Call for Papers on Implementation Science in Pediatric Health Care
Authors: Frederick P. Rivara
Journal: JAMA Pediatrics (2014)

Nooneneedsa reminderof the cost to taxpayers andconsumers forhealth careeachyear, bothhere in theUnitedStates and abroad.Legislators and taxpayers arealso concernedabout the returnon investment inhealth care research, andwhether this investment is furtheringorevenhindering theeffort toachieve 3objectives that are frequently in conflictwith eachother: improving quality, access, and cost-effectiveness. Muchevidencehasaccumulatedover the last coupleofdecades that the timebetweenaccumulationof evidence that an intervention or therapy does or does not work and its incorporation or removal from practice is measured in years if not decades. Simply implementing what we knowworks and desisting from what we know does not would have an enormous impact on health and health care. Investigators, clinicians, administrators, andgovernment agencies have learned that the translationofevidencetopolicyandpractice is far from simple and never assured. A new field of inquiry, implementation science, has developed that recognizes and addresses the multitude of gaps that impede evidence-based interventions fromproducingoptimal health outcomes. These knowledge and practice gaps include: • “Research-to-program”gaps,whichexistwhen researchevidence is not adequately or appropriately considered and integrated in the development of health outcomes. • “Research-to-policy” gaps, which exist when research evidence is not adequately or appropriately considered and integrated in the development of health policy. Implementation science is the study ofmethods to promote the integrationof research findingsandevidence intohealth care policy and practice. It seeks to understand the behavior of health careprofessionals andother stakeholders as a keyvariable in the sustainable uptake, adoption, and implementation of evidence-based practice. It also examines system issues for barriers to implementation and new methods to overcome these. A newer component of this science is starting to focusondeimplementation, thediscontinuanceof things proven not to be effective or safe. JAMAPediatricswill devote an entire issue in spring 2015 to implementation science research in childhealth, both in the United States and abroad, in high-resource aswell as lowand middle-resource countries.Aspediatric carebecomes increasingly focusedonchildren, adolescents, andyoungadultswith chronic illness, who account for the largest part of our health care expenditures, our hospital beds, and our specialty care, implementation research for these children and adolescents is of particular interest. Research on how to implement evidence-based practice is needed at all levels of care: the intensivecareunit, theemergencydepartment, thewards, theclinic, the home, and sites in the community including schools and neighborhoods. Implementationcanbe inall forms: frompractice to policy. We are interested in rigorous studies that test hypotheses about methods to close these gaps, to translate research in those stepsbetweenefficacy trials andpopulationhealth.This will include randomized clinical trials including cluster randomizedclinical trials,adaptiveresearchdesigns,carefullyconducted time series analyses, longitudinal studies, interrupted time series, andqualitative research.Weare interested aswell in cost-effectiveness analyses and systematic reviews on themost effective strategies to changeprofessional behavior; create informed, activated consumers; and guide the behavior of administrators and health care organizations and policy makers. Manuscripts submitted before October 2014 will have the bestchanceofacceptance.Fulldetailsonsubmissionandauthor guidelines are available at http://archpedi.jamanetwork.com.