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Efficacious, effective, and embedded interventions: implementation research in infectious disease control.

Allotey P, Reidpath DD, Ghalib H, Pagnoni F, Skelly WC - BMC Public Health (2008)

Bottom Line: Oft ignored, is the evidence to inform the best strategies that ensure the embedding of interventions into health systems and amongst populations.The greatest value for money in health research lies in the sustainable and effective implementation of already proven, efficacious solutions.The development of implementation research that can help provide some solutions on how this can be achieved is sorely needed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for Public Health Research/School of Health Sciences, Brunel University, West London, UK. pascale.allotey@brunel.ac.uk

ABSTRACT

Background: Research in infectious disease control is heavily skewed towards high end technology; development of new drugs, vaccines and clinical interventions. Oft ignored, is the evidence to inform the best strategies that ensure the embedding of interventions into health systems and amongst populations. In this paper we undertake an analysis of the challenge in the development of research for the sustainable implementation of disease control interventions.

Results: We highlight the fundamental differences between the research paradigms associated with the development of technologies and interventions for disease control on the one hand and the research paradigms required for enhancing the sustainable uptake of those very same interventions within the communities on the other. We provide a definition for implementation research in an attempt to underscore its critical role and explore the multidisciplinary science needed to address the challenges in disease control.

Conclusion: The greatest value for money in health research lies in the sustainable and effective implementation of already proven, efficacious solutions. The development of implementation research that can help provide some solutions on how this can be achieved is sorely needed.

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Related in: MedlinePlus

Product Development Cycle.
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Figure 1: Product Development Cycle.

Mentions: Research is a significant part of the strategy for the control of communicable diseases with the largest tranche of funding going to the development of new drugs, vaccines and clinical interventions. Success, particularly in drug and vaccine development, is unfortunately slow and failure is expensive [1]. Nonetheless, high-end technology continues to capture the imagination of funding bodies, in part because it is based on methodologies that are 'tried and true', including established research tools to demonstrate efficacy and the econometric techniques of cost effectiveness. It is also an area of investment that holds potential for direct economic return based on the sale of the developments [2]. However, at least as critical in the product development cycle (see figure 1) is the step, often ignored in public health, that lies between the ascertainment of effectiveness and the final sustained adoption of an intervention [3-5]. This is underscored by the fact that interventions currently exist for many high burden diseases but the conditions persist because of a failure in the uptake of the interventions by the communities that most need them. Indeed we would argue that even a single iteration of the product development cycle is not complete until (i) it has been scaled up to the end users and (ii) there is a further opportunity to contribute to ongoing product developments.


Efficacious, effective, and embedded interventions: implementation research in infectious disease control.

Allotey P, Reidpath DD, Ghalib H, Pagnoni F, Skelly WC - BMC Public Health (2008)

Product Development Cycle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2567977&req=5

Figure 1: Product Development Cycle.
Mentions: Research is a significant part of the strategy for the control of communicable diseases with the largest tranche of funding going to the development of new drugs, vaccines and clinical interventions. Success, particularly in drug and vaccine development, is unfortunately slow and failure is expensive [1]. Nonetheless, high-end technology continues to capture the imagination of funding bodies, in part because it is based on methodologies that are 'tried and true', including established research tools to demonstrate efficacy and the econometric techniques of cost effectiveness. It is also an area of investment that holds potential for direct economic return based on the sale of the developments [2]. However, at least as critical in the product development cycle (see figure 1) is the step, often ignored in public health, that lies between the ascertainment of effectiveness and the final sustained adoption of an intervention [3-5]. This is underscored by the fact that interventions currently exist for many high burden diseases but the conditions persist because of a failure in the uptake of the interventions by the communities that most need them. Indeed we would argue that even a single iteration of the product development cycle is not complete until (i) it has been scaled up to the end users and (ii) there is a further opportunity to contribute to ongoing product developments.

Bottom Line: Oft ignored, is the evidence to inform the best strategies that ensure the embedding of interventions into health systems and amongst populations.The greatest value for money in health research lies in the sustainable and effective implementation of already proven, efficacious solutions.The development of implementation research that can help provide some solutions on how this can be achieved is sorely needed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Centre for Public Health Research/School of Health Sciences, Brunel University, West London, UK. pascale.allotey@brunel.ac.uk

ABSTRACT

Background: Research in infectious disease control is heavily skewed towards high end technology; development of new drugs, vaccines and clinical interventions. Oft ignored, is the evidence to inform the best strategies that ensure the embedding of interventions into health systems and amongst populations. In this paper we undertake an analysis of the challenge in the development of research for the sustainable implementation of disease control interventions.

Results: We highlight the fundamental differences between the research paradigms associated with the development of technologies and interventions for disease control on the one hand and the research paradigms required for enhancing the sustainable uptake of those very same interventions within the communities on the other. We provide a definition for implementation research in an attempt to underscore its critical role and explore the multidisciplinary science needed to address the challenges in disease control.

Conclusion: The greatest value for money in health research lies in the sustainable and effective implementation of already proven, efficacious solutions. The development of implementation research that can help provide some solutions on how this can be achieved is sorely needed.

Show MeSH
Related in: MedlinePlus