible and appropriate to ultimately enhance fit and relevance of solutions. While there has been great progress made as a field, important gaps and opportunities remain, including understanding the impact of planned adaptions for new settings and populations, and the right balance of fidelity and adaptation as EBIs are delivered across new and diverse real-world settings and populations. Further, there are many important but understudied areas that warrant further empirical investigation, including sustainability, scale-up, de-implementation, health equity, and D&I science applied to evidence-based policies.

There are numerous resources for those interested in learning more about the field. There are excellent databases that identify evidence-based program/practices (e.g. RTIPs database through NCI), recent textbooks that cover the core foundations in the field (‘Dissemination and Implementation Research in Health: Translating Science to Practice’; Brownson, Colditz, Proctor 2018), numerous journals that focus on this area (e.g. Implementation Science, Translational Behavioral Medicine, Implementation Science Communications, Implementation Research & Practice), multiple conferences (e.g. Society for Implementation Research Collaboration or SIRC; conference on the science of D&I Research in Health hosted by Academy Health and NIH), regular newsletters that highlight the latest research and funding/training opportunities, including from NCI (https://cancercontrol.cancer.gov/IS/index.html) and UNC Consortium for Implementation Science (http://news.consortiumforis.org/newsletter/), and multiple training opportunities (https://sites.wustl.edu/mtdirc/resources/links/), including Training Institute for Dissemination and Implementation Research in Health (TIDIRC) materials now made Open Access (https://cancercontrol.cancer.gov/IS/training-education/tidirc/openaccess.html). There are numerous postdocs and job opportunities that are rapidly growing in the field as well (https://impsciuw.org/implementation-science/connect/global-job-board/). Additionally, SBM has a growing number of members who are D&I scientists, and we encourage you to explore opportunities to learn from rigorous examples of D&I research at our upcoming Annual Meeting.

For more introductory information and an orientation to key domains and resources in the field, we recommend the following articles:

  • Koh, Lee, Brotzman, Shelton. 2018. An orientation for new researchers to key domains, processes, and resources in implementation science. Trans Beh Med.
  • Bauer, Mark S., et al. 2015. "An introduction to implementation science for the non-specialist." BMC psychology 3.1:32.  
  • Shelton, R.C., Lee M, Brotzman L, Wolfenden L, Nathan N, Wainberg M. 2020. What is Dissemination and Implementation Science?: An Introduction and opportunities to advance behavioral medicine and public health globally. International Journal of Behavioral Medicine.
  • Implementation Science at a Glance, National Cancer Institute (https://cancercontrol.cancer.gov/IS/docs/NCI-ISaaG-Workbook.pdf)