Dissemination, Implementation, and Widespread Use of Injury Prevention Interventions

Despite the existence of many effective interventions, including those described throughout this handbook, more than 160,000 injury- and violence-related deaths occurred in the United States in 2002 (Centers for Disease Control and Prevention [CDC], 2005). In addition, in 2003, there were nearly 30 million nonfatal injuries requiring emergency department care (CDC, 2005). Too often, science-based interventions existed to prevent these injuries and deaths, but they were not available or were not used by providers and consumers.

This situation is equivalent to developing a life-saving medication but not telling physicians or patients that it is available, not packaging the product for public use, not having skilled pharmacists to dispense the medication, and not providing guidance about the management of its effects. This gap between research and practice, and between discovery and delivery, is large and continues to impede our progress in preventing and controlling injuries and violence (Sleet, Hopkins, & Olson, 2003).

For example, we know that the installation and maintenance of smoke alarms save lives, yet about half of the injuries from residential fi res occur in homes where there are no smoke alarms (Ahrens, 2004). Furthermore, where smoke alarms are installed in homes, 20% are not functional (Smith, 1994). (See more on fi res in Chapter 6.) To save more lives, consumers and providers need information about effective interventions, but more important, they need support for adopting, using, and maintaining interventions over time. For maximum impact, effective interventions require widespread, sustained use.


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  1. Agency for Healthcare Research and Quality. (2003). Diffusion and dissemination of evidence-based cancer control interventions, Summary. Evidence report/technology assessment number 79 (AHRQ Publication No. 03-E032). Retrieved January 20, 2006, from http://www.ahrq.gov/clinic/epcsums/canconsum.htm
  2. Ahrens, M. (2004). U.S. experience with smoke alarms and other fire detection/alarm equipment. Quincy, MA: National Fire Protection AssociationGoogle Scholar
  3. Azocar, F., Cuffel, B. D., Goldman, W., & McCarter, L. (2003). The impact of evidence-based guideline dissemination for the assessment and treatment of major depression in managed behavioral health care organizations. Journal of Behavioral Health Services & Research, 30 (1), 109–118CrossRefGoogle Scholar
  4. Azocar, F., Cuffel, B. D., Goldman, W., & McCulloch, J. (2001). Best practices: Dissemination of guidelines for the treatment of major depression in a managed behavioral health care network. Psychiatric Services, 52(8), 1014–1016PubMedCrossRefGoogle Scholar
  5. Backer, T. E., David, S. L., & Soucy, C. (1995). Reviewing the behavioral science knowledge base on technology transfer. National Institute on Drug Abuse [NIDA], Research Monograph Series, 155 (Pub. No. 95-4035). Retrieved December 20, 2005, from http://www.nida.nih.gov/pdf/monographs/155.pdf
  6. Ballesteros, M. F.Jackson, M. L., & Martin, M. W. (2005). Working towards the elimination of residential fire deaths: CDC’s Smoke Alarm Installation and Fire Safety Education (SAIFE) Program. Journal of Burn Care & Rehabilitation, 26 (5), 434–439CrossRefGoogle Scholar
  7. Battistich, V., Schaps, E., Watson, M., Solomon, D., & Lewis, C. (1996). Prevention effects of the child development project: Early findings from an ongoing multisite demonstration trial. Journal of Adolescent Research, 11, 12–35CrossRefGoogle Scholar
  8. Berwick, D. (2003). Disseminating interventions in health care. Journal of the American Medical Association, 289(15), 1969–1975PubMedCrossRefGoogle Scholar
  9. Blakely, C., Mayer, J., Gottschalk, R., Schmitt, N., Davidson, W., Roitman, D., & Emshoff, J. G. (1987). The fidelity-adaptation debate: Implications for the implementation of public sector social programs. American Journal of Community Psychology, 15, 253–268CrossRefGoogle Scholar
  10. Brink, S. G., Levenson-Gingiss, P., & Gottlieb, N. H. (1991). An evaluation of the effectiveness of a planned diffusion process: The smoke-free class of 2000 project in Texas. Health Education Research, 6(3), 353–362PubMedCrossRefGoogle Scholar
  11. Bryant, H. (1996). Breast cancer screening in Canada: Climbing the diffusion curve. Canadian Journal of Public Health, 87 (Suppl. 2), S60–S62Google Scholar
  12. Canadian Conference on Dissemination Research (1996). Strengthening health promotion and disease prevention. Canadian Journal of Public Health, 87 (Suppl. 2), 27–29Google Scholar
  13. Campbell, D. T., & Stanley, J. C. (1966). Experimental and quasi-experimental designs for research. Chicago: Rand-McNallyGoogle Scholar
  14. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2005). Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. Retrieved August 30, 2005, from http://www.cdc.gov/ncipc/wisqars
  15. Centers for Disease Control and Prevention. Health protection research guide, 2006–2015. (2006). Atlanta: Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry, U.S. Department of Health and Human ServicesGoogle Scholar
  16. Center for the Study and Prevention of Violence. (2005). Blueprints for violence prevention. Retrieved July 1, 2005, from http://www.colorado.edu/cspv/blueprints/index.html
  17. Center for Substance Abuse Prevention. (2001). Finding the balance: Program fidelity and adaptation in substance abuse. Rockville, MD: Substance Abuse and Mental Health Services AdministrationGoogle Scholar
  18. Cook, T. D., & Campbell, D. T. (1979). Quasi-experimentation: Design & analysis issues for field settings. Chicago: Rand-McNallyGoogle Scholar
  19. Dansereau, D. F., & Dees, S. M. (2002). Mapping training: The transfer of a cognitive technology for improving counseling. Journal of Substance Abuse Treatment, 22, 219–230PubMedCrossRefGoogle Scholar
  20. Davis, D. A. (1995). Changing physician performance: A systematic review of the effect of continuing medical education strategies. Journal of the American Medical Association, 274 (9), 700–705PubMedCrossRefGoogle Scholar
  21. Dirksen, C. D., Ament, A. J., & Go, P. M. (1996). Diffusion of six surgical endoscopic procedures in the Netherlands: Stimulating and restraining factors. Health Policy, 37 (2), 91–104PubMedCrossRefGoogle Scholar
  22. Elliott, D. S., & Mihalic, S. (2004). Issues in disseminating and replicating effective prevention programs. Prevention Science, 5(1), 47–53PubMedCrossRefGoogle Scholar
  23. Elliott, S. J., O’Loughlin, J., Robinson, K., Eyles, J., Cameron, R., Harvey, D., Raine, K., & Gelskey, D. (2003). Conceptualizing dissemination research and activity: The case of the Canadian heart health initiative. Health Education & Behavior, 30 (3), 267–282CrossRefGoogle Scholar
  24. Ellis, P., Robinson, P., Ciliska, D., Armour, T., Raina, P., Brouwers, M., O’Brien, M.A., Gould, M., & Baldassarre, F. (2003). Diffusion and dissemination of evidence-based cancer control interventions. Evidence report/technology assessment number 79. (AHRQ Publication No. 03-E033). Rockville, MD: Agency for Healthcare Research and QualityGoogle Scholar
  25. Fielding, J. E., Marks, J. S., Meyers, B. W., Nolan, P. A., Raswon, R. D., & Toomey, K. E. (2002). How do we translate science into public health policy and law? Journal of Law, Medicine, & Ethics, 30 (Suppl. 3), 22–32Google Scholar
  26. Fine, M. J., Stone, R. A., Lave, J. R., Hough, L. J., Obrosky, D. S., Mor, M. K., & Kapoor, W. N. (2003). Implementation of an evidence-based guideline to reduce duration of intravenous antibiotic therapy and length of stay for patients hospitalized with community-acquired pneumonia: A randomized controlled trial. American Journal of Medicine, 115 (5), 343–351PubMedCrossRefGoogle Scholar
  27. Fisher, R. L., & Price, L. L. (1992). An investigation into the social context of early adoption behavior. Journal of Consumer Research, 19, 477–487CrossRefGoogle Scholar
  28. Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A review (FMHI Publication #231). Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, the National Implementation Research NetworkGoogle Scholar
  29. Foshee, V., Bauman, S., Ennett, S., Linder, G., Benefield, T., & Suchindran, C. (2004). Assessing the long-term effects of the Safe Dates program and a booster in preventing and reducing adolescent dating violence victimization and perpetration. American Journal of Public Health, 94, 619–624PubMedCrossRefGoogle Scholar
  30. Frambach, R. T., & Schillewaert, N. (2002). Organizational innovation adoption: A multi-level framework of determinants and opportunities for future research. Journal of Business Research, 55, 163–176CrossRefGoogle Scholar
  31. Fuchs, D., & Fuchs, L. (1989). Exploring effective and efficient preferential interventions: A component analysis of behavioral consultation. School Psychology Review, 18, 260–283Google Scholar
  32. Gielen, A. C., Sleet, D. A., & Green, L. W. (2006). Community models and approaches for interventions. In A. C. Gielen, D. A. Sleet, & R. J. DiClemente (Eds). Injury and violence prevention: Behavioral science theories, methods, and applications (pp. 65–82). San Francisco: Jossey-BassGoogle Scholar
  33. Gillespie, L. D., Gillespie, W. J., Robertson, M. C., Lamb, S. E., Cumming, R. G., & Rowe, B. H. (2004). Interventions for preventing falls in elderly people (Cochrane Review). In The Cochrane Library, Issue 3. Chichester, UK: John Wiley & Sons, LtdGoogle Scholar
  34. Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93 (8), 1261–1267PubMedCrossRefGoogle Scholar
  35. Gottfredson, D. (2001). Schools and delinquency. Cambridge, UK: Cambridge University PressGoogle Scholar
  36. Gray, D., Emshoff, J., Jakes, S., & Blakely, C. (2000). ESID and dissemination research: A case study and critique of a change model’s fidelity. College Station, TX: Texas A&M UniversityGoogle Scholar
  37. Green, L. W., & Johnson, J. L. (1996). Dissemination and utilization of health promotion and disease prevention knowledge: Theory, research, and experience. Canadian Journal of Public Health, 87 (Suppl.), S12–S17Google Scholar
  38. Green, L. W. (2004). From evidence-based practice to practice-based evidence: The role of participatory research. Keynote address, 21st Annual Oregon Rural Health Conference, Portland, OregonGoogle Scholar
  39. Greenhalgh, T., Robert, G., MacFarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Quaterly, 82 (4), 581–629CrossRefGoogle Scholar
  40. Grunfeld, E., Zitzelsberger, L., Evans, W. K., Cameron, R., Hayter, C., Berman, N., & Stern, H. (2004). Better knowledge translation for effective cancer control: A priority for action. Cancer Causes & Control, 15, 503–510CrossRefGoogle Scholar
  41. Howat, P., Sleet, D. A., Elder, R., & Maycock, B. (2004). Preventing alcohol-related traffic injury: A health promotion approach. Traffic Injury Prevention, 5 (3), 208–219PubMedCrossRefGoogle Scholar
  42. Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy PressGoogle Scholar
  43. Kelly, J. A., Sogolow, E. D., & Neumann, M. S. (2000). Future directions and emerging issues in technology transfer between HIV prevention researchers and community-based service providers. Turning HIV prevention research into practice. AIDS Education and Prevention, 12 (Suppl. 5), 126–141PubMedGoogle Scholar
  44. Kerner, J., Rimer, B., & Emmons, K. (2005). Dissemination research and research dissemination: How can we close the gap? [Introduction to special section]. Health Psychology, 24 (5), 443–500PubMedCrossRefGoogle Scholar
  45. King, L., Hawe, P., & Wise, M. (1996). From research into practice in health promotion: A review of the literature on dissemination. Sydney, Australia: National Center for Heath PromotionGoogle Scholar
  46. Knox, K. L., Litts, D. A., Talcott, G. W., Feig, J. C., & Caine, E. D. (2004). Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the U.S. Air Force: Cohort study. British Medical Journal, 327, 1379–1380Google Scholar
  47. Kok, G., & Green, L. W. (1990). Research to support health promotion in practice: A plea for increased cooperation. Health Promotion International, 5, 173–179CrossRefGoogle Scholar
  48. Kotier, P. (1998). Marketing management, analysis, planning, implementation, and control. Englewood Cliffs, NJ: Prentice-HallGoogle Scholar
  49. Kraft, J. M., Mezoff, J. S., Sogolow, E. D., Neumann, M. S., & Thomas, P. A. (2000). A technology transfer model for effective HIV/AIDS interventions: Science and practice. AIDS Education and Prevention, 12 (Suppl. A), 7–20PubMedGoogle Scholar
  50. Lenfant, C. (2003). Clinical research to clinical practice—lost in translation? New England Journal of Medicine, 9(9), 868–874CrossRefGoogle Scholar
  51. Mansfield, E. (1993). The diffusion of flexible manufacturing systems in Japan, Europe, and the United States. Management Science, 39, 149–159CrossRefGoogle Scholar
  52. Marshall, J. G. (1990). Diffusion of innovation theory and end-user searching. Library & Information Science Research, 6 (1), 55–69Google Scholar
  53. McGuire, A. (2005). To burn or not to burn: An advocate’s report from the field. Injury Prevention, 11, 264–266PubMedCrossRefGoogle Scholar
  54. Mercy, J. A., Rosenberg, M. L., Powell, K. E., Boome, C. V., Roper, W. L. (1993). Public health policy for preventing violence. Health Affairs, 12 (4), 7–29PubMedCrossRefGoogle Scholar
  55. Meyer, M., Johnson, D., & Ethington, C. (1997). Contrasting attributes of preventive health innovations. Journal of Communication, 47, 112–131CrossRefGoogle Scholar
  56. Michie, S., Johnston, M., Abraham, C., Lawton, R., Parkter, D., & Walker, A. on behalf of the “Psychological Theory” group (2005). Making psychological theory useful for implementing evidence based practice: a consensus approach. Quality & Safety in Health Care (14), 26–33Google Scholar
  57. Mulrow, C. D., Langhorne, P., & Grimshaw, J. (1997). Integrating heterogeneous pieces of evidence in systemic reviews. Annals of Internal Medicine, 127, 989–995PubMedGoogle Scholar
  58. National Center for Injury Prevention and Control (NCIPC). (2002). CDC injury research agenda. Atlanta, GA: Centers for Disease Control and Prevention. (http://www.cdc.gov/ncipc/pub-res/research_agenda/agenda.htm)Google Scholar
  59. National Highway Traffic Safety Association (NHTSA) (2006). Traffice Safety Facts. Motorcycles. National Center for Statistics and Analysis, Washington, D.C.: US Department of TransportationGoogle Scholar
  60. National Institute of Mental Health. (1999). Translating behavioral science into action. Report of the National Advisory Mental Health Council Behavioral Science Workgroup. Final Report. Bethesda, MD: National Institutes of HealthGoogle Scholar
  61. National Institute of Mental Health. (2005). Program announcement on dissemination and implementation research in mental health. (PA#02–131& PA#99–068). Bethesda, MD: National Institutes of HealthGoogle Scholar
  62. Nguyen, M-N., Gauvin, L., Martineau, I., & Grignon, R. (2005). Sustainability of the impact of a public health intervention: Lessons learned from the Laval Walking Clubs Experience. Health Promotion Practice, 6(1), 44–52PubMedCrossRefGoogle Scholar
  63. Oldenburg, B., Hardcastle, D. M., & Kok, G. (1997). Diffusion of innovation. In K. Glanz, F.M. Lewis, & B. K. Rimer (Eds.), Health behavior and health education (pp. 270–286). San Francisco: Jossey-BassGoogle Scholar
  64. Oldenburg, B. F., Sallis, J. F., French, M. L., & Owen, N. (1999). Health promotion research and the diffusion and institutionalization of interventions. Health Education Research, 14 (1), 121–130PubMedCrossRefGoogle Scholar
  65. Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C. R., Jr., Ng, R. K., Sheff, K. L., Korfmacher, J., Hiatt, S., & Talmi, A. (2002). Home visiting by paraprofessionals and by nurses: A randomized control trial. Pediatrics, 110 (3), 486–496PubMedCrossRefGoogle Scholar
  66. Parcel, G. S., Taylor, W. C., Brink, S. G., Gottlieb, N., Engquist, K., O’Hara, N. M., & Eriksen, M. (1989). Translating theory into practice: Intervention strategies for the diffusion of a health promotion innovation. Family & Community Health, 12 (3), 1–13Google Scholar
  67. President’s Cancer Panel. (2005). Translating research into cancer care: Delivering on the promise. 2004–2005 annual report. Bethesda, MD: National Cancer Institute, National Institutes of HealthGoogle Scholar
  68. Preston, M. A., Baranowski, T., & Higginbotham, J. C. (1988). Orchestrating the points of community intervention: Enhancing the diffusion process. International Quarterly of Community Health Education, 9(1), 11–34PubMedGoogle Scholar
  69. Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change in smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, (51), 390–395Google Scholar
  70. Quan, L., & Gomez, A. (1990). Swimming pool safety: An effective submersion prevention program. Journal of Environmental Health, 52 (6), 344–346Google Scholar
  71. Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York, Simon & SchusterGoogle Scholar
  72. Shaw, F. E., & Ogolla, C. P. (2006). Law, behavior, and injury prevention. In A. C. Gielen, D. A. Sleet, & R. J. DiClemente (Eds.), Injury and violence prevention: Behavioral science theories, methods and applications (pp 442–466). San Francisco: Jossey-BassGoogle Scholar
  73. Sleet, D. A., Hopkins, K. N., & Olson, S. J. (2003). From discovery to delivery: Injury prevention at CDC. Health Promotion Practice, 4 (2), 98–102PubMedCrossRefGoogle Scholar
  74. Sleet, D. A., & Sogolow, E. (2004). Translation from science to practice: An essential link in injury prevention. Presentation to the New South Wales Health Department, Sydney, AustraliaGoogle Scholar
  75. Solarz, A. L. (2001). Investing in children, families, and communities: Challenges for an interdivisional public policy collaboration. American Journal of Community Psychology, 29 (1), 1–14PubMedCrossRefGoogle Scholar
  76. Smith, C. (1994). Smoke detector operability survey-report on findings. Bethesda, MD: U.S. Consumer Product Safety CommissionGoogle Scholar
  77. Sogolow, E., Kay, L., Doll, L., Neumann, M. S., Mezoff, J., Eke, A., Semaan, S., & Anderson, J. R. (2000). Strengthening HIV prevention: Application of a research-to-practice framework. AIDS Education and Prevention, 12 (Suppl. A), S21–32Google Scholar
  78. Southern California Evidence-Based Practice Center. (2003). Evidence report and evidence-based recommendations: Fall prevention interventions in the Medicare population. Rand Report. (Contract No. 500-98-281)Google Scholar
  79. Substance Abuse and Mental Health Services Administration. (2005). SAMHSA model programs: SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP). Retrieved July 1, 2005, from http://www.modelprograms.samhsa.gov
  80. Svanstrom, L., Boleslav, J., & Grivna, M. (2004). Sustainability within safe communities. Prague: Centrum Urazove PrevenceGoogle Scholar
  81. Valdiserri, R. O. (1996). Managing system-wide change in HIV prevention programs: A CDC perspective. Public Administration & Review, 56 (6), 545–553CrossRefGoogle Scholar
  82. Wandersman, A., Imm, P., Chinman, M., & Kafterian, S. (2000). Getting to outcomes: A results-based approach to accountability. Evaluation and Program Planning, 23 (3), 389–395CrossRefGoogle Scholar
  83. Wortman, P. M. (1983). Evaluation research: A methodological perspective. Annual Review Psychology, 34, 223–260CrossRefGoogle Scholar
  84. Zapka, J., Goins, K. V., Pbert, L., & Ockene, J. K. (2004). Translating efficacy research to effectiveness studies in practice: Lessons from research to promote smoking cessation in community health centers. Health Promotion Practice, 5 (3), 245–255PubMedCrossRefGoogle Scholar
  85. Zaza, S., Briss, P., & Harris, K. (Eds). (2005). The guide to community preventive services: What works to promote health? New York: Oxford University PressGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Home and Recreation TeamCDC National Center for Injury Prevention and ControlAtlanta
  2. 2.Division of Unintentional Injury PreventionCDC National Center for Injury Prevention and ControlAtlanta
  3. 3.Research Synthesis and Application TeamCDC National Center for Injury Prevention and ControlAtlanta

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