Dissemination, implementation and impact

The NIHR Mission is to improve the health and wealth of the nation through 'research'. To achieve this at scale, clear plans need to be in place to share the findings and outputs of the research as widely as possibly, through dissemination. Dissemination is defined as an active approach to spreading of research findings to the target audience via determined channels using planned strategies. Secondly, there is a need to map out the steps to upscaling an intervention or translating knowledge and guidance into practice, through implementation. Impact is the ‘demonstrable contribution that your research makes to society and the economy, of benefit to individuals, organisations and nations’ (NIHR 2022).

Dissemination is needed to communicate the key messages of the research to as wide an audience as possible.  This can include academic papers to an academic audience, but also executive summaries, lay summaries, infographics, videos and blogs. By using varied formats and media and budgeting for translation into different languages, your results can reach further and influence people who have either been disillusioned with research or have had little opportunity to engage with it.

It is particularly important that you explain in your proposal how you describe your dissemination plan, including how you will take the research findings back to the communities who have been involved, as public contributors or participants, and outline the next steps to them. This is key to sustaining relationships and ensuring that under-served communities are not left feeling shut out of the outcomes of the research and that their trust and good will has been exploited. Depending on who has been involved in your research, you may need to consider:

Making plans for implementation, and including questions or a work package about implementation in your study, is key to ensuring that your study has a credible and prompt ‘pathway to benefit’ for patients, service users and/or NHS, public health or social care services.

Implementation studies usually have outcomes which measure both effectiveness of the research/intervention/tool and effectiveness of the implementation strategy (Proctor et al. 2010). Some implementation studies have two primary outcomes; one effectiveness and the other, implementation to reflect this.  Researchers often concentrate on the effectiveness of the intervention and delay considering implementation until much later. 

 If the diversity  of the groups included and appropriate study design for these groups are not factored into the intervention effectiveness phase, the population that the intervention has been tested on could be quite narrow. The researchers may then have limited time, funds and mechanisms for making the intervention more inclusive at the implementation effectiveness stage.  For example, if up until this point the research has only been conducted with English-speaking participants, or only at urban sites with good hospital/university links (Smith et al 2016) or with people under 65 (Bourgeois et al. 2017), then the resultant implementation of the research could be contributing to health and care inequalities and not targeting the highest need. 

Prioritising research inclusion from the outset of any study is essential to avoid missed opportunities to tackle – or even the risk of exacerbating – health and care inequalities. Facilitating diverse and inclusive public involvement, research participation and stakeholder involvement, through a considered research design, will maximise the likelihood of the research findings being successfully mobilised in diverse and complex real-world settings. This is key to achieving equitable impact that benefits those in greatest need, thus helping to reduce health and care inequalities.

Key messages

• Dissemination needs to be tailored to the different and diverse audiences which your findings need to reach.
• Implementation to diverse communities needs to be considered at the design process, and not through adaptations further down the line.
• Adopting inclusive approaches to dissemination and implementation from the outset is more likely to lead to impact which includes reducing health and care inequalities.

• Plain English Campaign – guidance on writing in plain English
• Dos and don’ts on designing for accessibility – blog post by Karwai Pun
• Centre for Ethnic Health Research Equality Impact Assessment Toolkit to assist with planning the impact of research on different demographic groups
• NIHR knowledge mobilisation and impact guidance – for support with planning and useful resource

Bourgeois, F.T. (2017) Exclusion of elderly persons in randomized clinical trials of drugs for ischemic heart disease, Journal of American Geriatrics Society, 65 (11): 2354-2361.

Egli, V. et al. (2019) ‘Disseminating research results to kids: practical tips from the Neighbourhoods for Active Kids study’, Kōtuitui: New Zealand Journal of Social Sciences Online, 14(2): 257-275.

NIHR (2020) ‘Strengthening our commitment to equality, diversity, inclusion and patient and public involvement and engagement (PPIE). Available online at: https://www.nihr.ac.uk/documents/strengthening-our-commitment-to-equality-diversity-inclusion-and-patient-and-public-involvement-and-engagement-ppie/24697 (accessed  20/12/21).

NIHR (2021) Easy-read report: The risk of forced marriage for people with learning disabilities from South Asian communities. Available online at: https://evidence.nihr.ac.uk/alert/easy-read-risk-forced-marriage-people-with-learning-disabilities-south-asian-communities/ (accessed 5/05/21).

Proctor, E. et al. (2010), Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda, Journal of Administration and Policy in Mental Health, 38 (2): 65-76

Smith, T.A. et al. (2016) ‘Selecting, Adapting, and Implementing Evidence-based Interventions in Rural Settings: An Analysis of 79 Community Examples’, Journal of Health Care for the Poor and Underserved, 27(4A):181-193.