Research Priority 3: Implementation, Dissemination, and Equitable Impact
Too often, a gap exists between what is efficacious in well-controlled intervention research and what happens when those interventions are implemented in real-world clinical or community settings. Indeed, studies have shown it takes an average of 17 years13 to implement research results in clinical practice. Our previous strategic plan identified a need for more research designed to answer questions that can facilitate rapid data-driven decisions around the implementation of research and its relevance for policy recommendations. We remain committed to addressing this challenge in our current plan.
Goal 1: Encourage Rigorous and Innovative Implementation and Dissemination Research Methods
OBSSR encourages fully powered studies designed to understand and test mechanisms of action, real-world effectiveness, and implementation strategies in context. We promote research that examines factors influencing the equitable reach, access, adoption, scalability, and sustainability of behavioral and social interventions so that evidence-based applications can have a measurable effect on health outcomes. Research that incorporates dissemination and implementation strategies and frameworks up front can optimize how BSSR is applied in community or social contexts while also informing health services research, quality improvement projects, and policy-driven initiatives.
Innovative research methods that facilitate sustainable adoption include the following:
- Investigations of how innovative technologies might expand the scalability and reach of social and behavioral interventions
- Hybrid implementation/effectiveness designs
- Community engagement science approaches that involve bidirectional learning and dissemination
- Natural experiments that go beyond traditional clinical trials for research evaluating the effects of policy and/or social changes on population health and well-being
- Cost-effectiveness studies to inform policies around implementation
- Health services and health economics research to identify and evaluate systemic, structural, and policy changes
Goal 2: Center Health Equity in Implementation and Dissemination Research
In alignment with leading implementation science scholars and NIH ICO partners, OBSSR recognizes that health equity must be a priority when considering implementation and impact. Ensuring that BSSR findings are applicable to different populations and in diverse environments remains a key OBSSR priority. Challenges can arise when factors related to the implementation and adoption of research findings are not considered in advance. Scaling up interventions while retaining fidelity requires close attention to the types of settings in which they will be implemented. Settings in which behavioral and social interventions are best implemented often fall outside the formal health care system and involve communities, schools, workplaces, and social service providers that lack the resources to ensure quality control. Delays in the adoption and integration of evidence-based behavioral and social science interventions often disproportionally affect under-resourced communities, thus perpetuating health disparities.
Given these concerns, OBSSR’s implementation, dissemination, and impact priorities will benefit from adhering to the tenets of community-based participatory research (CBPR).14 CBPR prioritizes building relationships and partnerships with community organizations or health service providers to facilitate effective dissemination of research and interventions through bidirectional relationships. These partnerships serve as natural avenues for building trust and transparency with research participants. Involving community partners early in the intervention development process also enables investigators to gain an understanding of the contexts for research implementation and to improve dissemination of subsequent findings.
Health researchers and public health officials now recognize that environmental, social, and economic factors are key drivers of health. These SDOH, which include institutional racism and other systemic inequities, drive patterns of morbidity and mortality.15 Therefore, it is incumbent on OBSSR and our NIH ICO partners to formulate ways to better understand risk patterns in underserved and vulnerable populations and to design strategies and interventions that incorporate knowledge gained from studies of SDOH and health outcomes. The OBSSR Director co-chairs the NIH-Wide SDOH Research Coordinating Committee, which is committed to sharing information about SDOH research, developing SDOH expertise and capacity, identifying gaps and promising SDOH research directions, and building community and collaborations across NIH and with federal partners.
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13
Rubin, R. (2023). It takes an average of 17 years for evidence to change practice—the burgeoning field of implementation science seeks to speed things up. JAMA, 329(16), 1333-1336. https://doi.org/10.1001/jama.2023.4387
14
Elwood, W. N., Corrigan, J. G., & Morris, K. A. (2019). NIH-funded CBPR: Self-reported community partner and investigator perspectives. Journal of Community Health, 44(4), 740-748. https://doi.org/10.1007/s10900-019-00661-6
15
National Academies of Sciences, Engineering, and Medicine. (2024). Ending unequal treatment: Strategies to achieve equitable health care and optimal health for all. The National Academies Press. https://doi.org/10.17226/27820
