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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