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Diffusion, dissemination, and implementation: who should do what?

J Lomas1

  • 1Centre for Health Economics and Policy Analysis, Health Sciences Centre, McMaster University, Hamilton, Ontario, Canada.

Annals of the New York Academy of Sciences
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Summary
This summary is machine-generated.

Research knowledge moves into practice through diffusion, dissemination, and implementation. Each stage requires different skills, with journals aiding diffusion, collaborations aiding dissemination, and local agents driving implementation for sustained behavior change.

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Area of Science:

  • Health Services Research
  • Knowledge Translation
  • Clinical Practice Improvement

Background:

  • Effective translation of research findings into clinical practice is crucial for improving patient outcomes.
  • The distinct stages of knowledge flow into practice are often conflated, hindering targeted interventions.
  • Understanding the process is key to optimizing the adoption of evidence-based medicine.

Purpose of the Study:

  • To differentiate the concepts of diffusion, dissemination, and implementation in research utilization.
  • To propose a staged model for understanding the flow of research information into clinical practice.
  • To identify appropriate agents and skills for each stage of knowledge translation.

Main Methods:

  • Conceptual analysis using a staged model of behavior change.
  • Distinguishing the roles and characteristics of diffusion, dissemination, and implementation.
  • Identifying key actors and their suitability for each stage.

Main Results:

  • Diffusion, dissemination, and implementation are distinct, sequential steps in knowledge translation.
  • Diffusion, often facilitated by biomedical journals, precedes dissemination.
  • Dissemination, supported by academic-medical collaborations, predisposes clinicians to change.
  • Implementation, led by local agents, enables and reinforces practice change.

Conclusions:

  • A staged approach clarifies the process of moving research into practice.
  • Targeted strategies and skills are necessary for each phase: diffusion, dissemination, and implementation.
  • Optimizing knowledge translation requires recognizing the unique contributions of different agents and activities.