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      Implementation and scale up of population physical activity interventions for clinical and community settings: the PRACTIS guide

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          Abstract

          Background

          Few efficacious physical activity interventions are successfully translated and sustained in practice. We propose a practical guide for researchers to increase the likelihood of successful implementation and scale up of physical activity interventions in practice contexts. The guide is based on two principles: (i) differences between the research and practice context can be addressed during intervention development and implementation planning by focusing on system, delivery personnel, and intervention characteristics; and (ii) early planning for implementation barriers and facilitators can improve subsequent translation into practice.

          Methods

          From the published literature, we identified evidence of strategies to improve research-practice translation, along with narrative descriptions of different approaches to addressing translational challenges. These, along with constructs taken from widely cited implementation outcome, process, and mechanistic models were collated and inform the guide.

          Results

          The resultant PRACTIS guide ( PRACTical planning for Implementation and Scale-up) comprised the following four iterative steps: Step 1) Characterize the parameters of the implementation setting; Step 2) Identify and engage key stakeholders across multiple levels within the delivery system(s); Step 3) Identify contextual barriers and facilitators to implementation, and; Step 4) Address potential barriers to effective implementation.

          Conclusions

          A lack of practical guidance for researchers on how to effectively plan implementation and scale up of physical activity interventions prevents us moving quickly from evidence to action. We recommend that intervention development and adaptation for broad and sustained implementation be prioritized early in intervention planning and include active engagement from delivery organizations and stakeholders. The PRACTIS guide is also relevant for clinical and public health researchers in other areas of prevention.

          Electronic supplementary material

          The online version of this article (10.1186/s12966-018-0678-0) contains supplementary material, which is available to authorized users.

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          Most cited references33

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          Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation.

          If we keep on doing what we have been doing, we are going to keep on getting what we have been getting. Concerns about the gap between science and practice are longstanding. There is a need for new approaches to supplement the existing approaches of research to practice models and the evolving community-centered models for bridging this gap. In this article, we present the Interactive Systems Framework for Dissemination and Implementation (ISF) that uses aspects of research to practice models and of community-centered models. The framework presents three systems: the Prevention Synthesis and Translation System (which distills information about innovations and translates it into user-friendly formats); the Prevention Support System (which provides training, technical assistance or other support to users in the field); and the Prevention Delivery System (which implements innovations in the world of practice). The framework is intended to be used by different types of stakeholders (e.g., funders, practitioners, researchers) who can use it to see prevention not only through the lens of their own needs and perspectives, but also as a way to better understand the needs of other stakeholders and systems. It provides a heuristic for understanding the needs, barriers, and resources of the different systems, as well as a structure for summarizing existing research and for illuminating priority areas for new research and action.
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            How can we increase translation of research into practice? Types of evidence needed.

            This review summarizes key factors that have interfered with translation of research to practice and what public health researchers can do to hasten such transfer, focusing on characteristics of interventions, target settings, and research designs. The need to address context and to utilize research, review, and reporting practices that address external validity issues-such as designs that focus on replication, and practical clinical and behavioral trials-are emphasized. Although there has been increased emphasis on social-ecological interventions that go beyond the individual level, interventions often address each component as if it were an independent intervention. Greater attention is needed to connectedness across program levels and components. Finally, examples are provided of evaluation models and current programs that can help accelerate translation of research to practice and policy.
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              Community-based participatory research and integrated knowledge translation: advancing the co-creation of knowledge

              Background Better use of research evidence (one form of “knowledge”) in health systems requires partnerships between researchers and those who contend with the real-world needs and constraints of health systems. Community-based participatory research (CBPR) and integrated knowledge translation (IKT) are research approaches that emphasize the importance of creating partnerships between researchers and the people for whom the research is ultimately meant to be of use (“knowledge users”). There exist poor understandings of the ways in which these approaches converge and diverge. Better understanding of the similarities and differences between CBPR and IKT will enable researchers to use these approaches appropriately and to leverage best practices and knowledge from each. The co-creation of knowledge conveys promise of significant social impacts, and further understandings of how to engage and involve knowledge users in research are needed. Main text We examine the histories and traditions of CBPR and IKT, as well as their points of convergence and divergence. We critically evaluate the ways in which both have the potential to contribute to the development and integration of knowledge in health systems. As distinct research traditions, the underlying drivers and rationale for CBPR and IKT have similarities and differences across the areas of motivation, social location, and ethics; nevertheless, the practices of CBPR and IKT converge upon a common aim: the co-creation of knowledge that is the result of knowledge user and researcher expertise. We argue that while CBPR and IKT both have the potential to contribute evidence to implementation science and practices for collaborative research, clarity for the purpose of the research—social change or application—is a critical feature in the selection of an appropriate collaborative approach to build knowledge. Conclusion CBPR and IKT bring distinct strengths to a common aim: to foster democratic processes in the co-creation of knowledge. As research approaches, they create opportunities to challenge assumptions about for whom, how, and what is defined as knowledge, and to develop and integrate research findings into health systems. When used appropriately, CBPR and IKT both have the potential to contribute to and advance implementation science about the conduct of collaborative health systems research.
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                Author and article information

                Contributors
                h.koorts@deakin.edu.au
                e.eakin@uq.edu.au
                paul.estabrooks@unmc.edu
                Anna.timperio@deakin.edu.au
                jo.salmon@deakin.edu.au
                adrian.bauman@sydney.edu.au
                Journal
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central (London )
                1479-5868
                8 June 2018
                8 June 2018
                2018
                : 15
                : 51
                Affiliations
                [1 ]ISNI 0000 0001 0526 7079, GRID grid.1021.2, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, , Deakin University, ; Geelong, Australia
                [2 ]ISNI 0000 0000 9320 7537, GRID grid.1003.2, School of Public Health, Cancer Prevention Research Centre, , The University of Queensland, ; Herston, QLD Australia
                [3 ]ISNI 0000 0001 0666 4105, GRID grid.266813.8, Department of Health Promotion, College of Public Health, , University of Nebraska Medical Center, ; 984365 Nebraska Medical Center, Omaha, NE USA
                [4 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, School of Public Health, , University of Sydney, ; Sydney, NSW Australia
                Author information
                http://orcid.org/0000-0003-1303-6064
                Article
                678
                10.1186/s12966-018-0678-0
                5994105
                29884236
                500c5395-c8ff-4081-825d-fcb69b398e92
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 February 2018
                : 15 May 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;
                Funded by: FundRef http://dx.doi.org/10.13039/100000057, National Institute of General Medical Sciences;
                Award ID: U54 GM115458-01
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100001030, National Heart Foundation of Australia;
                Award ID: 100046
                Award Recipient :
                Categories
                Methodology
                Custom metadata
                © The Author(s) 2018

                Nutrition & Dietetics
                implementation,physical activity,translation,dissemination,health behaviour,public health

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