Selecting, adapting, and sustaining programs in health care systems.

Area of Science:

• Translational Behavioral Medicine
• Health Services Research
• Implementation Science

Background:

• Behavioral programs often show success in controlled research settings but face challenges in scaling up within healthcare systems.
• Effective program design frequently overlooks the critical planning phase necessary for large-scale implementation.
• Selecting, adapting, and implementing existing programs requires careful consideration of organizational objectives, resources, and costs.

Purpose of the Study:

• To identify key factors for selecting, adapting, and sustaining behavioral programs for scale-up in large healthcare systems.
• To apply the Knowledge to Action (KTA) Framework to illustrate program implementation and evaluation.
• To emphasize the need for translational behavioral medicine to extend successful programs beyond research studies.

Main Methods:

• The study outlines critical factors for program scale-up, adaptation, and sustainability.
• It applies the Knowledge to Action (KTA) Framework as a model for implementation.
• A case study is used to demonstrate knowledge creation and the action cycle of implementation and evaluation.

Main Results:

• Successful scale-up necessitates strategic planning, program selection, and adaptation tailored to organizational contexts.
• The Knowledge to Action (KTA) Framework provides a structured approach for implementation and evaluation.
• Sustaining programs requires ongoing attention to resources, costs, and alignment with healthcare system goals.

Conclusions:

• Translational behavioral medicine requires moving beyond single research studies to implement and sustain programs in real-world healthcare settings.
• Effective scale-up hinges on a systematic approach to program selection, adaptation, and integration within healthcare systems.
• The Knowledge to Action (KTA) Framework offers a valuable model for guiding the implementation and evaluation of behavioral interventions in healthcare.