Enhance Design Efficiencies
A final consideration is to use innovative study design strategies that combine various phases along the pipeline; for example: hybrid designs that combine effectiveness and implementation research questions (Curran et al., 2012); embedded or pragmatic trial methodologies including stepped, wedge, or adaptive designs; mixed methodologies that are emerging as potential strategies for maximizing the yield of evidence that is generated when evaluating an intervention. Other hybrid models involve conducting implementation trials that secondarily evaluate treatment benefits (Curran et al., 2012) or embedding the test of dissemination strategies early on in the development process. Such approaches make the most of field testing and may move interventions forward more rapidly. However, whether these strategies result in shortening the 17-plus-year time frame for intervention development and the generation of interventions that are more relevant to end users and service contexts still remains an empirical question (see Table 2.2 for definitions of designs).