Table 1.

Examples of interventions appropriate for de‐implementation

Intervention(s)	De‐implementation criteria	Description	Intended outcomes
D.A.R.E.	Ineffective	Drug Abuse Resistance Education (D.A.R.E.) program, designed to reduce drug use among adolescents (Ennett et al., 1994; Vincus et al., 2010; West & O'Neal, 2004), was widely implemented in the 1980s and 1990s. When evidence of effectiveness became part of the criteria for obtaining federal funding, the program was revised in 2003 (Petrosino et al., 2006), but failed to demonstrate effectiveness (Vincus et al., 2010).	Prevent youth substance abuse
Infant Sleeping Position Guidelines	Harmful	In the mid‐1950s, recommendations for infant sleeping position changed to placing children in a prone position (on their stomachs) out of choking concerns (Gilbert et al., 2005). The prone position continued to be recommended in the US and abroad into the 1990s (Dwyer & Ponsonby, 1996; Gilbert et al., 2005), and has likely contributed to unnecessary infant deaths due to SIDS. In 1992, the American Academy of Pediatrics Task Force on Infant Sleep Position and SIDS officially recommended that babies be placed on the back or side when sleeping and has subsequently revised guidelines multiple times.	Prevent infant mortality due to SIDS
Healthy Families America	Ineffective	Widely implemented across the US, Healthy Families America is an intervention designed to promote child well‐being and reduce child abuse. While demonstrating effectiveness in child well‐being, several studies showed the intervention failed to effectively reduce child abuse and neglect (Duggan et al., 2004).	Prevent child abuse and neglect
Well Digging in Himalaya regions	Harmful	Tube wells are a common approach to reduce waterborne disease, but led to one of the largest mass poisonings in history in the Himalaya region of the world because of naturally occurring arsenic in the water table. In Bangladesh alone approximately 57 million people were exposed to unacceptably high levels of arsenic through tube wells as of 2000 and experienced related complications (Smith, Lingas, & Rahman, 1997). Dismantling and replacing wells has proved difficult due to social and economic factors (Hossain et al., 2015).	Prevent waterborne infection
Deinstitutionalization for mental health in the US	Low value	Community‐based care and psychotropic medications for treatment developed in the 1950s became an alternative to long‐term, often involuntary commitment in mental hospitals (Chafetz et al., 1982; Gronfein, 1985). The collection of treatment alternatives supporting the deinstitutionalization movement led to an 80% drop in mental hospital populations in subsequent decades (Mechanic & Rochefort, 1990) allowing many individuals to reintegrate and participate in society.	Provide mental health treatment
Evidence‐based HIV interventions	Low value	Around 2006 the Centers for Disease Control and Prevention disseminated a suite of evidence‐based behavioral HIV prevention interventions to local organizations (Collins & Sapiano, 2016; Johns et al., 2016). Due to continued investment in biomedical research, pre‐ and postexposure prophylaxis (PreP and PEP) have demonstrated such high efficacy that it is now more cost‐effective to provide PreP and PEP to those who are at highest risk for HIV rather than provide behavior change interventions to a more general population (Holtgrave, 2010).	Prevent HIV infection
Polio eradication through immunization	Issue has dissipated	The Global Polio Eradication Initiative (GPEI) began in 1988 when polio was still a world‐wide epidemic (World Health Organization (WHO), 2017). To date, efforts have largely been scaled back and polio only persists in a small number of countries.	Prevent polio infection
Ebola outbreak	Issue has dissipated	The response to the Ebola outbreak in several African countries in 2014 involved massive deployment of staff, infrastructure build‐up, collaborations with other relief organizations and national governments, development of treatment guidelines and training for existing clinicians, and takeover of local health systems in multiple countries (WHO, 2015b). Much of the infrastructure persists although the epidemic has now subsided.	Prevent Ebola infection
Postdisaster relief	Issue has dissipated	The postdisaster relief effort in Japan after the 2011 earthquake, tsunami, and nuclear accident required incredible disaster relief effort and reconstruction. The Japan Medical Association dispatched approximately 1400 Japan Medical Association Teams within days which remained in place to provide care in impacted communities until the healthcare system could be reconstructed. After 3 months, teams were withdrawn upon full recovery of the healthcare system (Ishii & Nagata, 2013).	Provide emergency and urgent healthcare services