Abstract Background Evidence-based interventions (EBIs) exist across settings to promote health and prevent disease, yet dissemination—the strategic packaging and sharing of information—often receives less attention, funding, and methodological rigor than implementation science. There is a need to understand the dissemination pathway of an EBI over time to improve dissemination outcomes (e.g. comprehension, exposure, perceived fit). Methods Using a school-based asthma therapy (SBAT) program as an example, we applied a narrative inquiry approach to (i) adapt the model for dissemination of research based on program-specific sources, channels, messages, and audiences; (ii) use team members’ lived experiences to understand the evolution of the EBI; and (iii) illustrate core functions of SBAT and provide example implementation approaches and adaptations. Five of six interdisciplinary research and delivery team members were interviewed. Sessions were audio-recorded, transcribed verbatim, and analyzed using three analytic lenses: (i) participant voice from research and delivery team members; (ii) EBI implementation domains (context, content, training, evaluation); and (iii) reflexive monitoring by the inquirer. Results Four major themes were derived from the contextual and content analyses: (i) How it started: the value of interpersonal connection (I kind of chuckled, and the group looked at me, ‘Why are you laughing?’ I said, ‘Well, because [we] have been colleagues and friends since the 90s’); (ii) Why it worked: advocating for service- and solution-driven team science (We knew medications were making a difference, but kids weren’t getting them… how do we make sure the whole system can work?); (iii) How it worked: realistic resource needs and strong stories (We had the pharmacy itself has a whole infrastructure that it had to build to be able to get all the prescriptions up and running); and (iv) Keep it going: addressing the invisible work. “There was actually talk of… trying to get it out into… a pretty rural area…but the challenge there was going to be kind of some local boots on the ground invisible support.” Conclusions A team science approach is needed for effective dissemination and implementation of EBIs. All interviewees recalled similar threads of channels, sources, messages, and audiences to ensure successful dissemination of this specific SBAT program. Implementation success attributed to infrastructure and “moving cogs” the “invisible work” needed for a “complex system” to work. A limitation is that narrative inquiry relies on the researcher’s “personal wisdom, skills, integrity” and context for interpretation and thus, is subjective.
Abstract Background Capacity building in the science and practice of implementation is critical for driving and evaluating meaningful change. However, capacity needs of stakeholders to effectively apply implementation science in suicide prevention remain unclear. Purpose To address this gap in Australia, we conducted a concept mapping (CM) study to identify and prioritize stakeholder capacity-building needs in this area. Methods Diverse stakeholders: practitioners, lived experience advocates, researchers, public servants, and clinicians working within the suicide prevention sector in Australia participated in the study. Using CM, participants individually brainstormed statements representing capacity-building needs for implementation science for suicide prevention. These statements were then organized in clusters and rated on importance and feasibility. Data were collected, analyzed, and visually represented using the groupwisdom™ platform. Results In total, 52 stakeholders participated in at least one stage of the study (i.e. brainstorming, sorting and/or rating). Brainstorming generated 59 statements, which were synthesized into 53 distinctive statements and supplemented with 13 statements from the literature. A multidimensional scaling and hierarchical cluster analysis generated many cluster solutions, out of which an eight-cluster solution was chosen as the most meaningful. Knowledge dissemination and lived experience integration clusters were rated highest on importance and feasibility. Conclusions This study provides a snapshot of implementation capacity-building needs and priorities within the suicide prevention sector in Australia. The identified priorities can help inform future sector capacity-building initiatives for implementation.
Abstract Background Public health research must influence both the research field and health sector. This study explored the impacts of four multi-study prevention research programs conducted by an Australian public health research group. Methods Using a case study methodology and multiple data sources—document review, interviews, survey, and expert assessments—we studied the trajectories linking research to impact. Analyses included types of evidence generated, context, translational efforts, and impacts across four domains: knowledge development; use of research in the research system; health policy and practice; and health and social impacts. Expert reviewers assessed case studies against indicators covering each impact domain. A framework analysis was used to compare trajectories across cases. Results Each research program was assessed as having moderate to high impact across all domains. These highly applied, policy relevant research programs achieved significant peer review publications and citations. Both policy-initiated and research-initiated programs included policy collaborators as co-authors. All case studies were policy-aligned and addressed translation factors; and the capacity of individual researchers, the research organization’s culture and the degree of collaboration were facilitators of impact. Conclusions We found clear evidence of demonstrable policy, practice and academic impacts, with variations in impact degree and types. The differing trajectories signal the importance of assessing impacts in relation to the purpose and focus of the research. These case studies illustrate ways that research can be impactful and how classic translational enabling factors can be enhanced. Sophisticated research translation skills and a collaborative organizational culture appear key attributes for achieving impact.
Abstract Background The multiphase optimization strategy is employed to develop multi-component interventions that strike a balance between effectiveness, affordability, scalability, and efficiency. Detailed reporting is crucial for enhancing the rigor and reproducibility of the research within healthcare. However, checklists for the optimization and evaluation phases have not yet been developed. Purpose To examine the range and identify the gap in the application of the multiphase optimization strategy. Methods This scoping review was conducted across 16 online databases and related websites to locate studies published in English and Chinese before 14 May 2025. The pertinent information was extracted and synthesized by data-charting form. Results 159 papers met the inclusion criteria. Most papers focused on optimizing evidence-based practices (n = 138) rather than on implementation strategies (n = 21). In phase 1, 45.3% of studies did not report a conceptual model or did not depict it in a figure. One hundred and forty-six papers did not define optimization constraints, and 151 papers did not describe how constraints were determined. Similarly, 104 papers did not define the optimization objective or explain how it was established. In phase 2, the decision processes for selecting the optimal component were not described in 117 papers. A preliminary phase-specific reporting checklist was proposed. Conclusions The review reveals that many studies conflate “optimal” with “best,” leading to under-specification of the optimization objectives and constraints and, consequently, to unclear decision rules for selecting components. It also reveals the need for a rigorous report of each phase for future research.
Abstract Background Access remains a key barrier preventing families from enrolling in intensive health behavior and lifestyle treatment (IHBLT) to manage their obesity. Purpose This demonstration project integrated the Positive Actions Towards Health (PATH) IHBLT into a home health agency, documented delivery adaptations, and explored preliminary effects on health outcomes. Methods PATH was embedded into home health workflows and billed to Medicaid. Clinicians at a pediatric clinic referred patients ages 6–12 years with obesity (body mass index percentile [BMI%ile] ≥ 95th) to the home health agency who then delivered the 12-month program in the child’s home as part of their standard practice. The Framework for Reporting Adaptation and Modifications to Evidence-based Interventions (FRAME) was used to document modifications and Reach Effectiveness Adoption Implementation and Maintenance was used to track implementation. BMI%ile, blood pressure, and quality of life (QoL) were tracked. Results Eleven adaptations were identified using FRAME-IS. Key modifications to improve delivery included building PATH lesson content and assessment into the home health EHR, digitizing a tailored weight path to inform program adherence, and refining recruitment procedures. Ten families enrolled, attending an average 8 ± 7 sessions (Mean ± SD; range: 2–21). Five participants completed measures at six months and two at twelve months. Across timepoints BMI%ile appeared to be attenuated, systolic blood pressure improved, and gains in QoL were evident. Conclusions The PATH IHBLT was adapted for home health delivery and billed to Medicaid, showing preliminary success but challenges with retention. Further work is needed to increase dosage of IHBLT delivered in the home setting.
