Paul Flaspohler

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.

Unpacking prevention capacity: an intersection of research-to-practice models and community-centered models

Capacity is a complex construct that lacks definitional clarity. Little has been done to define capacity, explicate components of capacity, or explore the development of capacity in prevention. This article represents an attempt to operationalize capacity and distinguish among types and levels of capacity as they relate to dissemination and implementation through the use of a taxonomy of capacity. The development of the taxonomy was informed by the capacity literature from two divergent models in the field: research-to-practice (RTP) models and community-centered (CC) models. While these models differ in perspective and focus, both emphasize the importance of capacity to the dissemination and sustainability of prevention innovations. Based on the review of the literature, the taxonomy differentiates the concepts of capacity among two dimensions: level (individual, organizational, and community levels) and type (general capacity and innovation-specific capacity). The proposed taxonomy can aid in understanding the concept of capacity and developing methods to support the implementation and sustainability of prevention efforts in novel settings.

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.

Capacity-Related Innovations Resulting From the Implementation of a Community Collaboration Model for School Improvement

A new genus of district and school improvement models entails partnerships with other organizations and new working relationships with families, community leaders, and youths. The Ohio Community Collaboration Model for School Improvement (OCCMSI) is one such model. It enables partners to leverage family and community resources for learning, healthy development, and overall success in school. This study presents qualitative research findings about the key capacities developed by 6 schools and 6 districts piloting the OCCMSI. Process and product innovations, as well as facilitators and barriers, were tracked as these sites progressed with their implementation efforts. Implications are drawn in relation to how these new and expanded capacities might be prioritized by district and school leaders, consultants, and other professionals involved in partnership-centered models of school improvement.

Advances in Bridging Research and Practice: Introduction to the Second Special Issue on the Interactive System Framework for Dissemination and Implementation

The need for new ways to bridge the gap between research and practice is clear; the use of evidence-based prevention programs and implementation with fidelity in practice are strikingly limited. The Interactive Systems Framework for Dissemination and Implementation (ISF) was created to help bridge research and practice by specifying the systems and processes required to support dissemination and implementation of evidence-based programs, processes, practices, and policies. The ISF identifies three key systems necessary for this process which include the Synthesis and Translation System, the Support System, and the Delivery System. The ISF was featured in a special issue of the American Journal of Community Psychology in 2008. This special issue extends that work by including both researchers who have applied an ISF lens to aspects of their current work and researchers who have proactively applied the ISF in a process that goes across the various systems of the ISF, i.e., Synthesis and Translation, Support, and Delivery. Content areas include: children’s mental health, teen pregnancy prevention, HIV prevention, violence prevention, heart disease and stroke prevention, breast cancer prevention, and substance abuse prevention. In this introductory article, we provide a brief description of the history of the ISF and a summary of the articles in the special issue.

Readiness and School Improvement: Strategies for Enhancing Dissemination and Implementation of Expanded School Mental Health Practices

The primary purpose of this paper is to describe efforts to promote effective dissemination and adoption of an evidence-based school improvement model that incorporates expanded school mental health practices. A systematic readiness and capacity assessment process was used to identify and select pilot schools and school districts for participation in the Ohio Community Collaboration Model for School Improvement (OCCMSI: Anderson-Butcher et al, 2004, in press). In this paper we describe efforts used to incorporate assessment of readiness into selection, training, and implementation of OCCMSI, an evidence-based school improvement initiative. Assessments were used to ensure that pilot sites were ‘ready’ for adoption of the initiative and to promote attention to readiness and capacity as an integral part of the aims of the intervention. Assessments were based on the A-VICTORY model (Davis & Salasin, 1975; Robbins et al, 2003). Results from each readiness assessment were used to inform delivery of training and technical assistance in support of the implementation of the school improvement model. Our experience suggests that ongoing collection of information related to organizational readiness assists in adoption and implementation of effective practices and initiatives.

Supporting Implementation of Expanded School Mental Health Services: Application of the Interactive Systems Framework in Ohio

In this article, we compare and contrast the Multilevel Implementation Quality Framework (Domitrovich et al, 2008, this issue) with other emerging frameworks, theories, and models emerging in health services literature. We describe application of the Interactive Systems Framework for Dissemination and Implementation (ISF) to support strengthening implementation of Expanded School Mental Health Services (ESMH) in Ohio. We argue that participatory framework development presents promise as a means to overcome disciplinary and structural impediments to promoting implementation of ESMH. We describe the process of engaging key stakeholders to explore, understand, and improve implementation of ESMH services, and provide examples of how the process led to improved understanding of dissemination and implementation, and fomented commitment and support for strategies to strengthen implementation of ESMH services across the state.

Engaging youth in bullying prevention through community-based participatory research

Few studies that engage youth in community-based participatory research (CBPR) focus on issues of safety/violence, include elementary school-aged youth, or quantitatively assess outcomes of the CBPR process. This article expands understanding of CBPR with youth by describing and evaluating the outcomes of a project that engaged fifth-grade students at 3 schools in bullying-focused CBPR. Results suggest that the project was associated with decreases in fear of bullying and increases in peer and teacher intervention to stop bullying. We conclude with implications for the engagement of elementary school-aged youth in CBPR to address bullying and other youth issues.

Student, teacher, and classroom predictors of between-teacher variance of students’ teacher-rated behavior.

The current study examined between-teacher variance in teacher ratings of student behavioral and emotional risk to identify student, teacher and classroom characteristics that predict such differences and can be considered in future research and practice. Data were taken from seven elementary schools in one school district implementing universal screening, including 1,241 students rated by 68 teachers. Students were mostly African America (68.5%) with equal gender (female 50.1%) and grade-level distributions. Teachers, mostly White (76.5%) and female (89.7%), completed both a background survey regarding their professional experiences and demographic characteristics and the Behavior Assessment System for Children (Second Edition) Behavioral and Emotional Screening System–Teacher Form for all students in their class, rating an average of 17.69 students each. Extant student data were provided by the district. Analyses followed multilevel linear model stepwise model-building procedures. We detected a significant amount of variance in teachers’ ratings of students’ behavioral and emotional risk at both student and teacher/classroom levels with student predictors explaining about 39% of student-level variance and teacher/classroom predictors explaining about 20% of between-teacher differences. The final model fit the data (Akaike information criterion = 8,687.709; pseudo-R2 = 0.544) significantly better than the null model (Akaike information criterion = 9,457.160). Significant predictors included student gender, race ethnicity, academic performance and disciplinary incidents, teacher gender, student-teacher gender interaction, teacher professional development in behavior screening, and classroom academic performance. Future research and practice should interpret teacher-rated universal screening of students’ behavioral and emotional risk with consideration of the between-teacher variance unrelated to student behavior detected.