Measurement Issues in Dissemination and Implementation Research

Abstract The National Institutes of Health, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, and a number of private foundations have expressed the need for advancing the science of dissemination and implementation (D&I). Interest in D&I research is present in many countries, including the United Kingdom (UK Center for Reviews and Dissemination, the UK Medical Research Council) and Canada (Canadian Institutes of Health Research). Improving healthcare requires not only effective programs and interventions but also effective strategies to move them into community-based settings of care. But before discrete strategies can be tested for effectiveness, comparative effectiveness, or cost-effectiveness, context, and outcome constructs must be identified and defined in such a way that enables their manipulation and measurement. Measurement is underdeveloped with few psychometrically strong measures and very little attention paid to their pragmatic nature. A variety of tools is needed to capture healthcare access and quality, and no measurement issues are more pressing than those for D&I science.