The quip about toothbrushes and dissemination and implementation (D&I) science theories still makes Russell Glasgow, PhD, research professor at the University of Colorado Anschutz School of Medicine and director of the D&I core at the Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS) chuckle: “Theories in D&I are like toothbrushes; everybody has one, and no one wants to use anybody else’s.”
It’s an apt analogy for a field where more than 150 D&I theories, models, and frameworks (TMFs) have been identified. But it also speaks to the challenges faced by researchers trying to determine which TMFs to use in a specific research project, which is what led Glasgow to collaborate with colleagues across multiple institutions to develop a webtool guiding people through the process of selecting and adapting one or more TMFs for a project. A recent publication summarizes the webtool, its uses, and evolution over the past ten years.
Originally released in 2014 and refined using human-centered design and user feedback, the webtool gradually expanded over the years to include more than 110 D&I TMFs and new thematic content areas, including guidance and examples.
Today, the webtool is a robust resource widely used not only by local health services researchers but by their counterparts across the nation and the globe. In addition to its interactive and ever-evolving features, the webtool is available for free to support the thoughtful use of D&I TMFs across all phases of research and practice.
“Early-stage investigators, experienced researchers, people who want to know more about D&I science, teams that might want to use it for multidisciplinary research – all these people can benefit from using the webtool, which can help demystify some aspects of D&I science,” Glasgow explains.
How D&I TMF webtool works
By addressing a significant gap in D&I infrastructure and guiding users in selecting and operationalizing D&I TMFs, the webtool ultimately supports more rigorous, context-sensitive translational research and practice. The webtool’s features include logic model development, D&I TMF selection and comparisons, guidance on combining and adapting models, strategies for application, and links to assessment tools.
It works like this: When someone visits the website, they can either complete a planning exercise that takes them through identifying key constructs, or they can opt to enter directly the ones they want to use. An algorithm then searches 110 different websites covering various D&I TMFs before returning results to the user, ranked in order of those containing the most matches with the chosen constructs.
While there is rarely one perfect TMF for a research project, the webtool developed by Glasgow and his colleagues provides a starting set of TMFs to work with; that is, the tool is not going to provide a researcher with the answer, but it will tell them where they might want to go in more detail.
It’s not only the first tool of its kind to offer researchers an option like this in D&I; it is more comprehensive and frequently updated than other related guidance and acts more efficiently for researchers looking to explore diverse frameworks and integrate them into research projects.
Improving use of D&I frameworks in the scientific literature and pragmatic research
Over time, it became clear to Glasgow and his colleagues that the webtool could be used to usher researchers through TMF adaptations and strategies for applications. Now, the tool provides guidance on how best to combine, modify, or adapt TMFs. “We realized that often what you need to do is to adapt the framework,” notes Glasgow.
In response to this new understanding around adapting TMFs, the creators of the webtool added a feature guiding users through considerations about how they plan to use the framework throughout their study, as well as when reporting on the outcomes in the recent publication.
Glasgow hopes this newer feature will ultimately improve use of TMFs in the scientific literature. “What happens is a lot of people will say in their study’s introduction, ‘I’m using this specific framework,’ but then do not report how they’re using it, or they don’t use it consistently.” When researchers reference a TMF in their introduction but don’t refer to it when describing their methods or results or how they used the theory, it leads to gaps in understanding – gaps this webtool attempts to help close.
Expanding the webtool’s assessment resources
In addition to enhancing the literature, the webtool offers options for different assessments, like surveys, guidance and information on conducting interviews and focus groups, and suggestions on performing observations. A new section on assessments related to various TMFs, as well as characteristics of these different assessments, is designed to facilitate linkage of a TMF to measures of its use.
The webtool can be used in a variety of ways. While the website is used in academic coursework (for example, in D&I workshops and the D&I Graduate Certificate offered through ACCORDS), it has also been utilized in a variety of other ways, including connecting assessments to theories in research projects, during consultations with mentees and research teams, and for creating logic models to lay out a project from the initial problem to planned activities and anticipated outcomes.
Creation through collaboration among D&I researchers
While touting the tool’s features and benefits for health services researchers, Glasgow also credits its success to the multi-institutional partnerships that led to its creation in the first place, starting with a collaborative conversation with a colleague, Borsika Rabin, PhD, MPH, PharmD.
“We got together to try and address one of the most common, challenging, and confusing questions people have when they start looking at D&I science, which is what theory or framework should I use,” Glasgow explains. It’s a common challenge and one that many people struggle with, and Glasgow and Rabin thought if there were resources available, it would make things less overwhelming.
In addition to the webtool’s primary developer Rabin, who is now based at the University of California in San Diego (UCSD), and Glasgow, key collaborators in the creation of the webtool included Ross Brownson, PhD, distinguished professor and director of the Prevention Resource Center, and Rachel Tabak, PhD, RD, associate professor at Washington University in St. Louis; and ACCORDS research professionals Bryan Ford, MPH, and Rebekah Gomes, MA. Much of the work was funded by the National Cancer Institute along with the multi-institutional partners, including volunteer time, with special investments from the University of Colorado Anschutz School of Medicine. Collaboration among the three institutions made the webtool's achievement a shared success.
