DISSEMINATION AND IMPLEMENTATION RESEARCH IN MENTAL HEALTH – ADDENDUM TO 
PA-02-131

Release Date:  August 14, 2002

NOTICE NUMBER:  NOT-MH-02-009

National Institute of Mental Health (NIMH)
 (http://www.nimh.nih.gov)

This notice is an addendum to program announcement PA-02-131, 
(http://grants.nih.gov/grants/guide/pa-files/PA-02-131.html), which was 
released in the NIH Guide for Grants and Contracts on July 19, 2002.  PA-02-131 
supports work around the development of conceptualizations of dissemination and 
implementation that are applicable across diverse practice settings, and the 
design of studies that will accurately assess the outcomes of dissemination and 
implementation efforts.

PURPOSE

The purpose of this addendum is to clarify the specific terms used within the 
announcement to reinforce the research areas appropriate for funding 
consideration by the NIMH (see RESEARCH OBJECTIVES), and to note a correction to 
the Grants Management contact (see INQUIRIES).

RESEARCH OBJECTIVES

For the purpose of this PA, a distinction is made between the terms 
"dissemination" and "implementation."

o  Dissemination is the targeted distribution of information to a specific 
audience.  The intent is to spread knowledge, in this case about mental illness 
and the associated evidence-based interventions.

o  Implementation is the use of strategies to introduce or adapt evidence-based 
mental health interventions within specific settings.

Dissemination Research

Critical information is currently lacking about how, when, by whom, and under 
what circumstances research evidence spreads throughout the agencies, 
organizations, and front line workers providing mental health services.  As a 
necessary prerequisite for determining how information can lead to treatment or 
service changes, there is a need to understand how and why information on mental 
health treatments may or may not reach many different stakeholders.  There is 
also a need to understand what underlies the creation, transmission, and 
reception of information on evidence-based psychopharmacological and 
psychosocial interventions.  Successful dissemination of mental health 
information (including information about underutilized interventions) may occur 
quite differently depending upon whether the audience consists of consumers, 
caregivers, practitioners, policymakers, employers, administrators, or another 
stakeholder group.  Theory-driven research is needed that will identify 
mechanisms and approaches to package and convey the evidence-based information 
necessary to improve care.

Implementation Research

Previous efforts in dissemination research have often assumed that interventions 
can be transferred into any service setting without modification and that a 
unidirectional flow of information (e.g., publishing a guideline) is enough to 
achieve practice change.  "Success" of the transfer has been largely assessed 
based on structural measures (such as counts of personnel or contacts) or 
patient outcome measures that do not specifically assess how the intervention 
was implemented or whether the implementation remained faithful to the original 
conceptualization and intent of the intervention.  Development of a knowledge 
base about "how" interventions are transported to real-world practice settings 
is needed, which is likely to require more than the dissemination of information 
about the interventions.  This research announcement encourages theory-driven 
research to develop conceptual frameworks around implementation (processes that 
emphasize the constraints of resources in local care settings and needs of 
stakeholders).

Dissemination and implementation research must be interdisciplinary, and must 
utilize theories, empirical findings, and methods from a variety of fields not 
traditionally associated with mental health research.  Some examples of such 
fields are: information science, clinical decision-making, organizational theory, 
finance, strategic and behavioral change, anthropology, learning theory, and 
marketing.  Research plan must include collaboration with stakeholders from 
multiple mental health settings as well as consumers of services and their 
families/social networks.

INQUIRIES

o  Direct your questions about scientific/research issues to:

David A. Chambers, Ph.D.
Division of Services and Intervention Research
National Institute of Mental Health
Neuroscience Center, Room 7133 MSC-9631
Bethesda, MD  20892-9631
Telephone:  (301) 443-3747
FAX:  (301) 443-4045
Email:  dchamber@mail.nih.gov

o  Direct your questions about financial or grants management matters to:

Joy R. Knipple
Grants Management Branch
Division of Extramural Activities
National Institute of Mental Health
6001 Executive Boulevard, Room 6131 MSC 9605
Bethesda, MD  20892-9605
Rockville, MD 20852 (for express/courier service)
Telephone:  (301) 443-8811
FAX:  (301) 443-6885
Email:  jk173r@nih.gov


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