Historical Roots of Dissemination and Implementation Science

Research about dissemination and implementation (D&I) is a response to a general acknowledgment that successful, effective practices, programs, and policies resulting from clinical and community trials, demonstration projects, and community-based research as conducted by academicians very often do not affect the services that clinical staff, community service providers, and other practitioners fashion and provide to residents, clients, patients, and populations at risk. In any one societal sector (populated, for example, by planners for health care delivery, or city-level transportation and parkway planners), the state of the science (what researchers collectively know) and the state of the art (what practitioners collectively do) co-exist more or less autonomously, each realm of activity having little effect on the other. In the United States, this situation has been referred to as a “quality chasm” by the U.S. Institute of Medicine.12 Dissemination science is the study of how evidence-based practices, programs, and policies can best be communicated to an interorganizational societal sector of potential adopters and implementers to produce uptake and effective use. For example, public middle school nurses in U.S. southern states can comprise a societal sector. This definition means that dissemination embeds the objectives of both external validity, the replication of positive effects across dissimilar settings and conditions, and scale-up, the replication of positive effects across similar settings and conditions.