Selling Innovations Like Soap: The Interactive Systems Framework and Social Marketing

Despite the popularity and noted utility of Wandersman and colleagues' (2008) Interactive Systems Framework, the literature currently provides a primary focus on delivery organizations’ and supportive stakeholders’ capacities and strategies to implement innovations, presenting a critical gap in understanding. Unfortunately, reflective of a larger void in community dissemination and implementation efforts, there is a more limited focus on the dissemination of innovations. This paper presents the social marketing literature as a supplement to the Prevention Synthesis and Translation System (PSTS), the system responsible for dissemination. The study and practice of innovation synthesis and translation is examined in the literature; and based on the conclusions drawn, social marketing theory is used to provide a systematic approach to improving dissemination within the Interactive Systems Framework. Specifically, three gaps related to the PSTS are identified in the literature that align with and can be filled using social marketing. Social marketing is defined and presented as a supplement by providing theory and practices, within a systems context, for effectively communicating and influencing change. By blending social marketing with the Interactive Systems Framework, the aim is to improve the understanding of strategic communication and its role in the effective dissemination, and subsequent implementation, of innovations.     

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 a Training-of-Trainers Approach and Proactive Technical Assistance to Bring Evidence Based Programs to Scale: An Operationalization of the Interactive Systems Framework’s Support System

Bringing evidence based programs to scale was a major initial impetus for the development of the Interactive Systems Framework for Dissemination and Implementation (ISF). The ISF demonstrates the importance of the Support System in facilitating the uptake of innovations in the community (the Delivery System). Two strategies that members of the Support System commonly use are training‐of‐trainers (TOT) models and technical assistance (TA). In this article, we focus on the role of the Support System in bringing evidence‐based programs (EBPs) to scale in the Delivery System using a case example, with special attention on two strategies employed by Support Systems—training‐of‐trainers (TOT) and proactive technical assistance. We then report on findings from a case example from the Promoting Science Based Approaches to Teen Pregnancy Prevention project that furthers our conceptualization of these strategies and the evidence base for them. We also report on the limitations in the literature regarding research on TOTs and proactive TA and provide suggestions for future research on TOTs and proactive TA that will enhance the science and practice of support in the ISF. 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 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     

Research and Action for Bridging Science and Practice in Prevention

There is a well-known gap between science and practice. To address this gap in the areas of Child Maltreatment (CM) and Youth Violence (Y/V), the Division of Violence Prevention (DVP) at the Centers for Disease Control and Prevention (CDC) embarked on a Dissemination/Implementation (D/I) planning project. The project was aimed at identifying better ways to connect research and practice through reviews of the literature as well as through discussions with experts on violence prevention and research utilization. This introductory article sets the stage for the rest of the special issue by defining terms, providing a rationale for the planning project, describing the planning process, and summarizing what is to come in the rest of the issue. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.     

The Getting To Outcomes Demonstration and Evaluation: An Illustration of the Prevention Support System

Communities are increasingly being required by state and federal funders to achieve outcomes and be accountable, yet are often not provided the guidance or the tools needed to successfully meet this challenge. To improve the likelihood of achieving positive outcomes, the Getting To Outcomes (GTO) intervention (manual, training, technical assistance) is designed to provide the necessary guidance and tools, tailored to community needs, in order to build individual capacity and program performance. GTO is an example of a Prevention Support System intervention, which as conceptualized by the Interactive Systems Framework, plays a key role in bridging the gap between prevention science (Prevention Synthesis and Translation System) and prevention practice (Prevention Delivery System). We evaluated the impact of GTO on individual capacity and program performance using survey- and interview-based methods. We tracked the implementation of GTO and gathered user feedback about its utility and acceptability. The evaluation of GTO suggests that it can build individual capacity and program performance and as such demonstrates that the Prevention Support System can successfully fulfill its intended role. Lessons learned from the implementation of GTO relevant to illuminating the framework are discussed.     

Community-Based Prevention Support: Using the Interactive Systems Framework to Facilitate Grassroots Evidenced-Based Substance Abuse Prevention

The community plays an important role in the success of substance abuse prevention efforts. However, current funding structures and a focus on limited approaches to prevention delivery have created a large gap between what substance abuse prevention professionals practice and what the community at large knows about prevention. The concept of “community” has not always been well‐defined in the field of prevention, and there are few mechanisms to engage grassroots community members in evidence‐based substance abuse prevention. This article explains how Wandersman et al.'s (Am J Community Psychol 41:171–181, 2008) Interactive Systems Framework can be applied to grassroots prevention efforts. The authors describe a Community Prevention Support System that collaborates with the Professional Prevention Support System to promote the adoption of evidence‐based substance abuse prevention practices at the grassroots, community level. 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     

Disruptive innovations for designing and diffusing evidence-based interventions

Evidence-based therapeutic and preventive intervention programs (EBIs) have been growing exponentially. Yet EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically reexamine our scientific conventions and norms. Innovation may be spurred by reexamining the traditional biomedical model for validating, implementing, and diffusing EBI products and science. The model of disruptive innovations suggests that we reengineer EBIs on the basis of their most robust features in order to serve more people in less time and at lower cost. A disruptive innovation provides a simpler and less expensive alternative that meets the essential needs for the majority of consumers and is more accessible, scalable, replicable, and sustainable. Examples of disruptive innovations from other fields include minute clinics embedded in retail chain drug stores, $2 generic eyeglasses, automated teller machines, and telemedicine. Four new research approaches will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing monitoring data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Navigating the Road Ahead: Public Health Challenges and the Interactive Systems Framework for Dissemination and Implementation

Public health is currently faced with an array of critical challenges and disconnects. Research and evaluation have identified a number of evidence‐based strategies for effecting behavior change at individual, group, organizational, and environmental levels, all of which hold promise for leading to substantial reductions in morbidity and mortality, and increased quality of life. Unfortunately, there is huge variability across the public health system in awareness of the value of using evidence to inform decision making, let alone in capacity to locate, assess, compare, select, justify, adapt, implement, and evaluate evidence‐based strategies, or to participate in building the evidence base for practice‐based innovations. As a result, many communities may not be benefitting from research‐tested and practice‐based strategies that could help them to meet their public health goals more efficiently and effectively. CDC's Interactive Systems Framework for Dissemination and Implementation (ISF), released in 2008, was designed to help close this gap between research and practice. This commentary identifies the ways in which the ISF framework is useful in addressing the research practice gap; revisits the elements of the framework that have continued to guide research and practice in fruitful ways; and highlights areas that need further development to meet current public health challenges. 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     

Promoting Science-based Approaches to Teen Pregnancy Prevention: Proactively Engaging the Three Systems of the Interactive Systems Framework

In the field of teen pregnancy prevention many efficacious prevention programs are available but adoption of these programs is slow at the community level. In this article, we present a multi-site, capacity-building effort called the Promoting Science-based Approaches to Teen Pregnancy Prevention project (PSBA) as a case example of a proactive application of the Interactive System Framework (ISF) for dissemination and implementation. The ISF is a multi-system model leading to dissemination and implementation of science-based prevention programming through the work of three interactive systems: The "Prevention Delivery," "Prevention Support," and "Prevention Synthesis & Translation" Systems. This article describes the proactive use of the ISF to conceptualize and bolster the PSBA program's goal of assisting local prevention partners in the use of science-based approaches (SBA) to prevent teen pregnancy. PSBA uses all three systems of the ISF to facilitate practice improvements and offers valuable research opportunities to investigate factors related to dissemination and implementation processes across these systems. Describing our application of this framework highlights the feasibility of actively using the ISF to build prevention infrastructure and to guide large-scale prevention promotion strategies in the area of teen pregnancy prevention. The program's ongoing evaluation is presented as an example of early efforts to develop an evidence base around the ISF. Research implications are discussed.     

The Future of Psychology in Medicaid's Health Delivery System for People with Disabilities

State Medicaid programs are rapidly converting fee-for-service health delivery systems to managed care for people with disabilities. In theory, managed care models of health delivery will substantially improve the quality of care for people with disabilities, but in reality, few successful models exist. This period of transition holds both opportunities and challenges for psychologists in medical settings. Because Medicaid reforms for people with disabilities may herald similar reforms for both the public and the private sectors, psychology's response will determine its role in the future of health care delivery for this population. Changes in training and increased attention to outcomes research, innovations in practice, and advocacy will be the keys to success.     

Work stress and coping: drawing together research and practice

Despite the enthusiasm for coping research, reviewers are concerned that much of the research has failed to live up to expectations as to its practical relevance. Yet the debate about the application of coping research is not short on writers pointing the way forward. By examining a number of issues at the heart of the debate on coping research this paper focuses on what may be ways of bridging the gap between coping research and practice. What follows is a discussion around the belief that if coping research is to become more clinically relevant, then researchers need to make better use of transactional models of stress. More specifically this paper points to the explanatory potential in concepts like appraisal that provide the psychological links between the individual and the stressful encounter. Moreover if coping researchers are to focus on more process-focused models, then what is needed is a time of quiet reconstruction where researchers consider where current methodologies are taking us and what alternative methods can provide. The argument here is that coping research needs to adopt measurement methods that reflect the techniques of clinicians. The emphasis is for coping methods to become more ecologically sensitive, person- and meaning-centred, daily processing and narrative in application.     

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     

Being, Doing, and Knowing: Developing Ethical Competence in Health Care

There is a growing interest in ethical competence-building within nursing and health care practising. This tendency is accompanied by a remarkable growth of ethical guidelines. Ethical demands have also been laid down in laws. Present-day practitioners and researchers in health care are thereby left in a virtual cross-fire of various legislations, codes, and recommendations, all intended to guide behaviour. The aim of this paper was to investigate the role of ethical guidelines in the process of ethical competence-building within health care practice and medical research. A conceptual and critical philosophical analysis of some paragraphs of the Helsinki Declaration and of relevant literature was performed. Three major problems related to ethical guidelines were identified, namely, the interpretation problem (there is always a gap between the rule and the practice, which implies that ethical competence is needed for those who are to implement the guidelines); the multiplicity problem (the great number of codes, declarations, and laws might pull in different directions, which may confuse the health care providers who are to follow them); and the legalisation problem (ethics concerns may take on a legal form, where ethical reflection is replaced by a procedure of legal interpretations). Virtue ethics might be an alternative to a rule based approach. This position, however, can turn ethics into a tacit knowledge, leading to poorly reflected and inconsistent ethical decisions. Ethical competence must consist of both being (virtues) and doing (rules and principles), but also of knowing (critical reflection), and therefore a communicative based model is suggested.     

Design and Development of the ITC Guidelines on Computer-Based and Internet-Delivered Testing

This article describes the design and development of the International Test Commission's (ITC, this issue) Guidelines for Computer-Based and Internet-Delivered Testing. It examines some of the reasons why the ITC Council decided to invest in a program of research, consultation, and conferences designed to develop internationally agreed-on guidelines specifically aimed at computer- and Internet-based testing and describes the methodology involved in developing and disseminating the guidelines. Through a process of reviewing relevant literature and organizing conferences and wide consultations, a set of internationally recognized guidelines that highlighted good practice issues in computer/Internet testing were developed. The guidelines will raise awareness among all stakeholders in the testing process of what constitutes good practice in computer/Internet testing and can be used as a benchmark to set local standards and guidelines. Further issues are raised from the research, not least the need to ensure that with advances in technology and science comes the updating of training in tests and testing to keep up with such advances.     

UN Convention on the Rights of the Child and Global Childhoods: Transdisciplinary Reflections from Nepal

Abstract

Globally, humans face innumerable socioeconomic, cultural, and environmental problems while being threatened by ever more interconnected and complex geopolitical concerns. In this planetary context, unidisciplinary research and related teaching approaches often work to constrain our ability to move beyond institutional and bureaucratic mind-sets to become agents of social change within local systems impacting children. During its 40-year evolution from a sub-discipline of psychology, the international field of child and youth studies has sought common ground for interpreting these pedagogical and professional issues. Many authors now argue for transdisciplinary approaches to address and overcome these tensions in the effort to re-integrate epistemologies of the global South within more dominant global North knowledge production systems. Such approaches have been posited to add new analytical and methodological tools to achieve praxis—the Greek word for translating theory into practice. Transdisciplinary research transcends the usual gap between academia and the broader public by acknowledging the value of knowledge obtained from diverse, nonacademic stakeholders in the community, government, and business. In addition, these approaches in child and youth studies offer us new possibilities for translating and understanding the local and global implications of implementing the 1989 United Nations Convention on the Rights of Child, and the vast differences in the experiences of childhood amongst and between various socioeconomic, cultural, and political contexts in recognizing their own rights in situ. Moving beyond adult-focused and Eurocentric understanding of the childhood literature (and of children’s human rights), this paper reflects our experiences working with young people affiliated with the Lalitpur Metropolitan City Child Clubs in Nepal, and observing their participatory planning processes for annual budgets. In response to increasing complexity throughout all regions of the world, we consider historical, political, and cultural experiences in Nepal through this transdisciplinary approach to child-centered research and activism. Our paper details key learning and transitions from being “academic researchers” and “observers” of a participatory, child- and youth-focused budgeting process to “collaborators” and “co-constructors of knowledge” with key stakeholders—the young people of Lalitpur, Nepal.     

Citizen Science,the Body of Christ,and Testimonial Epistemology

How does explicit theological knowledge emerge out of communal practices, who is involved in its production, and what are its procedures? These are neither neutral nor arbitrary methodological questions; they are themselves deeply theological. Digital innovations and the subsequent transformations of society and academia invite us to redefine the work of theology. Epistemologically drawing on a theology of the cross and centring the communal nature and vulnerable existence of the witnessing community, we develop a model of doing theology that is collaborative and exploratory within the medial transformations of the digital age. Taking cues from participatory research conceptions of “citizen science,” we propose going toward and beyond a “citizen theology.” We need the courage to conceive of a theology that is ultimately centreless. Therefore, we cannot aspire to testimonially responsible forms of doing theology without striving for epistemic justice and diaconal empowerment at a global level. The “distributed theology” we envision promotes global (catholic), decentral (apostolic), and communal (local) forms of knowledge production by the whole of the body of Christ in ever more distributed ways.     

Lost in the great divide: Motivation in religious studies classrooms

One of the most illuminating finds in Barbara E. Walvoord's Teaching and Learning in College Introductory Religion Courses (2008) is what she calls “the great divide,” a mismatch between instructors’ goals for their courses, which are academic, and the students’ reasons for taking them, which relate to their personal interests and development. Motivation – or, rather, the lack thereof – is not explicitly considered as a potential victim of this mismatch. This article will turn its attention squarely to this issue. First, I will review data about the “great divide” and link them to the common practice of asking our students to bracket the personal when they take our courses. The article will juxtapose this practice with what research tell us about motivation, which will allow us to further explore why the divide Walvoord and others have identified is so problematic. The article will conclude with pedagogical strategies that can help instructors intentionally influence motivation in religion courses. Ultimately, I suggest that we may be doing students – as well as ourselves, as the purveyors of our discipline – a disservice, if we do not attend to (or, worse, if we actively avoid) what we know motivates students to learn.     

Moving Knowledge into Action: Developing the Rapid Synthesis and Translation Process Within the Interactive Systems Framework

The Interactive Systems Framework (ISF) for Dissemination and Implementation presents an overall framework for translating knowledge into action. Each of its three systems requires further clarification and explanation to truly understand how to conduct this work. This article describes the development and initial application of the Rapid Synthesis and Translation Process (RSTP) using the exchange model of knowledge transfer in the context of one of the ISF systems: the Prevention Synthesis and Translation System (see [special issue “introduction” article] for a translation of the Wandersman et al. (Am J Community Psychol 41:3–4, 2008) article using the RSTP). This six‐step process, which was developed by and for the Division of Violence Prevention at the Centers for Disease Control and Prevention in collaboration with partners, serves as an example of how a federal agency can expedite the transfer of research knowledge to practitioners to prevent violence. While the RSTP itself represents one of the possible functions in the Prevention Synthesis and Translation System, the resulting products affect both prevention support and prevention delivery as well. Examples of how practitioner and researcher feedback were incorporated into the Rapid Synthesis and Translation Process 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