? ? Background. Existing knowledge on chronic disease prevention is not systematically disseminated and applied. State-level public health practitioners are in positions to implement programs and services related to chronic disease control. To do so, evidence-based interventions are available within the Guide to Community Preventive Services (the Community Guide). Goal and aims. Our primary goal is to increase the dissemination of evidence-based interventions to prevent and control chronic diseases. The first set of specific aims seeks to identify:1) essential competencies for dissemination of evidence-based interventions for chronic disease prevention, 2) barriers for dissemination, and 3) how the stage of dissemination varies by agency size, capacity, and risk factor/disease. A second set of aims builds on these to: 1) conduct a prioritization process, 2) refine a menu of dissemination activities for implementation in the six dissemination states, and 3) implement and evaluate a menu-driven, active dissemination approach. Methods and evaluation. To advance dissemination science, we will evaluate how and why dissemination is occurring and will actively disseminate the Community Guide. This project will occur in two parts. Phase 1 research involves a nationwide survey of state-level practitioners in chronic disease prevention and control. The survey will rate the importance of and proficiency in dissemination-related competencies, barriers to evidence-based decision making, and the extent to which evidence-based interventions are used. Phase 2 builds on Phase 1, using a quasi-experimental design (pre-test/post-test with a comparison group) to evaluate the active dissemination of evidence-based chronic disease control interventions in six states. Qualitative interviews will supplement quantitative data to help us understand contextual factors. State selection will be based on chronic disease burden (a measure of health disparity), size of state, and geographic dispersion. Dissemination activities in Phase 2 include tool and skill development (e.g., issue briefs, dissemination workshops) to enhance uptake of evidence-based interventions. Evaluation of Phase 2 interventions will rely on two data sources: 1) measures of dissemination based on surveys of practitioners and 2) review and abstraction of state-level chronic disease control records. We will also conduct process evaluation and will pay particular attention to external validity. Dissemination and innovations. Concurrent with Phase 2, we will begin efforts to design for dissemination. The intent of these activities is to ensure that findings from our grant are useful, informative, relevant, and ready for widespread dissemination when funding ends. We will assemble and work with two advisory groups and capture project costs. Practice-relevant dissemination of evidence-based interventions is highly innovative yet is an area that remains largely uncharted. ? ? This project is relevant to public health because it addresses behaviors that lead to significant premature chronic disease morbidity and mortality. Sparse knowledge exists regarding effective approaches for dissemination of research-tested interventions among real world practice audiences. Upon completion, our study will provide feasible evidence-based dissemination strategies that can be adapted to other settings and risk factors. ? ? ?
