ORIGINAL PAPER Bridging the Gap Between Prevention Research and Practice: The Interactive Systems Framework for Dissemination and Implementation Abraham Wandersman �� Jennifer Duffy �� Paul Flaspohler �� Rita Noonan �� Keri Lubell �� Lindsey Stillman �� Morris Blachman �� Richard Dunville �� Janet Saul Published online: 27 February 2008 �� Springer Science+Business Media, LLC 2008 Abstract If we keep on doing what we have been doing, we are going to keep on getting what we have been getting. Concerns about the gap between science and practice are longstanding. There is a need for new approaches to sup- plement the existing approaches of research to practice models and the evolving community-centered models for bridging this gap. In this article, we present the Interactive Systems Framework for Dissemination and Implementa- tion (ISF) that uses aspects of research to practice models and of community-centered models. The frame- work presents three systems: the Prevention Synthesis and Translation System (which distills information about innovations and translates it into user-friendly formats) the Prevention Support System (which provides training, technical assistance or other support to users in the field) and the Prevention Delivery System (which implements innovations in the world of practice). The framework is intended to be used by different types of stakeholders (e.g., funders, practitioners, researchers) who can use it to see prevention not only through the lens of their own needs and perspectives, but also as a way to better understand the needs of other stakeholders and systems. It provides a heuristic for understanding the needs, barriers, and resources of the different systems, as well as a structure for summarizing existing research and for illuminating priority areas for new research and action. Keywords Dissemination Implementation Bridging research and practice Capacity building Prevention Introduction Descriptions of the gap between science and practice have long been noted in the literature (e.g., Backer et al. 1995 Morrissey et al. 1997), and they continue to be made (e.g., Clancy and Cronin 2005). The movement for more evi- dence-based practice continues to grow in medicine (e.g., Atkins et al. 2005), public health (e.g. Eagle et al. 2003 Lyles et al. 2006 Truman et al. 2000 Zaza et al. 2005), and psychotherapy treatment (e.g., Nathan and Gorman 2002) as well as in many other areas of prevention, inter- vention, and education. Using evidence-based practices has become a requirement for funding by many federal agen- cies, such as the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration, and the Department of Education. The dissemination of evidence-based practices has been identified as one way that community psychologists can influence social policy and create positive social change (Mayer and Davidson 2000). In its seminal report on prevention research in mental health, the Institute of Medicine (1994) developed a five step model for assessment, intervention, and dissemination: 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. A. Wandersman (&) J. Duffy L. Stillman M. Blachman Department of Psychology, University of South Carolina, Columbia, SC 29208, USA e-mail: wanderah@gwm.sc.edu P. Flaspohler Miami University, Oxford, USA R. Noonan K. Lubell J. Saul Centers for Disease Control and Prevention, Atlanta, USA R. Dunville Georgia Division of Public Health, Atlanta, USA 123 Am J Community Psychol (2008) 41:171���181 DOI 10.1007/s10464-008-9174-z

assessing the prevalence and risk and protective factors of a problem area, developing prevention innovations and researching their efficacy and effectiveness, and dissemi- nating these tested innovations into the community (Fig. 1). Similarly, a public health model outlines four stages necessary for developing public health interven- tions: defining the problem, identifying risk factors, developing and testing interventions, and ensuring wide- spread use (Mercy et al. 1993). However, both of these models assumed that effective interventions will be adop- ted in the field, but the models provide little information about how that jump from research to practice would occur. Although bodies of research on effective interven- tions have grown, we have not seen a corresponding increase in the use of effective programs. Examination of public health and prevention practice in the field suggests that those innovations that have been found most effective in prevention research are not necessarily those most commonly used in practice (e.g., Ringwalt et al. 2002 Wandersman and Florin 2003). Findings such as these illustrate the importance of seeking ways to decrease the gap between science and practice. We are proposing a framework that describes relevant systems to help bridge this gap between science and practice. In this article, we will: (1) describe why the framework was developed (2) demonstrate the need for this framework to clarify what is necessary to address the gap between science and practice and how the framework addresses that need (3) describe the framework and present literature that supports the inclusion of the elements of the framework and (4) briefly discuss the implications of the framework. The pro- cess that led to the development of this framework is described by Saul et al. (2008b). A discussion of the key concepts of capacity that emerged through the development of the framework is provided by Flaspohler et al. (2008). Why the Framework was Developed The specific motivation for developing this framework came from the Division of Violence Prevention (DVP) of the Centers for Disease Control and Prevention (for more information, see Saul et al. 2008b). DVP noted that knowledge was available about the effective prevention of child maltreatment and youth violence, but that knowledge was not broadly applied in the field. There was also an early recognition that the gap was bi-directional and should include practitioner perspectives on the best ways to bring research and practice together (Morrissey et al. 1997 Wandersman 2003). Sogolow et al. (2007) have proposed an extended public health model for injury and violence pre- vention that explicitly includes activities to address the gap between stage three (developing and testing the effectiveness of interventions) and stage four (ensuring their widespread use). The framework proposed in this article provides an examination of the systems and processes involved in moving from the development and testing of innovations to the widespread use of effective innovations (i.e., the framework explicates the arrow between the fourth and fifth boxes of the IOM model in Fig. 1 and the arrow between the third and fourth stages of the public health model). In order to address this research-practice gap, DVP initiated a process to identify strategies to increase the use of this knowledge in practice and key research questions related to dissemination and implementation. This process led to the collaborative development of the framework. The authors were members of a team comprised of DVP staff members and university faculty and graduate students. This team played a primary role in the development of the framework. The framework was also strongly influenced by input from practitioners, researchers, and funders. The framework was developed specifically as a heuristic to help clarify the issues related to how to move what is known about prevention into more widespread use. Therefore, we do not address the development and testing of new innovations (i.e., steps 1���4 in the IOM model or the first three steps of the public health model), or appropriate standards of effectiveness. While all of these topics are important, they fall outside the focus of this article. Throughout this article, we use the term innovation to refer to new knowledge or information that could be useful to prevention efforts in the field. In the realm of prevention, innovations typically can be categorized as programs, policies, processes, and principles (see Saul et al. 2008b). The framework can be applied to any of these four types of innovation. . 1 problem Identify and disorder(s) or information review it���s determine to extent . 2 emphasis an With and risk on factors, protective relevant review information���both outside fields fro and prevention existing from preventive intervention programs research . 3 conduct, Design, pilot analyze and and studies and confirmatory of trials replication preventive the intervention program . 4 conduct, Design, large- analyze and the of trials scale preventive intervention program . 5 large- Facilitate scale implementation ongoing and the of evaluation preventive intervention the in program community- Loop Feedback Fig. 1 IOM model of the prevention research cycle 172 Am J Community Psychol (2008) 41:171���181 123