America Walks, a national, nonprofit organization aimed at improving the walkability of communities across the country, sponsors and promotes research in line with those goals. One webinar they conducted, titled “Lessons from Dissemination and Implementation Research for Interventions Promoting Walking and Walkability,” featured two prominent researchers in the field, with lots of experience introducing walking interventions into different communities, who detailed lessons they’ve learned from their work in public health.
Dr. Ross Browson, a public health research at the University of Washington at St. Louis, spoke about the unique field of dissemination and implementation (D&I) research. The key characteristics of D&I research were multilevel complexity, scalability and sustainability, adaptiveness, and respect for diverse approaches. In other words, he argued that intervention programs need to fit the size and complexity of the community and need to be able to change based on how the community responds. In his experience, the most critical issues arose in the connection between research and public policy and whether those areas worked harmoniously. His advice to clinicians looking to implement interventions was to utilize hybrid designs that test both effectiveness and implementation simultaneously and to keep several “key ingredients” in mind when designing studies and applying for grants to fund them. These ingredients included clearly defining the evidence-based practice that will be utilized, using a D&I framework, documenting each member of the team’s D&I experience, and measuring more than one effectiveness endpoint or goal.
Dr. Jacqueline Kerr, a researcher in family medicine and public health at the University of California at San Diego, spoke about her experience in developing peer-led physical activity (PA) programs for seniors in retirement and senior center settings. Her group found great success in decreasing PA decline in this population and successfully partnered with a pedestrian advocacy organization (WalkSanDiego) to clean pedestrian bridges and create safer crosswalks and sidewalks. The most impactful aspect of her study, which she highly encouraged other practitioners to include in their interventions, was in-person counseling and employing educated, motivated, and excited staff to run the day-to-day programs. She also suggested using rolling recruitment throughout the program and creating a clear plan for how to seamlessly transition leadership so as not to interrupt the program.
The most interesting part of this webinar was the similarity between the two talks, primarily in relation to the hurdles they had to overcome. Their success was directly dependent on the community they came into, how they were received by the people in that community, and their ability to adjust accordingly. As exercise science researchers, we often feel far removed from study subjects. We publish papers about the benefits of exercise and cannot fathom why that doesn’t convince people to change their behavior. Public health takes almost the opposite approach and it’s fascinating to see how different problems arise. Different techniques from different fields need to work together to overcome inactivity.