Where is policy in dissemination and implementation science? Recommendations to advance theories, models, and frameworks: EPIS as a case example

Crable, EL (通讯作者),Univ Calif La Jolla, Dept Psychiat, San Diego, CA 92093 USA.;Crable, EL (通讯作者),Child & Adolescent Serv Res Ctr, San Diego, CA 92123 USA.;Crable, EL (通讯作者),Univ Calif San Diego, Disseminat & Implementat Sci Ctr, Altman Clin & Translat Res Inst, San Diego, CA 92093 USA.
2022-12-12
BackgroundImplementation science aims to accelerate the public health impact of evidence-based interventions. However, implementation science has had too little focus on the role of health policy - and its inseparable politics, polity structures, and policymakers - in the implementation and sustainment of evidence-based healthcare. Policies can serve as determinants, implementation strategies, the evidence-based thing to be implemented, or another variable in the causal pathway to healthcare access, quality, and patient outcomes. Research describing the roles of policy in dissemination and implementation (D & I) efforts is needed to resolve persistent knowledge gaps about policymakers' evidence use, how evidence-based policies are implemented and sustained, and methods to de-implement policies that are ineffective or cause harm. Few D & I theories, models, or frameworks (TMF) explicitly guide researchers in conceptualizing where, how, and when policy should be empirically investigated. We conducted and reflected on the results of a scoping review to identify gaps of existing Exploration, Preparation, Implementation, and Sustainment (EPIS) framework-guided policy D & I studies. We argue that rather than creating new TMF, researchers should optimize existing TMF to examine policy's role in D & I. We describe six recommendations to help researchers optimize existing D & I TMF. Recommendations are applied to EPIS, as one example for advancing TMF for policy D & I. Recommendations(1) Specify dimensions of a policy's function (policy goals, type, contexts, capital exchanged). (2) Specify dimensions of a policy's form (origin, structure, dynamism, outcomes). (3) Identify and define the nonlinear phases of policy D & I across outer and inner contexts. (4) Describe the temporal roles that stakeholders play in policy D & I over time. (5) Consider policy-relevant outer and inner context adaptations. (6) Identify and describe bridging factors necessary for policy D & I success. ConclusionResearchers should use TMF to meaningfully conceptualize policy's role in D & I efforts to accelerate the public health impact of evidence-based policies or practices and de-implement ineffective and harmful policies. Applying these six recommendations to existing D & I TMF advances existing theoretical knowledge, especially EPIS application, rather than introducing new models. Using these recommendations will sensitize researchers to help them investigate the multifaceted roles policy can play within a causal pathway leading to D & I success.
IMPLEMENTATION SCIENCE
卷号:17|期号:1
ISSN:1748-5908|收录类别:SCIE
语种
英语
来源机构
University of California System; University of California San Diego; University of California System; University of California San Diego; Washington University (WUSTL); Curtin University
资助信息
Drs. Crable and Lengnick-Hall are fellows, Dr. Stadnick is an alumnus, and Dr. Aarons is core faculty with the Implementation Research Institute (IRI, at the George Warren Brown School of Social Work, Washington University in St. Louis, through an award from the National Institute of Mental Health (R25 MH080916). Dr. Crable is also funded by NIDA 1K01DA056838. Dr. Lengnick-Hall is also funded by NIMH P50MH113662. Dr. Moullin is partially funded by a Medical Research Future Fund grant (GNT1168155). Drs. Aarons and Crable are supported by NIDA grant R01DA049891, and Drs. Aarons and Stadnick are supported by NIMH P50MH126231 Center for Team Effectiveness to Accelerate EBP Implementation in Children's Mental Health Services.
被引频次(WOS)
0
被引频次(其他)
0
180天使用计数
1
2013以来使用计数
1
出版年
2022-12-12
DOI
10.1186/s13012-022-01256-x
学科领域
循证公共卫生
关键词
Theory Model Framework Policy Politics Context
资助机构
National Institute of Mental Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Mental Health (NIMH)) NIDA(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Drug Abuse (NIDA)) NIMH(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Mental Health (NIMH)) Medical Research Future Fund grant(Medical Research Future Fund (MRFF)) NIMH Center for Team Effectiveness to Accelerate EBP Implementation in Children's Mental Health Services
WOS学科分类
Health Care Sciences & Services Health Policy & Services