Toward an Evidence-Based System for Innovation Support for Implementing Innovations with Quality: Tools,Training, Technical Assistance,and Quality Assurance/Quality Improvement

An individual or organization that sets out to implement an innovation (e.g., a new technology, program, or policy) generally requires support. In the Interactive Systems Framework for Dissemination and Implementation, a Support System should work with Delivery Systems (national, state and/or local entities such as health and human service organizations, community-based organizations, schools) to enhance their capacity for quality implementation of innovations. The literature on the Support ystem has been under-researched and under-developed. This article begins to conceptualize theory, research, and action for an evidence-based system for innovation support (EBSIS). EBSIS describes key priorities for strengthening the science and practice of support. The major goal of EBSIS is to enhance the research and practice of support in order to build capacity in the Delivery System for implementing innovations with quality, and thereby, help the Delivery System achieve outcomes. EBSIS is guided by a logic model that includes four key support components: tools, training, technical assistance, and quality assurance/quality improvement. EBSIS uses the Getting To Outcomes approach to accountability to aid the identification and synthesis of concepts, tools, and evidence for support. We conclude with some discussion of the current status of EBSIS and possible next steps, including the development of collaborative researcher-practitioner-funder-consumer partnerships to accelerate accumulation of knowledge on the Support System.     

The Interactive Systems Framework Applied to the Strategic Prevention Framework: The Rhode Island Experience

The Interactive Systems Framework for Dissemination and Implementation (ISF) was introduced as a heuristic systems level model to help bridge the gap between research and practice (Wandersman et al., in Am J Commun Psychol 41:171–181, 2008). This model describes three interacting systems with distinct functions that (1) distill knowledge to develop innovations; (2) provide supportive training and technical assistance for dissemination to; (3) a prevention delivery system responsible for implementation in the field. The Strategic Prevention Framework (SPF) is a major prevention innovation launched by the Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA). The SPF offers a structured, sequential, data‐driven approach that explicitly targets environmental conditions in the community and aims for change in substance use and problems at the population level. This paper describes how the ISF was applied to the challenges of implementing the SPF in 14 Rhode Island communities, with a focus on the development of a new Training and Technical Assistance Resources Center to support SPF efforts. More specifically, we (1) describe each of the three ISF interacting systems as they evolved in Rhode Island; (2) articulate the lines of communication between the three systems; and (3) examine selected evaluation data to understand relationships between training and technical assistance and SPF implementation and outcomes. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Developing a Prevention Synthesis and Translation System to Promote Science‐Based Approaches to Teen Pregnancy,HIV and STI Prevention

The Interactive Systems Framework for Dissemination and Implementation (ISF) is a multi‐system framework that can guide research‐to‐practice efforts by building and supporting the work of three interacting systems: the Prevention Delivery, Support, and Synthesis and Translation Systems. The Synthesis and Translation system is vital to bridging science and practice, yet how to develop it and train support system partners to use it is under‐researched. This article bridges this gap by offering a case example of the planning, development, and use of a synthesis and translation product called Promoting Science‐based Approaches to Teen Pregnancy Prevention using Getting To Outcomes. The case presented documents the process used for developing the synthesis and translation product, reports on efforts to engage the Prevention Support system to use the product, and how we approached building interaction between the Synthesis and Translation System and the Support System partners. Practice‐oriented evaluation data are also presented. Implications for practice, policy and research are discussed. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Using the Interactive Systems Framework to Support a Quality Improvement Approach to Dissemination of Evidence-Based Strategies to Promote Early Detection of Breast Cancer: Planning a Comprehensive Dynamic Trial

Dissemination efforts must optimize interventions for new settings and populations. As such, dissemination research should incorporate principles of quality improvement. Comprehensive Dynamic Trial (CDT) designs examine how information gained during dissemination may be used to modify interventions and improve performance. Although CDT may offer distinct advantages over static designs, organizing the many necessary roles and activities is a significant challenge. In this article, we discuss use of the Interactive Systems Framework for Dissemination and Implementation to systematically implement a CDT. Specifically, we describe “Bronx ACCESS”, a program designed to disseminate evidence‐based strategies to promote adherence to mammography guidelines. In Bronx ACCESS, the Intervention Delivery System will elicit information needed to adapt strategies to specific settings and circumstances. The Intervention Synthesis and Translation System will use this information to test changes to strategies through “embedded experiments”. The Intervention Support System will build local capacities found to be necessary for intervention institutionalization. Simulation modeling will be used to integrate findings across systems. Results will inform on‐going policy debate about interventions needed to promote population‐level screening. More generally, this project is intended to advance understanding of research paradigms necessary to study dissemination. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

The Role of a State‐Level Prevention Support System in Promoting High‐Quality Implementation and Sustainability of Evidence‐Based Programs

Although numerous evidence‐based programs (EBPs) have been proven effective in research trials and are being widely promoted through federal, state, and philanthropic dollars, few have been “scaled up” in a manner likely to have a measurable impact on today's critical social problems. The Interactive Systems Framework for Dissemination and Implementation (ISF) explicates three systems that are critical in addressing the barriers that prevent these programs from having their intended public health impact. In this article we describe the relevance of these systems in a real‐world context with a specific focus on the Prevention Support System (PSS). We expand on the ISF model by presenting funders and policy‐makers as active and engaged stakeholders, and demonstrate how a state‐level PSS has used empirical evidence to inform general and program‐specific capacity‐building and support interactions among researchers, funders, and practitioners in Pennsylvania. By embracing this expanded ISF framework as a conceptual model for the wide‐scale dissemination and support of EBPs, and recognizing the need for a distinct state‐level PSS, Pennsylvania has created an infrastructure to effectively address the primary barriers to moving from lists of EBPs to achieving population‐level public health improvement. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Four Keys to Success (Theory, Implementation, Evaluation, and Resource/System Support): High Hopes and Challenges in Participation

In this article, I attempt to merge two themes. First, there is often a large gap between high hopes about impacts of policies or programs and the demonstrated results. I describe four keys/threats to success in any social problem area: theory, implementation, evaluation, and resource/system support. Second, I present theory and research from over 30 years of work on participation, conducted by my colleagues and myself that can illuminate and be illuminated by theory, implementation, evaluation, and resource/system support. I offer ideas for solutions that increase the probability of success. I conclude with the need to have high hopes tempered by theory and research to develop realistically ambitious solutions to social problems.