TY - JOUR
T1 - Letting go
T2 - Conceptualizing intervention de-implementation in public health and social service settings
AU - McKay, Virginia R.
AU - Morshed, Alexandra B.
AU - Brownson, Ross C.
AU - Proctor, Enola K.
AU - Prusaczyk, Beth
N1 - Funding Information:
Acknowledgments We thank Chao Cao for helping with the preparation of the manuscript for submission and review. The writing of this manuscript is supported by the National Institute of Mental Health grant numbers 5T32 MH019960, 1R21 MH115772-01, 5R25 MH080916; the National Cancer Institute grant number 5R25CA171994-02; the National Institute of Diabetes and Digestive and Kidney Diseases grant number 1P30DK092950; National Heart, Lung, and Blood Institute grant number 1T32HL130357, and Washington University Institute of Clinical and Translational Sciences grant UL1 TR000448 from the National Center for Advancing Translational Sciences. The Brown School of Social Work and the Institute for Public Health at Washington University also provided generous support.
Publisher Copyright:
© 2018 The Authors.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - The discontinuation of interventions that should be stopped, or de-implementation, has emerged as a novel line of inquiry within dissemination and implementation science. As this area grows in human services research, like public health and social work, theory is needed to help guide scientific endeavors. Given the infancy of de-implementation, this conceptual narrative provides a definition and criteria for determining if an intervention should be de-implemented. We identify three criteria for identifying interventions appropriate for de-implementation: (a) interventions that are not effective or harmful, (b) interventions that are not the most effective or efficient to provide, and (c) interventions that are no longer necessary. Detailed, well-documented examples illustrate each of the criteria. We describe de-implementation frameworks, but also demonstrate how other existing implementation frameworks might be applied to de-implementation research as a supplement. Finally, we conclude with a discussion of de-implementation in the context of other stages of implementation, like sustainability and adoption; next steps for de-implementation research, especially identifying interventions appropriate for de-implementation in a systematic manner; and highlight special ethical considerations to advance the field of de-implementation research.
AB - The discontinuation of interventions that should be stopped, or de-implementation, has emerged as a novel line of inquiry within dissemination and implementation science. As this area grows in human services research, like public health and social work, theory is needed to help guide scientific endeavors. Given the infancy of de-implementation, this conceptual narrative provides a definition and criteria for determining if an intervention should be de-implemented. We identify three criteria for identifying interventions appropriate for de-implementation: (a) interventions that are not effective or harmful, (b) interventions that are not the most effective or efficient to provide, and (c) interventions that are no longer necessary. Detailed, well-documented examples illustrate each of the criteria. We describe de-implementation frameworks, but also demonstrate how other existing implementation frameworks might be applied to de-implementation research as a supplement. Finally, we conclude with a discussion of de-implementation in the context of other stages of implementation, like sustainability and adoption; next steps for de-implementation research, especially identifying interventions appropriate for de-implementation in a systematic manner; and highlight special ethical considerations to advance the field of de-implementation research.
KW - De-implementation
KW - Implementation science
KW - Public health
KW - Social service
KW - Theory
UR - http://www.scopus.com/inward/record.url?scp=85050508541&partnerID=8YFLogxK
U2 - 10.1002/ajcp.12258
DO - 10.1002/ajcp.12258
M3 - Review article
C2 - 29971792
AN - SCOPUS:85050508541
VL - 62
SP - 189
EP - 202
JO - American Journal of Community Psychology
JF - American Journal of Community Psychology
SN - 0091-0562
IS - 1-2
ER -