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QUERI Implementation Guide

Part 1 Section 3: Methods Used in Translating Research into Practice

In describing methods that are appropriate to use across the pipeline of activities involved in moving research evidence into practice, it is helpful to understand the larger context of the QUERI program and its current (as of 2004) portfolio of activities. QUERI targets nine conditions/diseases that are prevalent among veterans, including: chronic heart failure (CHF), colorectal cancer (CRC), diabetes mellitus (DM), HIV/AIDS, ischemic heart disease (IHD), mental health (MH), spinal cord injury (SCI), stroke (STR), and substance use disorders (SUD). Additional conditions may be added periodically. This section of the Guide includes:

  • An overview of the QUERI approach,
  • The QUERI process with examples of methods,
  • Typology of QUERI implementation project designs, and
  • Resources detailing these and related methods.

Most health services researchers have received a significant amount of training in study design, and are generally prepared to use the texts and references cited throughout and at the end of this section. Rather than attempt to replicate or reproduce the work of literally hundreds of texts and articles, we refer you to them. If these are not easily understood, we recommend working closely with a seasoned methodologist or researcher with a background in implementation of quasi-experimental and other non-randomized controlled trial designs or in program evaluation.

The Big Picture: Efficacy to Effectiveness Trials

Recently, Glasgow and others1 reviewed the distinctions between efficacy and effectiveness studies within the larger context of the Greenwald and Cullen model of sequential phases of intervention research.2 According to this scheme, benefits of interventions are first tested in small-scale, tightly controlled efficacy trials. Once benefits are demonstrated under those conditions, improvements in outcomes are then tested in larger, real world settings via effectiveness trials. QUERI’s portfolio is largely comprised of effectiveness-style research. However, according to the Greenwald-Cullen model, effectiveness studies are necessarily followed by large-scale demonstrations, or what they refer to as dissemination projects.

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