Addicted to discovery: Does the quest for new knowledge hinder practice improvement?

Perl, Harold I.

doi:10.1016/j.addbeh.2011.01.027

Cited by 15Health Policy Implementation ScienceHealth Sciences Research and EducationSubstance Abuse Treatment and Outcomes

Addicted to discovery: Does the quest for new knowledge hinder practice improvement?

Perl, Harold I.·2011·Addictive Behaviors

DOI 10.1016/j.addbeh.2011.01.027

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Abstract

Despite the billions of dollars spent on health-focused research and the hundreds of billions spent on delivering health services each year, relatively little money and effort are directed toward investigating how best to connect the two. This results in missed opportunities to assure that research findings inform and improve quality across healthcare in general and for addiction prevention and treatment in particular. There is an asymmetrical focus that favors the identification of new interventions and neglects the implementation of science-based knowledge in actual practice. The consequences of that neglect are severe: significantly diminished progress in research on how to implement treatments that could improve the lives of persons with addiction problems, their families, and the rest of society. While the advancement of knowledge regarding effective implementation is lagging, it is clear that existing systemic incentives in the conduct of science inhibit rather than facilitate widespread adoption of evidence-based practices. This commentary proposes three interrelated strategies for improving the implementation process. First, develop scientific tools to understand implementation better, by expanding investigations on the science of implementation and broadening approaches to the design and execution of research. Second, nurture and support a collaborative implementation workforce comprised of scientists and on-the-ground practitioners, with an explicit focus on enhancing appropriate incentives for both. Third, pay closer attention to crafting research that seeks answers that are most relevant to clinicians' actual needs, primarily by ensuring that the anticipated users of the evidence-based practice are full partners in developing the questions right from the start.

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“Limitations in our understanding of dissemination and implementation have been well-documented (1, 2, 86).”
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Diffusion of Innovations 1
Rogers, E. M., Singhal, A., & Quinlan, M. M. (2019) · Routledge eBooks · doi:10.4324/9780203710753-35 · Cited by 37,557 · see citing works
Diffusion of innovations
Valente, T. W. (2003) · Genetics in Medicine · doi:10.1097/01.gim.0000061743.67794.c4 · Cited by 20,555 · see citing works
Crossing the Quality Chasm: A New Health System for the 21st Century
Baker, A. (2001) · BMJ · doi:10.1136/bmj.323.7322.1192 · Cited by 10,754 · see citing works
Crossing the Quality Chasm: A New Health System for the 21st Century
Committee on Quality of Health Care in America (2002) · Journal for Healthcare Quality · doi:10.1111/j.1945-1474.2002.tb00463.x · Cited by 8,508 · see citing works
Evaluating the public health impact of health promotion interventions: the RE-AIM framework.
Glasgow, R. E., Vogt, T. M., & Boles, S. M. (1999) · American Journal of Public Health · doi:10.2105/ajph.89.9.1322 · Cited by 7,217 · see citing works
Untitled work
(2005) · Cited by 3,748 · see citing works
Untitled work
(2002) · DigitalGeorgetown (Georgetown University Library) · Cited by 2,351 · see citing works
Welcome to Implementation Science
Eccles, M. P., & Mittman, B. S. (2006) · Implementation Science · doi:10.1186/1748-5908-1-1 · Cited by 2,254 · see citing works
Using Community-Based Participatory Research to Address Health Disparities
Wallerstein, N. B., & Duran, B. (2006) · Health Promotion Practice · doi:10.1177/1524839906289376 · Cited by 2,243 · see citing works
Methods For Community - Based Participatory Research For Health
Israel, B. A., & Satcher, D. S. (2013) · Cited by 2,128 · see citing works
Student achievement through staff development
Joyce, B. R., & Showers, B. (1988) · Cited by 2,111 · see citing works
Disseminating Innovations in Health Care
Berwick, D. M. (2003) · JAMA · doi:10.1001/jama.289.15.1969 · Cited by 1,878 · see citing works
Untitled work
Tunis (2003) · doi:10.1001/jama.290.12.1624 · Cited by 1,724 · see citing works
Managing Clinical Knowledge for Health Care Improvement
Balas, E. A., & Boren, S. A. (2000) · Yearbook of Medical Informatics · doi:10.1055/s-0038-1637943 · Cited by 1,479 · see citing works
Community-based participatory research: assessing the evidence.
Viswanathan, M., Ammerman, A., Eng, E. M., Garlehner, G., Lohr, K. N., Griffith, D. M., Rhodes, S. D., Samuel‐Hodge, C. D., Maty, S. C., Lux, L. J., et al. (2004) · PubMed Central · Cited by 956 · see citing works
Evaluating the Relevance, Generalization, and Applicability of Research: Issues in External Validation and Translation Methodology
Green, L. W., & Glasgow, R. E. (2006) · Evaluation & the Health Professions · doi:10.1177/0163278705284445 · Cited by 922 · see citing works
The RE-AIM framework for evaluating interventions: what can it tell us about approaches to chronic illness management?
Glasgow, R., Mckay, H., Piette, J. D., & Reynolds, K. (2001) · Patient Education and Counseling · doi:10.1016/s0738-3991(00)00186-5 · Cited by 643 · see citing works
Making research relevant: if it is an evidence-based practice, where's the practice-based evidence?
Green, L. W. (2008) · Family Practice · doi:10.1093/fampra/cmn055 · Cited by 633 · see citing works
Bridging the Gap Between Practice and Research: Forging Partnerships with Community-Based Drug and Alcohol Treatment
Lamb, S., Greenlick, M. R., & McCarty, D. W. (2013) · Cited by 506 · see citing works
Assessment/evaluation. Using participatory action research to build healthy communities
Minkler, M. (2000) · Public Health Reports · doi:10.1093/phr/115.2.191 · Cited by 421 · see citing works
Practical Clinical Trials for Translating Research to Practice: Design and Measurement Recommendations
Glasgow, R. E., Magid, D. J., Beck, A., Ritzwoller, D., & Estabrooks, P. A. (2005) · Medical Care · doi:10.1097/01.mlr.0000163645.41407.09 · Cited by 308 · see citing works
The break-even point: when medical advances are less important than improving the fidelity with which they are delivered
Woolf, S. H. (2005) · The Annals of Family Medicine · doi:10.1370/afm.406 · Cited by 208 · see citing works
Dissemination of Results in Community-Based Participatory Research
Chen, P. G., Diaz, N., Lucas, G. I., & Rosenthal, M. S. (2010) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.05.021 · Cited by 199 · see citing works
RE-AIM: Evidence-based standards and a web resource to improve translation of research into practice
Dzewaltowski, D. A., Glasgow, R. E., Klesges, L. M., Estabrooks, P. A., & Brock, E. (2004) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2802_1 · Cited by 192 · see citing works
Community program therapist adherence and competence in motivational enhancement therapy
Martino, S., Ball, S. A., Nich, C., Frankforter, T. L., & Carroll, K. M. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.01.020 · Cited by 179 · see citing works
A vision of the next generation of behavioral therapies research in the addictions*
Carroll, K. M., & Rounsaville, B. J. (2007) · Addiction · doi:10.1111/j.1360-0443.2007.01798.x · Cited by 177 · see citing works
Reviewing the behavioral science knowledge base on technology transfer. Introduction.
Backer, T. E., David, S. L., & Soucy, G. (1995) · PubMed · Cited by 173 · see citing works
Correspondence of motivational enhancement treatment integrity ratings among therapists, supervisors, and observers
Martino, S., Ball, S. A., Nich, C., Frankforter, T. L., & Carroll, K. M. (2009) · Psychotherapy Research · doi:10.1080/10503300802688460 · Cited by 164 · see citing works
Making Evidence from Research More Relevant, Useful, and Actionable in Policy, Program Planning, and Practice
Green, L. W., Glasgow, R. E., Atkins, D. C., & Stange, K. C. (2009) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2009.08.017 · Cited by 153 · see citing works
Toward more responsive and effective intervention systems for alcohol‐related problems
Humphreys, K. N., & Tucker, J. A. (2002) · Addiction · doi:10.1046/j.1360-0443.2002.00004.x · Cited by 140 · see citing works
Organizational Readiness for Change and opinions toward treatment innovations
Fuller, B. E., Rieckmann, T. R., Nunes, E. V., Miller, M. J., Arfken, C. L., Edmundson, E., & McCarty, D. W. (2007) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2006.12.026 · Cited by 123 · see citing works
Community-Based Participatory Research in Practice-Based Research Networks
Westfall, J. M. (2006) · The Annals of Family Medicine · doi:10.1370/afm.511 · Cited by 114 · see citing works
Direct Care Workers in the National Drug Abuse Treatment Clinical Trials Network: Characteristics, Opinions, and Beliefs
McCarty, D. W., Fuller, B. E., Arfken, C. L., Miller, M. J., Nunes, E. V., Edmundson, E., Copersino, M. L., Floyd, A., Forman, R. F., Laws, R., et al. (2007) · Psychiatric Services · doi:10.1176/appi.ps.58.2.181 · Cited by 100 · see citing works
An Historical and Developmental Analysis of Social Model Programs
Borkman, T. J., Kaskutas, L. A., Joshua Room, M., Bryan, B. K., & David Barrows, P. (1998) · Journal of Substance Abuse Treatment · doi:10.1016/s0740-5472(97)00244-4 · Cited by 97 · see citing works
The federal role in drug abuse technology transfer: a history and perspective
Brown, B. S., & Flynn, P. M. (2002) · Journal of Substance Abuse Treatment · doi:10.1016/s0740-5472(02)00228-3 · Cited by 92 · see citing works
Collaborative research between clinicians and researchers: a multiple case study of implementation
Blevins, D., Farmer, M. S., Edlund, C. N., Sullivan, G., & Kirchner, J. E. (2010) · Implementation Science · doi:10.1186/1748-5908-5-76 · Cited by 89 · see citing works
The Community Pulling Together: A Tribal Community–University Partnership Project to Reduce Substance Abuse and Promote Good Health in a Reservation Tribal Community
Thomas, L. R., Donovan, D. M., Sigo, R. L. W., Austin, L., Marlatt, G. A., & Tribe, T. S. (2009) · Journal of Ethnicity in Substance Abuse · doi:10.1080/15332640903110476 · Cited by 87 · see citing works
Using the RE-AIM Framework to Evaluate the Statewide Dissemination of a School-Based Physical Activity and Nutrition Curriculum: “Exercise Your Options”
Dunton, G. F., Lagloire, R., & Robertson, T. (2009) · American Journal of Health Promotion · doi:10.4278/ajhp.071211129 · Cited by 64 · see citing works
Potential Health and Economic Consequences of Misplaced Priorities
Woolf, S. H. (2007) · JAMA · doi:10.1001/jama.297.5.523 · Cited by 63 · see citing works
Twenty-five strategies for improving the design, implementation and analysis of health services research related to alcohol and other drug abuse treatment.
Dennis, M. L., Perl, H. I., Huebner, R., & McLellan, A. (2000) · Addiction · doi:10.1046/j.1360-0443.95.11s3.2.x · Cited by 58 · see citing works
Self-citation
Optimizing Practice Through Research: A New Perspective to Solve an Old Problem
Kottke, T. E., Solberg, L. I., Nelson, A. F., Belcher, D. W., Caplan, W., Green, L. W., LYDICK, E. G., Magid, D. J., Rolnick, S. J., & Woolf, S. H. (2008) · The Annals of Family Medicine · doi:10.1370/afm.862 · Cited by 42 · see citing works
Direct Care Workers in the National Drug Abuse Treatment Clinical Trials Network: Characteristics, Opinions, and Beliefs
McCarty, D. W., Fuller, B. E., Arfken, C. L., et al. (2007) · Psychiatric Services · doi:10.1176/ps.2007.58.2.181 · Cited by 42 · see citing works
Reducing Impediments to Technology Transfer in Drug Abuse Programming
Brown, B. S. (1995) · PsycEXTRA Dataset · doi:10.1037/e495742006-011 · Cited by 38 · see citing works
Understanding attitudes toward use of medication in substance abuse treatment: A multilevel approach.
Fitzgerald, J., & McCarty, D. W. (2009) · Psychological Services · doi:10.1037/a0013420 · Cited by 33 · see citing works
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L.Fisher, G., & Roget, N. A. (2009) · doi:10.4135/9781412964500.n214 · Cited by 28 · see citing works
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Brown, B. S. (2005) · Advances in medical sociology · doi:10.1016/s1057-6290(00)80017-0 · Cited by 26 · see citing works
Editorial
Brown, B. S. (1998) · Journal of Substance Abuse Treatment · doi:10.1016/s0740-5472(97)00284-5 · Cited by 11 · see citing works
State-of-the-art methodologies in alcohol-related health services research
Perl, H. I., Dennis, M. L., & Huebner, R. B. (2000) · Addiction · doi:10.1080/09652140020004232 · Cited by 9 · see citing works
Self-citation
State‐of‐the‐art methodologies in alcohol‐related health services research
Perl, H. I., Dennis, M. L., & Huebner, R. B. (2000) · Addiction · doi:10.1046/j.1360-0443.95.11s3.1.x · Cited by 7 · see citing works
Self-citation
Romance, Realism and the Future of Alcohol Intervention Systems
Humphreys, K. N., & Tucker, J. A. (2002) · Addiction · doi:10.1046/j.1360-0443.2002.0005f.x · Cited by 5 · see citing works
Ask the Right Questions and Make Good Use of the Answers: A Response to Humphreys & Tucker
Perl, H. I., & Hilton, M. E. (2002) · Addiction · doi:10.1046/j.1360-0443.2002.0005c.x · Cited by 3 · see citing works
Self-citation
In This Issue: Real Change Is Real Hard in the Real World
Stange, K. C., & Phillips, W. R. (2007) · The Annals of Family Medicine · doi:10.1370/afm.684 · Cited by 3 · see citing works

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Authors: Perl, H. I.
Corresponding author: Perl, Harold I.
Venue: Addictive Behaviors
Publisher: Elsevier BV
Published: 2011-06
Volume: 36
Issue: 6
Pages: 590-596
ISSN: 0306-4603 (ISSN-L)
DOI: 10.1016/j.addbeh.2011.01.027
OpenAlex: W2061564892
Cited by: 15
References: 50
Citations by year: 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2015: 1 · 2014: 1 · 2013: 1 · 2012: 1
FWCI: 1.79
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Addictive Behaviors (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute on Drug Abuse
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords: addiction prevention, addiction treatment, implementation research, evidence-based practice, research-practice gap, research incentives, research funding priorities, quality of care
MeSH terms: Delivery of Health Care, Health Plan Implementation, Humans, Terminology as Topic, Research, Behavior, Addictive, Evidence-Based Medicine, Information Dissemination

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Addicted to discovery: Does the quest for new knowledge hinder practice improvement?

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