Translating Research to Practice
Lessons learned, areas for improvement, and future directions
- Russell E. Glasgow, PHD
- From the Clinical Research Unit, Kaiser Permanente–Colorado, Denver, Colorado
- Address correspondence and reprint requests to Russell E. Glasgow, PhD, Kaiser Permanente–Colorado, P.O. Box 378066, Denver, CO 80237-8066. E-mail: russg{at}ris.net
- DPP, Diabetes Prevention Program
- RE-AIM, Reach, Effectiveness, Adoption, Implementation, and Maintenance
Diabetes and its care have captured the attention of clinicians, managed care, regulatory agencies, and the media. Several successful trials over the past decade have brought the issue of translating evidence-based findings on diabetes care into practice to the forefront of health care discussions (1–3).
Despite these promising advances, it is well documented that there is a large gap between what is known about diabetes care and what is commonly practiced (4–6). Studies of the level of diabetes care provided in the real world, and especially in primary care practices where the vast majority of patients are seen, consistently show that performance levels fall short of what is recommended (4–7). Even relatively simple actions, such as ordering a blood sample for analysis or regularly checking HbA1c, are performed far less frequently than recommended (5,6). Adherence to behaviorally oriented aspects of good diabetes and preventive care are performed even less often (with the possible exception of smoking cessation advice) (4,7).
Diabetes Care has devoted a series of articles to the discussion of translation issues and different perspectives on this topic (8–10). This article contributes to the discussion by 1) discussing changes needed in the conduct of research studies if we are to reduce the gap between research and practice, and 2) identifying specific areas for future translation research. There have been two positive examples of the adoption of research-based innovations. First, there has been a paradigm shift in the approach to self-management education and behavior change, both within diabetes education and the broader behavioral science community. This shift has been from provider-centered “compliance” approaches to more patient-centered “empowerment” methods (11–13).
The second change that has become widely adopted, at least within leading …
