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Table 1 Dissemination and implementation models and frameworks assessed

From: Integrated knowledge translation to advance noncommunicable disease policy and practice in South Africa: application of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework

Model/framework D/I# Description Pros Cons
Research Development Dissemination and Utilization Framework [49] D = I Model of social system of knowledge transfer focused on understanding processes of innovation, dissemination, and knowledge utilization • Focus on 4 socio-ecological levels: individual, interpersonal, organizational, and (social) system level
• Stresses the importance of a “linkage” model for describing collaborative interaction between user and resource systems related to internal and external resources
• Focus on research utilization
•Oriented towards dissemination and utilization in social science/education
• Focus on traditional knowledge translation (i.e. research utilization and dissemination only)
• Does not include the policy socio-ecological level
•Low construct flexibility
• No figure associated with this model
Conceptual Model of Knowledge Utilization [50, 51] D Model for knowledge utilization among United States state agency officials focusing on contextual, technical, and bureaucratic variables • Focus on 3 socio-ecological levels: community, system, and policy socio-ecological levels
• Focus on knowledge utilization in public policy
• Highlights the importance of contextual variables
• Dissemination only
• Focus on knowledge utilization
• Does not include individual or organizational socio-ecological levels
Research Knowledge Infrastructure [19] D > I Framework for knowledge translation based on five elements (message, target audience, messenger, KT processes, and evaluation) • Good construct flexibility
• Focus on 4 socio-ecological levels: individual, community, organization, and policy level
• Lacks systems focus
• Generic knowledge transfer framework
• No figure associated with this model
Promoting Action on Research Implementation in Health Services (PARIHS) [52] I Multidimensional evidence-based healthcare determinant framework that focuses on the dynamic relationship among evidence, context, and facilitation • Focus on 3 socio-ecological levels: individual, organizational, community
• Refined framework focusing on integration of theoretical concepts and diagnostic and evaluative measures
• Good conceptual integrity, and face and concept validity
• Developed for use in evidence-based healthcare in nursing practice
• No focus on systems/policy level
Pathways to Evidence-Informed Policy [53] I > D Policy and practice framework outlining three stages (adopt, adapt, and act) in the uptake of evidence • Focuses on 3 socio-ecological levels: individual-, organizational- and systems-level factors in the decision-making process
• Emphasizes the policy context and its influence on each stage of the interaction between research, evidence, and the policy process
• Conceptualized as a pathway rather than framework
• Focuses on policy ideas as the starting point for health decision-making
• No figure associated with this model
Consolidated Framework for Implementation Research (CFIR) [41] I Meta-theoretical determinants framework which identifies constructs across five domains (intervention, inner and outer setting, characteristics of the individual, and process) • Focus on 5 socio-ecological levels: individual, organization, community, systems, and policy level
• Highly cited framework which offers an overarching typology to promote implementation
• Complements process and evaluation theories
• Specifically developed for the field of health services
• Taxonomy of dissemination and implementation (D&I) constructs rather than operational framework
• Lacks focus on dynamic and interlinking factors
Exploration, Preparation, Implementation, Sustainment (EPIS) framework [34, 54] I Framework with four distinct phases to guide and describe implementation (exploration, preparation, implementation, sustainment) that outlines the factors that bridge the outer and inner context, as well as the interconnections and interlinkages that characterize the dynamics, complexity, and interplay of contexts • Focus on 5 socio-ecological levels: individual, organization, community, systems, and policy level
• Offers a temporal element against which to plot D&I constructs
• Research-oriented
• Developed for public services in general
• Limited prescriptive guidance for its use
Evidence Integration Triangle [46] I > D Three-pronged model which emphasizes the interaction between evidence-based interventions, longitudinal measures of progress, and participatory implementation processes • Focus on 5 socio-ecological levels: individual, organization, community, system, and policy levels
• Centred around stakeholder engagement, evidence, and paying attention to context
• Developed for public health policy and practice
• Fosters the creation of rapid learning organizations
• Relative lack of D&I constructs
• No figure associated with this model
Dynamic Sustainability Framework (DSF) [47] I Framework centred around intervention, context, and the broader ecological system and their consideration over time
Arose from the need to better understand how the sustainability of health interventions can be improved
• Focus on 5 socio-ecological levels: individual, organization, community, systems, and policy levels
• Focus on continuous quality improvement to maximize programme fit, organizational learning, and stakeholder involvement
• Developed for health services research
• Focus on sustainability
Relative lack of specific D&I constructs
• Framework needs to be refined and improved over time
Framework for enhancing the value of research for dissemination and implementation research [55] D = I Framework focused on the value of D&I research for end users and key D&I evaluation needs • Focus on 5 socio-ecological levels: individual, organization, community, systems, and policy level
• Focus on consistent evaluation including use of reporting and assessment tools
• Focus on context, stakeholder engagement, and societal cost
• Developed for public health
• Framework to advance D&I research in general aimed at informing D&I reporting guidelines
• Lists essential domains but not D&I constructs
• No figure associated with this model
The context and implementation of complex interventions (CICI) framework [48]   Framework for complex interventions focused on context, implementation, and setting interacting with each other and the intervention for use in systematic reviews and health technology assessments • Solid conceptualization and development with step-by-step pragmatic guidance for operationalization
• Applicable at micro, meso, and macro levels
• Developed for public health
• Requires detailed assessment and reporting of primary research to populate the framework
  1. Adapted from the overview by Tabak et al. [44] and a comparative analysis using the Dissemination-Implementation Webtool (
  2. #D = Dissemination / I = Implementation. The focus is on dissemination and/or implementation activities. D—-only focuses on an active approach of spreading evidence-based interventions to target audience via determined channels using planned strategies. D = I, D > I, and I > D means there is some focus on both dissemination and implementation. I—only focuses on process of putting to use or integrating evidence-based interventions within a setting