Keri Lubell

Bridging the Gap Between Prevention Research and Practice: The Interactive Systems Framework for Dissemination and Implementation

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 supplement 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 Implementation (ISF) that uses aspects of research to practice models and of community-centered models. The framework 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.

Seeking help from the internet during adolescence.

OBJECTIVE To assess the prevalence and demographic and psychological correlates of Internet use as a help-seeking resource for emotional problems in a community sample of adolescents. METHOD A self-report survey was completed by 9th-through 12th-grade students ( = 519) enrolled in health courses in six New York State high schools in the fall/winter of 1999. The relationship between Internet help-seeking behavior and demographic characteristics, hopelessness, functional impairment, and use of various treatment services was examined. RESULTS Nearly one fifth (18.2%) of the adolescents sought help on the Internet for emotional problems in the previous year. The proportions of males and females seeking help on the Internet did not significantly differ (15.6% and 20.8%, respectively). Internet help-seekers were significantly more likely than non-help-seekers to score above the clinical threshold on the Columbia Impairment Scale (34% versus 20.6%; chi(2)(1) = 7.4, <.01) or Beck Depression Inventory (16.1% versus 9.1%; chi(2)(1) = 3.8, <.05). These at-risk youths tended to combine Internet help-seeking with other sources of help, rather than substituting it for other resources. More than 20% of Internet help-seekers were dissatisfied with the help they received, and only 14% thought it had helped them very much. CONCLUSIONS For the Internet to realize its potential as an effective resource for teenagers struggling with emotional problems, further development is needed.

Novel pandemic A (H1N1) influenza vaccination among pregnant women: motivators and barriers

We sought to examine motivators and barriers related to monovalent 2009 influenza A (H1N1) vaccination among pregnant women. We conducted a national poll of pregnant women using a random online sample (237) and opt-in supplement (277). In all, 42% of pregnant women reported getting the vaccine. Vaccination was positively associated with attitudinal factors including believing the vaccine is very safe or benefits the baby, and with provider recommendations. Women in racial/ethnic minority groups, women with less education, and women <35 years were less likely to get the vaccine and had differing views and experiences. Despite H1N1 vaccination rates that are higher than past seasonal influenza rates, barriers like safety concerns may persist in a pandemic. Messaging from providers that encourages women to believe the vaccine is very safe and benefits their baby may be compelling. Messaging and outreach during future pandemics may require customization to increase vaccination among high-risk groups.

Bridging Science and Practice in Violence Prevention: Addressing Ten Key Challenges

This article illustrates ideas for bridging science and practice generated during the Division of Violence Prevention’s (DVP) dissemination/implementation planning process. The difficulty of moving what is known about what works into broader use is near universal, and this planning process pushed us to look beyond the common explanations (e.g., providers were resistant/unwilling to change practice) and think about the multiple layers and systems involved. As part of this planning process, the Interactive Systems Framework for Dissemination and Implementation (ISF) was developed and then applied to the fields of child maltreatment and youth violence prevention. Challenges for each of the three systems in the ISF are discussed as well as and action and research ideas to address the challenges. Also described are actions taken by DVP in response to the planning process to illustrate how a funder can use the ISF to bridge science and practice.

Research and Action for Bridging Science and Practice in Prevention

There is a well-known gap between science and practice. To address this gap in the areas of Child Maltreatment (CM) and Youth Violence (Y/V), the Division of Violence Prevention (DVP) at the Centers for Disease Control and Prevention (CDC) embarked on a Dissemination/Implementation (D/I) planning project. The project was aimed at identifying better ways to connect research and practice through reviews of the literature as well as through discussions with experts on violence prevention and research utilization. This introductory article sets the stage for the rest of the special issue by defining terms, providing a rationale for the planning project, describing the planning process, and summarizing what is to come in the rest of the issue.

The Garrett Lee Smith Memorial Suicide Prevention Program

In response to calls for greater efforts to reduce youth suicide, the Garrett Lee Smith (GLS) Memorial Act has provided funding for 68 state, territory, and tribal community grants, and 74 college campus grants for suicide prevention efforts. Suicide prevention activities supported by GLS grantees have included education, training programs (including gatekeeper training), screening activities, infrastructure for improved linkages to services, crisis hotlines, and community partnerships. Through participation in both local- and cross-site evaluations, GLS grantees are generating data regarding the local context, proximal outcomes, and implementation of programs, as well as opportunities for improvement of suicide prevention efforts.

Adoption of preventive behaviors in response to the 2009 H1N1 influenza pandemic: a multiethnic perspective

As public health leaders prepare for possible future influenza pandemics, the rapid spread of 2009 H1N1 influenza highlights the need to focus on measures the public can adopt to help slow disease transmission. Such measures may relate to hygiene (e.g., hand washing), social distancing (e.g., avoiding places where many people gather), and pharmaceutical interventions (e.g., vaccination). Given the disproportionate impact of public health emergencies on minority communities in the United States, it is important to understand whether there are differences in acceptance across racial/ethnic groups that could lead to targeted and more effective policies and communications.

Crisis and emergency risk messaging in mass media news stories: is the public getting the information they need to protect their health?

ABSTRACT The mass media provide an important channel for delivering crisis and emergency risk information to the public. We conducted a content analysis of 369 newspaper and television broadcast stories covering natural disaster and foodborne outbreak events and coded for seven best practices in crisis and emergency risk messaging. On average, slightly less than two (1.86) of the seven best practices were included in each story. The proportion of stories including individual best practices ranged from 4.6% for “expressing empathy” to 83.7% for “explaining what is known” about the event’s impact to human health. Each of the other five best practices appeared in less than 25% of stories. These results suggest much of the risk messaging the public receives via mass media does not follow best practices for effective crisis and emergency communication, potentially compromising public understanding and actions in response to events.

Frequency of Risk-Related News Media Messages in 2016 Coverage of Zika Virus: Risk-Related News Media Messages about Zika

News media plays a large role in the information the public receives during an infectious disease outbreak, and may influence public knowledge and perceptions of risk. This study analyzed and described the content of U.S. news media coverage of Zika virus and Zika response during 2016. A random selection of 800 Zika-related news stories from 25 print and television news sources was analyzed. The study examined 24 different messages that appeared in news media articles and characterized them using theories of risk perception as messages with characteristics that could increase perception of risk (risk-elevating messages; n = 14), messages that could decrease perception of risk (risk-minimizing messages; n = 8), or messages about travel or testing guidance (n = 2). Overall, 96% of news stories in the study sample contained at least one or more risk-elevating message(s) and 61% contained risk-minimizing message(s). The frequency of many messages changed after local transmission was confirmed in Florida, and differed between sources in locations with or without local transmission in 2016. Forty percent of news stories included messages about negative potential outcomes of Zika virus infection without mentioning ways to reduce risk. Findings from this study may help inform current federal, state, and local Zika responses by offering a detailed analysis of how news media are covering the outbreak and response activities as well as identifying specific messages appearing more or less frequently than intended. Findings identifying the types of messages that require greater emphasis may also assist public health communicators in responding more effectively to future outbreaks.

A Conceptual Model for Evaluating Emergency Risk Communication in Public Health.

Public health threats, such as emerging infectious diseases, terrorism, environmental catastrophes, and natural disasters, all require effective communication. Emergency risk communication is a critical component of public health emergency planning and response. It is a complex process involving a variety of constructs that interact in dynamic ways over time. While emergency risk communication is generally recognized as an important tool for risk management and emergency response, the specific elements, processes, and outcomes are not well described and have not been systematically assessed. In this article, we describe a conceptual model for public health developed in collaboration with the Centers for Disease Control and Prevention (CDC). We propose using this model to inform practice and to guide evaluations of emergency risk communication. The model was informed by an extensive review of the emergency risk communication literature, interviews with researchers, and discussions with CDC stakeholders. This model can be adapted for a wide range of emergency events and incorporates key constructs to assess internal processes, as well as outcomes of emergency risk communication on audiences. Evaluating internal processes can help identify and correct messaging deficiencies. Outcome constructs describe expected target audience responses to emergency risk communication, such as changes in knowledge, attitudes, beliefs, and behaviors that may occur over time. This can help public health communicators learn how their various activities contribute to emergency risk communication outcomes.