Key terms from implementation and dissemination science.

  • Adoption: whether a local organization or group decides to try the new program; occurs faster when the program is compatible with existing systems, has low perceived complexity, has high perceived relative advantage, and begins with trial use
  • Diffusion: passive process by which recipients absorb and act on information. The four phases of diffusion are exploration, preparation, implementation, and sustainment
  • Dissemination: how well information about a practice’s existence and value is supplied to communities; the active approach to spreading interventions to the target stakeholders. Studies have found that dissemination is necessary but not sufficient to ensure wide-spread use of an intervention. Mass communication: creates awareness; interpersonal communication: persuades behavior change. Individuals are more likely to adopt if more members of their personal network have adopted. Opinion leaders tend to be early adopters when system norms favor change
  • Empowerment Evaluation/Pragmatic Measures: based on the premise that interventions are more likely to achieve desired outcomes if stakeholders (e.g., healthcare providers, clinical administrative staff) have the capacity to conduct and use their own evaluations. Based on a set of 10 principles: improvement, community ownership, inclusion, democratic participation, social justice, community knowledge, evidence based strategies, capacity building, organizational learning, and accountability. Pragmatic measures are those that are psychometrically valid, actionable, sensitive to change, brief, and important to stakeholders, and are effective in the following:
    • Building local capacity for planning systematically
    • Implementing with quality
    • Self-evaluating
    • Using the information for continuous quality improvement.
    • Implementation: the process of putting to use, integrating interventions, and/or changing practice patterns within a setting
  • Fidelity: degree to which an intervention is implemented as it is prescribed in the original protocol or as it was intended by the program developers. Fidelity of the intervention in a “real world” setting may be compared to the fidelity from the original evidence-based intervention.
  • Implementation Team: implementation teams are commonly used as a formal structure for implementation efforts. These teams may be comprised of those in leadership roles, volunteers, and/or influential stakeholders
  • Planning: the process of thinking about and organizing the activities required to achieve a goal (Rosen)
  • Reinvention/adaptation: the degree to which an evidence-based intervention is changed or modified by a user during adoption and implementation to suit the needs of the setting and local conditions. The core components/essential features of an intervention (i.e. those responsible for its efficacy/effectiveness) must be identified and preserved
  • Sustainability: whether the practice can be maintained over time; key indicators: whether the practice can deliver its intended benefits, if there is institutionalization and capacity building within the setting, and if there is continued use of the intervention components.