Preventing Chronic Disease | A Tool for Rating Chronic Disease Prevention and Public H . . .

Bridging the gap between research and practice requires more than evaluating the effectiveness of interventions in controlled studies. To bridge this gap, evidence needs to be defined in different ways, and opportunities need to be provided for practice-based evidence to be replicated and disseminated. Community-based interventions are often not conducted or evaluated in controlled settings, yet they provide more real-world context and have the potential to have a greater effect on population health than findings from controlled studies that are limited in generalizability. The purpose of this article is to describe an approach to identify community-based programs and interventions that have the potential for replication and dissemination. In our study, such interventions met criteria in 3 primary domains: innovativeness, effectiveness, and sustainability. The criteria and tool developed were applied to 2 obesity-prevention programs to demonstrate the usefulness of the tool for identifying potential programs for replication and dissemination, contributing to practice-based evidence. Funders, practitioners, and researchers can apply these criteria to identify programs, environmental changes, or policies that may be replicated and disseminated. Introduction The gap between research and practice in public health has been well documented (1). With calls from the Institute of Medicine, National Institutes of Health, and Centers for Disease Control and Prevention (CDC), public health institutions are attempting to accelerate the path from intervention development and evaluation to dissemination and adoption by practitioners. It has been suggested that it takes 17 years for 14% of original clinical research to reach patients (2). Researchers are pushing the scientific field to redefine evidence in a way that will expedite the process. Historically, public health evidence has been developed on the basis of studies that meet rigorous research standards (eg, experimental designs) (3). Although these studies are important for determining efficacy or effectiveness (internal validity), they often lack consideration of external validity or generalizability and applicability outside of a controlled setting (due to unrepresentative samples and lack of consideration for real-world contextual variables) (4–9). Evaluations of community-based programs that lack internal validity (ie, no control groups) but still have a large effect on a population are often excluded from evidence-based research. Publications of rigorous, less generalizable findings often trump publication of practice-based research that can speed up dissemination so that behavior change can be made. There is a need for greater recognition of “practice-based evidence” where knowledge is derived from real-world settings often via evaluation of natural experiments. This type of evidence addresses the lack of generalizability issue resulting from methodologically strong research designs by producing results that are relevant and applicable to the community (7). Recognizing the need to ensure that more practice-based evidence is recognized as valid and disseminated appropriately, researchers and practitioners have suggested criteria for identifying effective, promising, and emerging intervention strategies ready for dissemination and replication (3,10,11). For example, Glasgow and colleagues Page 1 of 8 Preventing Chronic Disease | A Tool for Rating Chronic Disease Prevention and Public H.