response to ongoing evaluations over the past 15 years, advances in this area must continue to keep pace with and respond to new knowledge that affects prevention science. The significant rise in interventions with evidence of effectiveness, the importance of implementing interventions with fidelity, and the lack of empirical evidence on how to successfully implement interventions will call for the development of new methodologies to explore various implementation and dissemination strategies (see also Chapter 11). This might include exploration of such questions as implementability, adaptability, extensibility, sustainability, and scalability.

Conclusion: Methodologies to evaluate approaches to implementation and dissemination are less well developed than methodologies related to efficacy and effectiveness.

Other recent research advances, including the results of imaging and other developmental neuroscience studies and findings related to the role of gene–environment interactions (see Chapter 5), provide new challenges and opportunities for intervention research and will require thoughtful consideration of design strategies.

Recommendation 10-2: The National Institutes of Health should be charged with developing methodologies to address major gaps in current prevention science approaches, including the study of dissemination and implementation of successful interventions.

The methodologies developed should include designs to test alternative approaches to implementation and dissemination of evidence-based and community-generated prevention programs (see Chapter 11). Priority areas should also include approaches that link neuroscience methods and clinical research with epidemiology and prevention in understanding the etiology of mental health and of disorders and approaches that link theories developed through neuroscience research with preventive intervention approaches designed to test causal mechanisms (see Chapter 5).

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