Abstract
Dissemination efforts must optimize interventions for new settings and populations. As such, dissemination research should
incorporate principles of quality improvement. Comprehensive Dynamic Trial (CDT) designs examine how information gained during
dissemination may be used to modify interventions and improve performance. Although CDT may offer distinct advantages over
static designs, organizing the many necessary roles and activities is a significant challenge. In this article, we discuss
use of the Interactive Systems Framework for Dissemination and Implementation to systematically implement a CDT. Specifically,
we describe “Bronx ACCESS”, a program designed to disseminate evidence-based strategies to promote adherence to mammography
guidelines. In Bronx ACCESS, the Intervention Delivery System will elicit information needed to adapt strategies to specific
settings and circumstances. The Intervention Synthesis and Translation System will use this information to test changes to
strategies through “embedded experiments”. The Intervention Support System will build local capacities found to be necessary
for intervention institutionalization. Simulation modeling will be used to integrate findings across systems. Results will
inform on-going policy debate about interventions needed to promote population-level screening. More generally, this project
is intended to advance understanding of research paradigms necessary to study dissemination.
incorporate principles of quality improvement. Comprehensive Dynamic Trial (CDT) designs examine how information gained during
dissemination may be used to modify interventions and improve performance. Although CDT may offer distinct advantages over
static designs, organizing the many necessary roles and activities is a significant challenge. In this article, we discuss
use of the Interactive Systems Framework for Dissemination and Implementation to systematically implement a CDT. Specifically,
we describe “Bronx ACCESS”, a program designed to disseminate evidence-based strategies to promote adherence to mammography
guidelines. In Bronx ACCESS, the Intervention Delivery System will elicit information needed to adapt strategies to specific
settings and circumstances. The Intervention Synthesis and Translation System will use this information to test changes to
strategies through “embedded experiments”. The Intervention Support System will build local capacities found to be necessary
for intervention institutionalization. Simulation modeling will be used to integrate findings across systems. Results will
inform on-going policy debate about interventions needed to promote population-level screening. More generally, this project
is intended to advance understanding of research paradigms necessary to study dissemination.
- Content Type Journal Article
- Category Original Paper
- Pages 1-21
- DOI 10.1007/s10464-012-9518-6
- Authors
- Bruce D. Rapkin, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA
- Elisa S. Weiss, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA
- David W. Lounsbury, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA
- Hayley S. Thompson, Wayne State University, Detroit, MI, USA
- Robert M. Goodman, Indiana University Bloomington, Bloomington, IN, USA
- Clyde B. Schechter, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA
- Cheryl Merzel, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA
- Rachel C. Shelton, Columbia University, New York, NY, USA
- Arthur E. Blank, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA
- Jennifer Erb-Downward, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA
- Abigail Williams, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA
- Pamela Valera, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 3300 Kossuth Avenue, Bronx, NY 10467, USA
- Deborah K. Padgett, New York University, New York, NY, USA
- Journal American Journal of Community Psychology
- Online ISSN 1573-2770
- Print ISSN 0091-0562