Table 1.

Extending D&I principles to early-stage translational research

Principles from D&I sciences	Implications for late-stage research	Rationale for role in early-stage research
Context matters and is multi-level	Successful dissemination of research knowledge and implementation of scientific discoveries are profoundly affected by healthcare policy, organizational and community culture and climate, and attitudes and behaviors of key stakeholders	All research, including basic and pre-clinical, is conducted and translated within a complex multi-level context
It is not sufficient that evidence exists and/or a practice works	We must be equally concerned with whether evidence can be disseminated to reach key stakeholders and whether practices can be taken up and delivered in real-world settings. This compels accompanying lines of inquiry	Intervention design and development benefits from appreciation of the factors that influence later-stage adoption and implementation, such as usability, desirability, feasibility, and cost
Change happens proactively	To facilitate the adoption, spread, and sustainment of improved diagnostics, therapeutic, and service delivery interventions, strategies must be developed, used, and continually improved through scientific inquiry	Even in the early stages of research, people working in systems decide what research will be pursued and how it will be done. Strategies that influence behaviors and social relationships are relevant
Both implementation practice and implementation science are team endeavors	Implementation practice requires iterative engagement and involvement of a range of stakeholders, including patients, clinicians, administrators, researchers, and policymakers. Similarly, implementation science is inherently transdisciplinary, involving treatment developers and researchers, health services researchers, and experts from closely related fields such as industrial psychology and communications research	The bidirectional exchange of information and perspectives between stages and disciplines improves the likelihood that research products will bridge translational gaps. This is true even in early stages of research

D&I, dissemination and implementation.