Bringing New Prototypes into Practice: Dissemination, Implementation, and "Facilitating Transformation." A Center Report

It is encouraging to see increasing attention to improving interventions in fields such as mental health, public health, and education. This includes the growing emphasis on transferring evidence-based interventions into practice. The trend continues to be stimulated and supported by the high priority endorsement of federal, state, and local governments, foundations, and third-party payers. All of the work has reinvigorated research in what are commonly referred to as the translation, dissemination, and implementation problems. Much of the discussion in the literature focuses on bringing a specific prototype developed and researched in a rarified setting into the "real world." An eventual aim in most instances is to replicate the prototype on a large scale and often in diverse settings. And, in some instances, the aim is not just to replicate a practice or program but to transform the nature and scope of a field. In these latter cases, the problems of translation, dissemination, and implementation become enmeshed with the problems of institutional transformation and sustainability. Not surprisingly, the aims, nature, and scope of how knowledge transfer problems are discussed varies greatly within and between disciplines and fields, and at this juncture, little cross fertilization is apparent. However, there are some common themes. One is that of preserving the integrity of the prototype by ensuring fidelity in translating research into practice. Another theme is the influence of context. This report is made up of three sections. In the first section, Efforts to Improve Dissemination and Implementation of Good Practices, the authors highlight prominent examples from clinical psychology, public health, and education and indicate a sampling of major organizations that intend to advance implementation research. In the second section, Enhancing Basic Dissemination and Implementation Research, they outline some basic matters that warrant greater attention by implementation researchers. In the final section, Focusing on "Facilitating" Institutional Transformation: Our Center's Pursuit of New Directions for Student & Learning Supports, the authors (1) differentiate "direct" implementation from the process of "facilitating" implementation; and (2) differentiate implementation of a "specific practice or program" from efforts to "transform institutions" such as schools. A list of references cited in this report and others that have informed the authors' understanding