Advancing the Science of Public Health Practice: Using PBRNs for Implementation Research

OBJECTIVES: Prior studies have found evidence of wide variation in public health practices across communities despite an expanding evidence base of efficacious interventions. Existing research on dissemination and implementation processes in health has focused on clinical practice settings with relatively little attention paid to public health settings – where research is made more difficult by wide heterogeneity in settings and limited measures. This study examines the research designs and methods employed by five Public Health Practice-Based Research Networks (PH-PBRNs) to elucidate processes influencing the implementation of evidence-based practices (EBPs) within diverse public health settings. DATA: Each PH-PBRN network includes a collection of state and local public health agencies collaborating with an academic research center to design and conduct comparative studies of public health strategies using participatory approaches. Data for this panel were collected through a survey of PBRN participants during 2010, which were linked with secondary data from NACCHO, the Census Bureau, and the Area Resource File. ANALYSIS: PH-PBRN research networks employ quasi-experimental research designs, natural experiments, and mixed-method analytic techniques to evaluate how community partnerships, economic shocks, and policy changes impact EBP implementation in public health settings. Additionally, network analysis methods are used to assess how the PH-PBRN networks themselves function as mechanisms for influencing dissemination and implementation processes. FINDINGS: Findings from individual PH-PBRN studies elucidate the roles of information exchange, community resources, and leadership and decision-making structures in shaping implementation outcomes in public health. Network analysis reveals that the density and centrality of research networks vary by more than 60% and that practitioners in the periphery of their networks report significantly larger benefits from research participation (p<0.05). CONCLUSIONS: PH-PBRN networks not only provide structures for implementation research, but also serve as vehicles for accelerating the translation and implementation of research findings in public health settings.