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Federal Leaders and Policy Makers Learn from CFS Staff

Sunday, July 30, 2006

Karen Blase and Dean Fixsen were asked to share their expertise recently when Kevin Hennessy, Science to Service Coordinator from the Substance Abuse and Mental Health Services Administration (SAMHSA) invited them to present to important federal leaders and policy makers on effective implementation strategies needed to make evidence based services more routinely available. They shared research and lessons learned regarding implementation approaches to install innovative programs and practices in order to improve a broad range of child, family, and adult outcomes.

The first of what SAMHSA hopes will be periodic invitational briefings for senior government staff, this 'Science to Service' briefing brought together leading staff from agencies representing research, services, accountability, as well as experts in implementation science, all concerned with the application of knowledge to real world problems.

" The attendance of nearly everyone invited is testament to the fact that leaders in the field agree there are gaps from science to service which need to be filled," said Blase. "For the past several years, leaders have been expressing this need and are increasingly aware that the missing link is effective implementation."

"We are refining our basic and clinical research programs to ensure that new discoveries rapidly lead to new and improved diagnostics, treatments and prevention strategies that extend the length and improve the quality of human life," stated Dr. Elias A. Zerhouni, Director of the National Institutes of Health (NIH) in his 2004 testimony to Congress. Also at that time, John M. Eisenberg, M.D., Director of the Agency for Healthcare Research and Quality (AHRQ) said, " the primary focus of our mission is to ensure that the research we support gets translated into practice so it can actually help improve people's lives." In addition, Julie Louise Gerberding, MD, MPH, Director of the Centers for Disease Control and Prevention remarked, "the ability to transform knowledge into impact is a fundamental element of assuring broad health protection. This is achieved through a combination of applied public health research and implementation of effective public health programs at the federal, state and local levels."

Dr’s Blase and Fixsen are Co-Directors of the National Implementation Research Network (NIRN), housed at the USF’s Louis de la Parte Florida Mental Health Institute (FMHI). The 'Science to Service' briefing highlighted NIRN's study of the implementation evaluation literature and development of implementation strategies and frameworks based on the current science and best practices. They have also convened meetings of implementation researchers, program developers, and implementing organizations to glean best implementation practices from the field and have participated in similar meetings convened by others.

“ These reviews of the literature and current practices are augmented by our own experiences with research and practical experience regarding program development and national implementation since 1967,” said Fixsen. “Knowing what works for whom and relying on efficacy and effectiveness research can help clinicians, families, consumers, and communities choose therapies, interventions, and services that meet specific consumer needs. However, such knowledge will not help communities effectively implement proven therapies and interventions. We need the science and practice of effective implementation to install, maintain, and sustain evidence-based efforts in the real world."

Blase added that the principles and processes related to effective implementation strategies appear to be applicable across varied content areas and service settings, including mental health, social services, medicine, juvenile justice, education, early childhood education, employment services, and substance abuse prevention and treatment.

“ We now have enough information about successful implementation strategies to suggest ideas for a more collaborative and unified federal agenda on how to bring scientific findings to service environments,” said Fixsen. "A jointly developed, funded, and managed process over the next few years at the federal level could lead to a dramatic change in how federal agencies promote and support successful implementation with benefits collectively and for each individual agency.”

“ As Dean and Karen were presenting, I could see lights going on for everyone,” said David Shern, recent dean of FMHI and now president of the National Mental Health Association. “It is clear to me that we have hit upon a critical missing link, implementation science, in the knowledge to practice enterprise. FMHI will be a national leader in establishing the field of implementation science and practice and guiding its diffusion and impact.”

Also presenting at the briefing were invited experts Mark W. Lipsey and Phyllis C. Panzano. Lipsey is Professor of Public Policy at Vanderbilt University's Peabody College and Co-director of the Center for Evaluation Research and Methodology at the Vanderbilt Institute for Public Policy Studies. His professional interests are in the areas of public policy, program evaluation research, social intervention, field research methodology, and research synthesis. Dr. Panzano has 20 years of experience conceptualizing, implementing and managing applied research and consulting projects in the public and private sectors, mainly in the health care and mental health care domains.