Dissemination of Empirically Supported Interventions as a Matter of Social Justice: Using a Public Health Framework to Improve Social Welfare

To the extent that empirically well-supported interventions are not treatment-as-usual or the standard-of-care, disparities and inequities in public health will persist. This paper argues that increasing the dissemination of well-supported interventions so that they approach treatment-as-usual is a matter of social justice. For social and public services there is a special need for translational research to speed up the dissemination of strong interventions given a lag time that can average a generation or more before such services become part of usual treatment. Many dissemination and translation frameworks are considerably oriented toward a diffusion of innovational products in which market supply and demand will abet translation. However, for many public health and social welfare interventions, the outcomes of interventions are public goods rather than private goods that are easily malleable by or directly responsive to economic supply and demand. Market forces may even directly work against knowledge translation for many social interventions, reinforcing or exacerbating existing inequities. These public goods often rely on a wide variety of relatively poorly paid paraprofessional staff that may not be present in marginalized or disadvantaged areas. Moreover, the accessibility of interventions is often much below identified need in a given community, and translational research seeks to gain a sense of the state or degree of translation of a given intervention across the field of need or eligibility for it. Using a public health framework for examining the dissemination of social interventions highlights sectors most in need to which additional intervention resources can be targeted.