of policies and on strategies for achieving effective public policies should be a portion of the nation’s prevention science portfolio.

RESEARCH NEEDS

Implementation and Dissemination Research

An important step prior to implementation should be the availability of effectiveness studies. As more programs have shown efficacy in controlled trials, a next stage in prevention is studies of effectiveness under real-world conditions (Institute of Medicine, 1994). This research focus, often called “type 2 translational” research, occurs after efficacy has been established and focuses on factors associated with the adoption and use of scientifically validated interventions by service systems (Green, 2007). It also includes consideration of maintenance and sustainability issues at the practice level that can be used to guide implementation. In the real world, translation of science-based practices often stumbles, largely unguided, toward uneven, incomplete, and disappointing outcomes.

Translational research explores the factors that influence the quality of implementation; in such studies, implementation quality itself may be the outcome. A developing “science of implementation” (Dane and Schneider, 1998; Durlak, 1998; Domitrovich and Greenberg, 2000) emphasizes the potential to advance the adoption of effective programs and redesign of health systems to ultimately improve health (Madon, Hofman, et al., 2007; Chambers, 2008). There is increasing knowledge regarding a variety of factors that influence implementation quality and recognition that better quality implementation leads to improved outcomes for children (Durlak, Weissberg, et al., 2007).

Translational research related to school-based interventions should focus on a variety of factors: the decision-making process, the curriculum model or policy and the implementation support system, nonprogram factors, such as characteristics of teachers and students, and policies and regulations of school and governmental bodies. For example, a recent community-based study highlighted the interactive influences of high-quality implementation by teachers and level of principal leadership in influencing aggressive behavior in elementary school-age children (Kam, Greenberg, and Wells, 2003). There are at least three conceptual models that may assist in guiding research questions, including those of the National Implementation Research Network (Fixsen, Naoom, et al., 2005), the school ecological model (Greenberg, Domitrovich, et al., 2006), and the REACH model (Glasgow, Klesges, et al., 2004).

In addition, Spoth and Redmond (2002) present a conceptual framework for scaling up preventive interventions and moving from effectiveness to



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement