Translation of Science to Practice and Policy

by

Ross C. Brownson, Lauren Cardick

• LAST REVIEWED: 26 June 2012
• LAST MODIFIED: 26 June 2012
• DOI: 10.1093/obo/9780199756797-0022

Introduction

One of the greatest challenges for public health researchers and practitioners is the translation of knowledge into evidence-based programs and policies. University-based research yields a growing supply of new discoveries, and practitioners, payers, and consumers are eager to benefit from this science. However, clinical and public health research findings are often “lost in translation” for fifteen to twenty years before their incorporation into practice. This translation gap prevents many nations from reaping the benefits of billions of dollars of funds spent on research, and it frustrates researchers and funders who are motivated to improve real-world practice. Over the past several years, much more attention has been paid to translational research in mainline medical and public health journals. Similarly, federal agencies and foundations are beginning to support translational research more fully. For example, recent funding announcements from the US National Institutes of Health show the higher priority being placed on translational research. Similarly, the Canadian Institutes of Health Research has increased its emphasis on funding translational research. This article provides a collection of resources that offer insight into the translation of science to practice and policy, organized into seventeen sections that are designed to highlight the key issues involved in shortening the translation gap.

Introductory Works

Brownson, et al. 2011 covers the evidence base for translating research to practice and policy. Berwick 2008; Institute of Medicine 2007; Khoury, et al. 2007; and Woolf 2008 place translational research (sometimes called dissemination and implementation research) in context. Challenges in translational research are identified by Glasgow and Emmons 2007 and Kerner, et al. 2005. Green, et al 2009 highlights potential approaches for increasing knowledge translation and research utilization. Many of the most important concepts in translational science originated in Rogers 2003, making it a seminal work in this field.

• Berwick, D. 2008. The science of improvement. JAMA 299.10: 1182–1184.

  DOI: 10.1001/jama.299.10.1182

  This article describes four recommended changes in the use of health-care evidence that would speed along improvements in health care and practice: (1) use a range of scientific methodologies, considering both mechanisms and contexts; (2) reconsider thresholds for action on evidence, making incremental changes; (3) reconsider concepts of trust and bias; and (4) engage both academics and patient caregivers with respect.

• Brownson, R. C., E. A. Baker, T. L. Leet, K. N. Gillespie, and W. R. True. 2011. Evidence-based public health. 2d ed. Oxford and New York: Oxford Univ. Press.

  This book reviews the concepts of evidence-based public health and seeks to cover several key issues, including how to identify the lessons learned from successful interventions and apply them to other issues and settings, whether evidence is well established in scientific studies, and how to foster greater political will to support evidence-based decision making.

• Glasgow, R. E., and K. M. Emmons. 2007. How can we increase translation of research into practice? Types of evidence needed. Annual Review of Public Health 28:413–433.

  DOI: 10.1146/annurev.publhealth.28.021406.144145

  Glasgow and Emmons offer a summary and review of what is needed to facilitate more and faster uptake of research. The authors use the RE-AIM model (see Assessing Impact and Scaling Up) and community partnership perspectives to discuss current status and future needs.

• Green, L. W., J. M. Ottoson, C. Garcia, and R. A. Hiatt. 2009. Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annual Review of Public Health 30:151–174.

  DOI: 10.1146/annurev.publhealth.031308.100049

  Authors provide a rigorous review of the public health implications of diffusion, dissemination, and implementation to improve public health practice and guide the design of future research. The article suggests a decentralized approach to dissemination and implementation, as well as ways diffusion may be combined with other theories.

• Institute of Medicine. 2007. The learning healthcare system: Workshop summary. Edited by Leigh Anne Olsen, Dara Aisner, and J. Michael McGinnis. Washington, DC: The National Academies Press.

  This report summarizes the work of Lynn Etheredge and other leaders, describing their concept of need for rapid-learning health-care systems, and the types of research this would involve. These data provide real-time information on thousands (or hundreds of thousands, depending on condition) of patients in real-world settings, and the report discusses how these data can be used for decision making.

• Kerner, J., B. Rimer, and K. Emmons. 2005. Introduction to the special section on dissemination: Dissemination research and research dissemination: How can we close the gap? Health Psychology 24.5: 443–446.

  DOI: 10.1037/0278-6133.24.5.443

  This article highlights the vital importance of disseminating evidence-based interventions into public health practice. It also makes a case for enhanced dissemination research efforts. The journal issue in question is meant to provide a dissemination resource for practitioners that can serve as a baseline for future research.

• Khoury, M. J., M. Gwinn, P. W. Yoon, N. Dowling, C. A. Moore, and L. Bradley. 2007. The continuum of translation research in genomic medicine: How can we accelerate the appropriate integration of human genome discoveries into health care and disease prevention? Genetics in Medicine 9.10: 665–674.

  DOI: 10.1097/GIM.0b013e31815699d0

  This article introduces concepts of T3 and T4 research in this key emerging area of public health genomics. It emphasizes the need to conduct research and programs that lead to better care and have a public health impact.

• Rogers, E. M. 2003. Diffusion of innovations. 5th ed. New York: Free Press.

  Rogers’s classic text on how ideas and opinions diffuse over time through various communication channels and networks. Because many new ideas involve taking a risk, people seek out others who have already adopted it. As a result, the new idea is spread through social networks over a period of weeks, months, or years.

• Woolf, S. H. 2008. The meaning of translational research and why it matters. JAMA 299.2: 211–213.

  DOI: 10.1001/jama.2007.26

  This article is an important contribution, defining the stages of research and the importance of translation from bench to bedside, and from research clinic to population-wide applications. It also calls for research funding to be directed to improving population health outcomes.