Moving from Research to Large-Scale Change in Child Health Care

December 5, 2011

Authors: David A. Bergman, M.D., and Arne Beck, Ph.D.
Journal: Academic Pediatrics, Sept./Oct. 2011 11(5):360–68
Contact: David A. Bergman, M.D., Department of Pediatrics, Stanford University School of Medicine,
Summary Writers: Cara Dermody
Access to full article: View Article

The Issue

Evidence-based practices for improving child health care often are not implemented on a large scale. While research continues to advance ways to reduce variability in service delivery and disparities in health outcomes, the promise of these findings has yet to be realized.

What the Study Found

Dissemination, diffusion, and implementation (DD&I) science offers a model to identify innovations and understand the preferences, capabilities, and social networks likely to help facilitate adoption. This Commonwealth Fund–supported study outlines how the DD&I model can be used to enhance widespread adoption of innovative care practices that can improve the overall health of children. The authors detail the DD&I process from the initial exploration for practice change to planning, pilot implementation, and organization-wide implementation. The success and sustainability of each model requires constant surveillance and assessment to enable continuous improvement, the authors write.

DD&I research is still "in its infancy," caution the authors. Further research is needed to define the characteristics of successful DD&I programs and the impact environment has on their sustainability.


As the Affordable Care Act introduces innovative models of care, providers must develop an effective system for adopting and sustaining practice improvements. In the field of child health care, strides made in best practice design and research continually fail to reach full-scale implementation. DD&I science provides a framework and tool set to empower organizations to adopt innovations, gradually introduce changes, and ensure sustainability.


D. Berman and A. Beck, "Moving From Research to Large-Scale Change in Child Health Care," Academic Pediatrics, Sept./Oct. 2011 11(5):360–68.