Academic journal article Journal of Marital and Family Therapy

Dissemination and Implementation Research in Marriage and Family Therapy: An Introduction and Call to the Field

Academic journal article Journal of Marital and Family Therapy

Dissemination and Implementation Research in Marriage and Family Therapy: An Introduction and Call to the Field

Article excerpt

DISSEMINATION AND IMPLEMENTATION RESEARCH IN MARRIAGE AND FAMILY THERAPY

There is great concern across the mental health and social service fields that interventions capable of making a critical difference in the lives of individuals, couples, and families are not finding their way into regular practice. Despite billions of dollars invested each year in the United States toward research to promote public health, we are still highly unsuccessful in reaching those in need of evidence-based prevention programs and interventions to improve health (Kazdin & Blase, 2011; Spoth et al., 2013). This process has been compared to a leaky pipeline in which a significant amount of time and information is lost as research findings slowly get funneled down into practice and policy settings (Green, Ottoson, García, & Hiatt, 2009). Finding ways to translate important research results into everyday practice is both a tremendous challenge and a great opportunity that is faced by scholars and practitioners today (Kerner, Rimer, & Emmons, 2005; National Institutes of Health, Department of Health and Human Services, 2015). It is also an issue with great relevance to marriage and family therapy researchers who want their findings to have a meaningful impact on couples and families, practitioners committed to provide current and effective clinical services to their community, and students who deserve to not only be trained in traditional therapy approaches but also innovative and efficacious new models of clinical treatment and intervention delivery.

An important avenue for addressing this "leaky pipeline" and improving the ability of research findings to make a positive impact in the real world is through dissemination and implementation (D&I) research. In the past, intervention research was conceptualized to consist of intervention development, efficacy studies (testing if interventions worked in tightly controlled clinical trials), and then effectiveness research (examining if interventions could demonstrate positive outcomes in community settings; e.g., Onken, Blaine, & Battjes, 1997). For example, couple or family interventions would be developed from behavioral data (e.g., observational data), tested in research labs and community settings, and the results would be published in academic journals and books. The assumption was that tested interventions would then be readily incorporated into everyday practice. Instead, the physical and mental health fields witnessed a growing disconnect between the existence of evidence-based interventions and those who actually received them, which gave rise to the burgeoning field of dissemination and implementation science (Glasgow et al., 2012).

Broadly defined, D&I is the process of moving research findings into everyday practice (NIH, 2015). A key characteristic of D&I research is the goal of bridging the disconnect between clinical research efforts, everyday practice, and public health and wellbeing (NIH, 2015). D&I research represents a paradigm shift away from standard research questions associated with intervention efficacy and effectiveness outcomes. Instead, D&I research investigates if different strategies of sharing information, or ways of delivering an intervention, lead to faster uptake, better program delivery, or better integration of an intervention within a service delivery context (Landsverk et al., 2012). D&I research emphasizes public health impact and is therefore a promising approach for promoting more cost-effective interventions and improving the health and quality of life for individuals and families (Glasgow et al., 2012; Spoth et al., 2013). We will discuss the specific definitions of dissemination and implementation later in this article, but it is important to note they are interrelated yet distinct constructs. Broadly defined, dissemination is how intervention material is distributed to a target audience (e.g., practitioners), whereas implementation is how evidence-based interventions are integrated within a specific setting (NIH, 2015). …

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