Determining Leadership Capacity
A fourth dimension that influences whether an intervention has dissemination potential is the person and/or group or team that will drive the process. An effective dissemination approach requires a charismatic and credible “champion” who can demonstrate the relevance and importance of an intervention to a variety of key decision makers and potential stakeholders. This person may be different from the lead investigator/researcher who developed/evaluated the intervention. The ability to create and nurture collaborative relationships with various settings, communities, or organizations is crucial (Gladwell, 2000) to successful dissemination. This champion must build awareness about an intervention and rally opinion leaders who influence decision making for the targeted setting.
Access to Communications Channels
The fifth dimension that influences dissemination potential is whether the investigator/ team has access to appropriate “communications channels” (Rogers, 2003), or ways to reach potential adopting agencies, settings, and interventionists and individuals who may benefit from the intervention. At the heart of a dissemination plan is identifying different forums for communicating about the intervention. This may include but is not limited to identifying local meetings, organizations, or settings where one can provide talks or demonstrations of the intervention in one-on-one or group meetings with key stakeholders such as agency or community leaders, Grand Rounds in health organizations, or other venues such as professional association meetings. For example, program leaders of the Chronic Disease Self-Management Program (CDSMP), a 6-week, six-class patient activation and peer-led model (Lorig et al., 1999), create a “drumbeat of touchpoints,” including person-to-person marketing, in addition to more traditional flyers, brochures, and media outreach to disseminate the program in a particular locale (Compton, 2014).
For regional or national dissemination, researchers need access to professional journals and meetings, media (e.g., radio, television, print), social media, and/or other public relations vehicles to spread the word. Conduits that matter are the ones that provide access to the key decision makers of a practice setting and those individuals who may want to be interventionists as well as end users such as the consumers or ultimate beneficiaries of an intervention. This may mean publishing and presenting in settings other than traditional professional meetings. For example, in seeking to disseminate Guided Care, a patient-centered medical home model for older adults (Boult et al., 2011), the Johns Hopkins University team purposely sought out policy gatherings and meetings that involved clinicians and administrators of primary care practices and health systems (e.g., Case Management Society of America and TransforMED conferences), which the team had not attended previously.
Finding ways to partner with others who have access to key stakeholders and decision makers of organizations and settings is also important (Bradley et al., 2004). Identifying potential relationships and channels for broad dissemination early on in the pipeline when developing an intervention can be helpful.
To summarize, when advancing an intervention, it is important to determine its dissemination potential along five dimensions: intervention characteristics; the environmental context in which it might be embedded; the fit between the intervention and a particular context and perceived ease of implementation; capacity to lead a dissemination effort; and access to communication outlets. Helpful self-reflective questions to evaluate the dissemination potential of an intervention include the following:
- ? Does the intervention have characteristics that make it likely to be adopted?
- ? Is the broader environment or more local organizational context ripe for the innovation?
- ? Is the intervention team sufficiently credible and connected to the range of stakeholders necessary for adoption?
- ? Does the team have access to the right communication channels so that it can sufficiently communicate to and persuade potential adopters to implement the new program, intervention, service, or model?