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Disseminating, implementing, scaling, and sustaining proven interventions
Book chapter

Disseminating, implementing, scaling, and sustaining proven interventions

Laura N. Gitlin and Sara J. Czaja
Handbook of Intervention Science: From Design to Implementation, pp 587-617
01 Jan 2025
DOI: https://doi.org/10.1016/B978-0-443-21664-0.00004-0

Abstract

Diffusion Dissemination Implementation Replication Scaling Spread Sustainability Sustainment Value proposition
Bringing an evidence-based program to scale and purposively disseminating, implementing, and sustaining it represents yet another stage in the lifecycle of an intervention. This stage is typically considered the final iterative set of steps for moving an evidence-based intervention into real-world settings to realize its promise for equitable public health impact. Even at this final stage, interventions typically need to be adapted and continuously evaluated to understand their fit with real-world contexts and distinct populations as they are rolled out and scaled with the goal of sustainment. As such, some suggest that this “last” stage and sustainability step is not actually the end of the road but sets off additional steps and activities to maintain implementation as intended and assure continued benefits. The way in which an intervention functions in this complex stage is of great import, yet research in this area is underfunded. Proven interventions that have significant benefits but are not pursued in these steps contribute to research waste. There are also ethical considerations; by not moving effective and acceptable interventions into the public realm, the needs of individuals are not being met. Although in the past 10years, more attention has been devoted to dissemination, our knowledge about the optimal strategies, associated challenges, and outcomes of scaling and sustaining evidence-based programs in different contexts remains limited. This chapter provides an overview of these interlocking steps and examines the implications they present for career pathways and decision-making.

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