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Annu Rev Public Health. 2017 Mar 20;38:1-22. doi: 10.1146/annurev-publhealth-031816-044215.

An Overview of Research and Evaluation Designs for Dissemination and Implementation.

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Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611; email:
Division of Health Services Research, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205; email:
Department of Children, Youth and Families, School of Social Work, University of Southern California, Los Angeles, California 90089; email:
Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, California 92093; email:
Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California 90024; email:
Healthy African American Families, Los Angeles, California 90008; email:
The Methodology Center and Department of Human Development & Family Studies, Pennsylvania State University, University Park, Pennsylvania 16802; email:
Department of Psychiatry, Columbia University Medical Center, Columbia University, New York, NY 10027; email:
VA Center for Implementation Practice and Research Support, Virginia Greater Los Angeles Healthcare System, North Hills, California 91343; email:
College of Nursing, The University of Iowa, Iowa City, Iowa 52242; email:
Prevention Research Center, George Warren Brown School, Washington University, St. Louis, Missouri 63105; email:
National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland 20814; email:
Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland 20850; email: ,
National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland 20814; email:
Oregon Social Learning Center, Eugene, Oregon 97401; email:
Mailman School of Public Health, Columbia University, New York, NY 10032; email:
Department of Health Policy and Management, University of North Carolina, Chapel Hill, North Carolina 27514; email:


The wide variety of dissemination and implementation designs now being used to evaluate and improve health systems and outcomes warrants review of the scope, features, and limitations of these designs. This article is one product of a design workgroup that was formed in 2013 by the National Institutes of Health to address dissemination and implementation research, and whose members represented diverse methodologic backgrounds, content focus areas, and health sectors. These experts integrated their collective knowledge on dissemination and implementation designs with searches of published evaluations strategies. This article emphasizes randomized and nonrandomized designs for the traditional translational research continuum or pipeline, which builds on existing efficacy and effectiveness trials to examine how one or more evidence-based clinical/prevention interventions are adopted, scaled up, and sustained in community or service delivery systems. We also mention other designs, including hybrid designs that combine effectiveness and implementation research, quality improvement designs for local knowledge, and designs that use simulation modeling.


adaptation; adoption; fidelity; implementation trial; scale up; sustainment

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