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. 2015 Jun 11:10:88.
doi: 10.1186/s13012-015-0274-5.

Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support

Enola Proctor  1 , Douglas Luke  2 , Annaliese Calhoun  3 , Curtis McMillen  4 , Ross Brownson  5 , Stacey McCrary  6 , Margaret Padek  7
Affiliations

Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support

Enola Proctor et al. Implement Sci. .

Abstract

Background: Little is known about how well or under what conditions health innovations are sustained and their gains maintained once they are put into practice. Implementation science typically focuses on uptake by early adopters of one healthcare innovation at a time. The later-stage challenges of scaling up and sustaining evidence-supported interventions receive too little attention. This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work.

Methods: A multi-method, multi-stage approach, was used: (1) identifying and recruiting experts in sustainability as participants, (2) conducting research on sustainability using concept mapping, (3) action planning during an intensive working conference of sustainability experts to expand the concept mapping quantitative results, and (4) consolidating results into a set of recommendations for research, methodological advances, and infrastructure building to advance understanding of sustainability. Participants comprised researchers, funders, and leaders in health, mental health, and public health with shared interest in the sustainability of evidence-based health care.

Results: Prompted to identify important issues for sustainability research, participants generated 91 distinct statements, for which a concept mapping process produced 11 conceptually distinct clusters. During the conference, participants built upon the concept mapping clusters to generate recommendations for sustainability research. The recommendations fell into three domains: (1) pursue high priority research questions as a unified agenda on sustainability; (2) advance methods for sustainability research; (3) advance infrastructure to support sustainability research.

Conclusions: Implementation science needs to pursue later-stage translation research questions required for population impact. Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence about the value of sustaining interventions over time, identifying correlates of sustainability along with strategies for sustaining evidence-supported interventions, advancing the theoretical base and research designs for sustainability research, and advancing the workforce capacity, research culture, and funding mechanisms for this important work.

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Figures

Fig. 1
Fig. 1
Sustainability Research Landscape
See this image and copyright information in PMC

References

    1. McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348(26):2635–45. doi: 10.1056/NEJMsa022615. - DOI - PubMed
    1. Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC. Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 2005;62(6):629–40. doi: 10.1001/archpsyc.62.6.629. - DOI - PubMed
    1. Proctor EK, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):65–76. doi: 10.1007/s10488-010-0319-7. - DOI - PMC - PubMed
    1. Glasgow RE, Chambers D. Developing robust, sustainable, implementation systems using rigorous, rapid, and relevant science. Clin Transl Sci. 2012. In Press - PMC - PubMed
    1. Spoth R, Guyll M, Redmond C, Greenberg M, Feinberg M. Six-year sustainability of evidence-based intervention implementation quality by community-university partnerships: the PROSPER study. Am J Community Psychol. 2011;48:412–25. doi: 10.1007/s10464-011-9430-5. - DOI - PMC - PubMed

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