Date: July 7, 2015
Rachel C. Shelton, ScD, MPH
Assistant Professor, Sociomedical Sciences
Columbia University Mailman School of Public Health
Dissemination and implementation sciences are defined as the systematic study of how a specific set of activities and designated strategies are used to successfully adopt and integrate an evidence-based public health intervention (EBI) within specific settings, and are comprised of four steps: 1) exploration, 2) adoption/preparation, 3) implementation, and 4) sustainment. The overall goal is to reduce the gap between science and practice/policy. Implementation research speaks more to processes and factors associated with successful integration of EBIs within a particular setting, while dissemination research focuses on the processes and factors that lead to widespread adoption and use of EBIs. EBIs are shaped by research evidence, resources, population, and context, and are popularly used due to their demonstrated effectiveness, cost-effectiveness, and fast process. In order to successfully select an EBI, interventionists must Identify community needs, assess organizational capacity, and search program registries to select a program. When preparing for implementation, and EBI can either be adopted as is or adapted to fit the local conditions. Adaptation is an important part of the process in order to enhance engagement, reach the audience, address disparities, increase fit and relevance, and reinforce the message. Adaptations can be either surface or deep structure, and the use of either or both should be a conscious, well thought out decision. Surface adaptations use visual and auditory cues for culturally appropriate messages, while deep structure adaptations involves cultural sensitivity and comprehensive understanding of ethnic group’s core cultural values, norms, and stressors (economic, social, environmental) affecting health behaviors. Models for guiding adaptation include Card, ADAPT-ITT, and MAP.