Translation science and context

Evidence-based health care practices are available for a number of conditions such as asthma, smoking cessation, heart failure, and management of diabetes. However, these practices are not routinely implemented in care delivery and variations in practices abound. Implementing evidence-based practices (EBPs) is challenging, and difficulties implementing evidence may be largely explained by contextual factors. Thus, strategies are needed that address the complexity and systems of care, individual practitioners, senior leadership, and ultimately changing health care cultures to promote an evidence-based practice environment. To advance knowledge about promoting and sustaining adoption of EBPs in health care, translation science needs more studies that test translating research into practice (TRIP) interventions; studies are needed that investigate what TRIP interventions work, for whom, in what circumstances, in what types of settings, and studies that explain the underlying mechanisms of effective TRIP interventions. According to the Translation Research Model, adoption of innovations, such as EBPs, are influenced by the nature of the innovation (e.g., the type and strength of evidence; the clinical topic), and the manner in which it is communicated (disseminated) to members (e.g., physicians, nurses) of a social system (organization, nursing profession). This article discusses the importance of context in translation using this framework as a guide.