Life Stages of an Intervention: A practical approach to spreading good ideas

Public health practitioners recognize the need to use evidence-based interventions. Public health researchers are well aware that evidence-based interventions should be disseminated broadly. But the events occurring between efficacy research and local use are frequently treated as a black box leaving both groups unaware of the impact each of their choices have on the work of the other. To provide a practical framework for discussing improved integration of practice and research, an exploratory review was conducted of the dissemination and implementation literature from multiple disciplines and fields of study. From it, we generated a list of common elements related to the broad stages through which an intervention passes. We will present the Life Stages of an Intervention Framework to stimulate discussion of which practice and research activities should be better integrated within particular stages and to pose important questions as the dialogue ensues about how best to spread good ideas. The practical framework includes stages of discovery, efficacy, effectiveness, implementation research, dissemination and diffusion, adoption, implementation practice and institutionalization. It suggests a very non-linear approach to intervention development, testing, and use acknowledging the varying influences of marketing, organizational systems, and decision-making protocols on intervention adoption. Finally, the framework provides rationale for inclusion of both research and practice at every stage.