Dissemination Strategies to Accelerate the Policy Impact of Children’s Mental Health Services Research

Abstract

The United States is in the midst of a children’s mental health crisis, with rates of depression, anxiety, and suicide increasing precipitously. Evidence produced by children’s mental health services research can help address this crisis by informing public policy decisions about service delivery, system design, and investments in the social determinants of mental health. Unfortunately, the policy impact of children’s mental health services research is limited because evidence often fails to reach policymakers, be responsive to their needs, resonate with their worldview¹, or reflect the contexts in which they make decisions. Dissemination strategies—defined as the development and targeted distribution of messages and materials about research evidence pertaining to a specific issue or intervention—can help address these challenges. Yet, limited integrated guidance exists to inform the design of such strategies. This article addresses this need by synthesizing the results of empirical studies to provide guidance about how to enhance the dissemination of children’s mental health services research to policymakers. The article: 1) provides recommendations about the content of policymaker-focused dissemination materials, 2) discusses how strategic framing and message tailoring can increase the chances that evidence is persuasive to policymakers, and 3) highlights strategies to ensure that evidence reaches policymakers.

INTRODUCTION

In 1980, two policy scientists—Jack Knott and Aaron Wildavsky—published an article entitled “If dissemination is the solution, what is the problem?” The article thoughtfully critiqued the idea that disseminating research findings to policymakers was a panacea to social problems, a notion that was gaining acceptance at the time. A central tenant of Knott and Wildavsky’s argument was that the problem which dissemination sought to solve was often ill-defined and that blindly disseminating evidence without considering the diverse characteristics of policymakers and the contexts in which they make decisions was ineffective, and potentially counterproductive.

Although dissemination is by no means a silver bullet to challenges related to evidence-informed policymaking,^3–7 we argue that effective knowledge translation is part of a solution to an important problem in the arena of children’s mental health services research. We view the problem as this. The United States is in the midst of a children’s mental health crisis, with rates of depression, anxiety, and suicide demonstrating historically steep increases.^8–11 Many policymakers are aware of the crisis and most, if not all, want children to be mentally healthy and flourish. And yet, they often do not develop or support the policies that would contribute to this goal because they are unaware of, or uncompelled by, evidence produced by children’s mental health services research. Evidence about what treatments work and the social determinants of children’s mental health is generally not communicated in ways that reaches policymakers, is responsive to their information preferences, resonates with their worldview, or reflects the contexts in which they operate.

As a consequence of the ineffective translation of children’s mental health research, the policy and funding environment hinders the reach, fidelity, and sustainment of evidence-based mental health treatments for children and their families as well as social and economic policies that contribute to youths’ mental wellness.^12–14 For example, state mental health agency investments in evidence-based treatments are in decline¹⁵ and only 29 states have a definition of “evidence” to inform mental health policy and program decisions, and only 16 of these definitions have multiple tiers of evidence. ^{14–15, 17} Policies that increase access to children’s mental services are under-utilized¹⁸ and, as a result, approximately half of children who need mental health services do not receive them—in some states the proportion not receiving these services is greater than 70%.¹⁹

Dissemination Science: Not a Panacea, but Potentially Useful

Dissemination science—defined by the National Institutes of Health as the “scientific study of targeted distribution of information and intervention materials to a specific public health or clinical practice audience” (PAR-19–274)—can generate information to enhance the translation of children’s mental health services research. However, relatively little dissemination research in the United States has focused on public policymakers;²⁰ and even less has explicitly focused on mental health,^21–23 let alone children’s mental health.

Successful policymaker-focused dissemination strategies are presumably different for mental health than physical health because mental illness stigma is pervasive^24–30 and public willingness to allocate financial resources is lower for mental than physical health services.^31,32 The importance of effective policymaker-focused dissemination is amplified for children’s mental health because complexities which are specific to the issue. Such complexities include, but are not limited to the following: a paradox in which some mental health conditions (e.g., attention deficit hyperactivity disorder)³³ are over diagnosed and some medications (e.g., antipsychotics)³⁴ are over prescribed among children while, simultaneously, many children with serious need are not diagnosed or treated;¹³ the fact that families, and opposed to individuals, are often the unit intervention; and that a wide range of public sector agencies interface with children’s mental health issues (e.g., education, child welfare, Medicaid, juvenile justice) but few policymakers in these agencies having specialized knowledge about children’s mental health. In the absence of empirical guidance to help children’s mental health services researchers and advocates effectively disseminate evidence to policymakers, the designs of dissemination strategies are typically based on anecdote, not data. As a consequence, evidence is not sufficiently reach, educate, or inform policymakers.

The aim of this article is to provide guidance for researchers, advocates, and organizations who wish to use dissemination strategies to accelerate the policy impact of evidence produced by children’s mental health services research. To achieve this, we synthesize research about evidence-informed policymaking, including recent studies about the dissemination of mental health and substance use (i.e., behavioral health) research to state policymakers. The article builds on prior reviews of barriers and facilitators to evidence-informed policymaking^{3–5,7,35–37} by extending learnings to the specific area of children’s mental health. The article is also sensitive to critiques of the evidence-informed policymaking literature^38–40 as we approach policymaker-focused dissemination as a challenge of political persuasion, not only a challenge of technical communication.

There are several parameters of the article that should be noted. The article does not provided recommendations regarding specific findings from children’s mental health research that should inform policy decisions, as such recommendations are provided in other reviews.^13,41–44 The article also does not discuss barriers related to fundamental differences between researchers and policymakers (e.g., different incentive structures, different thresholds for accepting scientific uncertainty)⁷ because these barriers, and interventions to address them, are not specific to children’s mental health. Finally, the focus of the article limited to dissemination strategies that push mental health research findings to policymakers as opposed to complementary strategies that encourage the pull of research findings by policymakers.⁴⁵

REVIEW OF RELEVANT RESEARCH

This article draws heavily from findings from studies conducted as part of a National Institute of Mental Health-funded R21 project focused on developing the evidence base to inform the dissemination of mental health research to state policymakers.^23,46–50 In response to feedback obtained from policymakers during the instrument piloting phase of the project, the focus of the project was expanded to include substance use research. Thus, project instruments used language of “mental health/substance use” and the term “behavioral health” is used in the paper when referring to project findings. Complete details about the methodologies of the surveys are available in the published study protocol.²³

The project involved surveys of two types of policymakers: state legislators and state mental health agency (SMHA) directors and senior staff. Table 1 summarizes differences between these two types of policymakers that are relevant to dissemination. It should also be noted that there is substantially heterogeneity among both legislators and state agency officials when it comes to their knowledge about, and ability to address, children’s mental health issues. Among legislators, the most important dissemination audiences are likely legislators on key committees—such as health, education, and child welfare. Among SMHA officials, the most relevant policymakers are likely those who lead the children’s division.⁵¹ Policymakers in other state agencies—such as Medicaid, child welfare, education, and juvenile justice—are also highly relevant dissemination audiences.

Table 1.

Differences Between State Legislators and State Mental Health Agency Officials that Are Relevant to Dissemination

Key Characteristic Relevant to Dissemination	State Legislators	State Mental Health Agency Officials
Content expertise	Unlikely to have content expertise in behavioral health	Likely has content expertise in behavioral health, with most leaders having advanced degrees in psychology or psychiatry
Primary sources of accountability	Constituents, political party	Governor, senior leadership within agencies, state legislature
Scope of practice	Very broad, behavioral health is only one of hundreds of issues that legislators might address	Narrowly focused on behavioral health issues, often one specific aspect of a behavioral health system (i.e., child and family services)
Primary roles in policy process	Policy development	Policy implementation, as well as policy development

The research synthesis presented in this section focuses on three domains of policymaker-focused dissemination strategies (Table 2). Drawing from Leeman and colleagues’ definition, we define dissemination strategies as the development and targeted distribution of messages and materials about research evidence pertaining to a specific issue or intervention.⁵² We first synthesize research about what evidence policymakers want when it comes to mental health issues and provide recommendations for developing dissemination materials. Second, we discuss how strategic framing and message tailoring can increase the chances that evidence is persuasive to policymakers. Third, we highlight how intermediary organizations and initiatives that foster relationships between researchers and policymakers can help ensure that children’s mental health services research findings reach and are used by policymakers.

Table 2.

Empirically-Informed Recommendations for the Design of Strategies to Disseminate Children’s Mental Health Services Research Policymakers

Dissemination Strategy Domain	Recommendation
Curate Content of Dissemination Materials	• Include economic evaluation data, such as information about the cost-effectiveness of different children’s mental health services and budget impact of investments in children’s mental health service systems • Use state and local data that corresponds with the jurisdiction of policymaker when presenting evidence about the prevalence of children’s mental health issues and service availability • Keep dissemination materials concise and to the point • Emphasize evidence in dissemination materials that target legislators who prioritize behavioral health issues (e.g., legislators who introduce behavioral health bills)
Use Strategic Frames and Tailor Materials for Different Audiences	• Use stories to illustrative and systems and structural factors influence children mental health outcomes • Emphasize that factors beyond the control of children and their families affect mental health outcome • Be sensitive to the fact that stigma towards children with mental illness is pervasive among state legislators and their constituents • Recognize that framing investments in children’ mental health as a strategy to prevent mass shootings is likely to produce and perpetuate stigma • Recognize that Democrat and Republican (and liberal and conservative) legislators have different behavioral health dissemination preferences, knowledge about children’s mental health issues, and opinions about the effectiveness of mental health services
Use Intermediary Organizations to Ensure Reach of Dissemination Materials	• Account for the fact that elected and administrative policymakers turn to different sources for behavioral health evidence—with mental health advocacy organizations being the primary sources for legislators and professional organizations being the primary source for state mental health agency officials.

Being Responsive to Policymakers’ Information Preferences: Curating the Content of Dissemination Materials

Although the amount of information that can be included in dissemination materials (e.g., a policy brief) is finite, the number of ways in which information can be presented is infinite. Thus, the development of dissemination materials necessitates decisions about what information to include and how it should be packaged.⁵³ Drawing from the literature, we identify four key considerations for developing dissemination materials about children’s mental health for state policymakers and provide concrete guidance to aid the development of these materials. Readers may consult Butler and Rodgers for a detailed description of the process of developing a policy brief about children’s mental health.⁵⁴

The Value of Economic Evaluation Data

Developing budgets and allocating resources for mental health services are core activities of policymakers.⁵⁵ Thus, policymakers want information about the economic impacts of mental health interventions. Among state legislators, 82% identify cost-effectiveness data as a “very important” feature of behavioral health evidence summaries and 82% identify data about budget impact as “very important.”⁴⁶ Among SMHA officials the proportions are 86% and 81%, respectively.⁴⁹ Cost-effectiveness data appear to be of particular importance to legislators and influencing likelihood that they will use evidence summaries. Eighty percent of legislators indicate that they would be substantially more likely (rated as 4 or 5 on a 5-point Likert scale) to use a research brief if it presented data about cost effectiveness of behavioral health treatments, instead of just the clinical effectiveness of the treatments. Among SMHA officials the proportion is 44%.

While economic evaluation data is important to all legislators, is it especially important to Republicans. When Republican and Democrat legislators are compared, a significantly higher proportion of Republicans identify data about cost-effectiveness (89% vs. 76%) and budget impact (87% vs 77%) as “very important” features of behavioral health research.⁴⁶ Given that prior research has found that Republicans are generally less supportive of spending on behavioral health services than Democrats,^29,55 demonstrating the economic benefits of investments in children’s mental health could be key to cultivating bipartisan support for policies that increase access to children’s behavioral health services.

Recommendation #1: Include Economic Evaluation Data in Dissemination Materials.

To produce mental health economic evaluation data, researchers might consult reviews which have estimated the costs-effectiveness of various mental illness prevention initiatives⁵⁶ and published guidance for conducting economic evaluations of mental health interventions.^57,58 To obtain estimates related to specific evidence-based children’s mental health services, the Washington State Institute for Public Policy’s Benefit-Cost Results database offers useful information (e.g., cognitive behavioral therapy for anxiety among children, cost-benefit ratio= $24.18; Triple P—Positive Parenting Program, cost-benefit ratio= $7.66).⁵⁶ Information about SMHA spending across different program areas is also publicly available, making it possible to produce and disseminate state budget-specific estimates of the economic impact of scaling-up, scaling-out, and de-implementing various children’s mental health interventions.

The Local Relevance of Research Findings

State policymakers serve their constituents. Thus, it is not surprising that studies show that policymakers want mental health research that is relevant to populations they represent.⁶⁰ This is especially true for SMHA directors, 93% of whom identify “relevance to residents in [their] state” as a “very important” feature of behavioral health research.^46,49 Forty-eight percent of legislators indicate that that they would be substantially more likely (rated as 4 or 5 on a 5-point Likert scale) to use a research brief if it presented data about behavioral health problems among residents in their legislative district as opposed to their state in aggregate. Among SMHA officials, 37% indicate that that they would be substantially more likely to use a research brief if it presented this data for different counties in their state, as opposed to their state in aggregate. Randomized-controlled dissemination experiments in the U.S. and U.K. have found that tailoring evidence summaries with data that corresponds with the geography that a policymaker serves increases the likelihood of using and engaging with evidence.^61,62

Recommendation #2: Use State and Local Data.

Using state and local, as opposed to national, data about the magnitude of children’s mental health problems is one way to demonstrate the relevance of an issue to a policymaker’s constituents. State estimates of the prevalence of children’s mental health issues are readily available, such as those that can be derived from the National Survey on Children’s Health and other children’s mental health surveillance systems.⁶³ Local-level estimates are more challenging to produce. However, national surveillance efforts such as the Youth Risk Behavior Survey produce comparable local data.⁶⁴ Other studies have used small area estimation techniques to present data at the level of U.S. Congressional districts.^65–67 These approaches could be used to generate estimates of the prevalence of child mental health issues at the state legislative district-level.

State and local estimates of children’s mental health service availability can be created through datasets such as the SAMHSA National Mental Health Services and National Survey of Substance Abuse Treatment Services surveys. Preparing and presenting maps using Geographic Information Systems (GIS) is a potentially effective way demonstrate the local relevance of an issue to policymakers^68,69—such as by depicting the distribution of facilities that offer evidence-based children’s mental health services in a geographic region. PolicyMap, a web-based data mapping tool, allows for the boundaries of state legislative districts to be overlaid on top of data relevant to children’s mental health—such as the location of mental health treatment facilities and Head Start Centers. Finally, many states have periodic or point-in-time local service inventories that can be included in dissemination materials.⁷⁰

The Importance of Brevity

Policymakers are very busy and typically under-resourced.^7,71 In many states, legislators have few or no staff—leaving it to them alone to sift through all of the information they receive.⁷² For these reasons, policymakers value brevity in mental health evidence summaries. When presented with a list of 11 potential barriers to using behavioral health research and instructed to select “the three biggest barriers, 43% of legislators and 33% of SMHA officials identify “lack of time” as a primary barrier to using behavioral health research in their work and 28% and 30% of these policymakers, respectively, identify “lack of clear summary of research findings” as a primary barrier. Thus, not surprisingly, 82% of legislators and 81% of SMHA officials identify behavioral health research “being presented in a brief, concise way” as a “very important” feature of disseminated evidence.^46,49 Not only do policymakers value brevity, research suggests that too much evidence can be counterproductive. A randomized-controlled dissemination experiment with policymakers’ in Denmark found that increasing the amount of information in an evidence summary did not produce beliefs that were aligned with the evidence, and in some cases amplified beliefs that were counter to the evidence.⁷³

Recommendation #3: Keep it Brief.

The Importance of Evidence

Studies suggest that the details about empirical evidence should be explicitly emphasized, not glossed over, when communicating with legislators who prioritize behavioral health issues. These legislators are an important target audience because they are typically the ones who draft and introduce children’s mental health bills and cultivate support for their passage.⁷⁴ A 2012 survey of state legislators found that those who prioritized behavioral health issues were significantly more likely than legislators who did not prioritize these issues to identify research evidence as a factor that that influenced their policy priorities.⁷⁵ More recent data are consistent with these results. A 2017 survey found that state legislators who prioritized behavioral health issues were most strongly influenced by the extent a behavioral health bill was based on evidence when deciding whether to support it.⁴⁷

Recommendation #4: Emphasize Evidence for Legislators who Prioritize Mental Health Issues.

When developing evidence summaries for legislators who prioritize mental health issues (identified as such by mental health advocacy organization or a track record of introducing mental health bills), researchers might consider adding details about the study design, p-values, and confidence intervals—while also keeping the information presented concise.

Creating Dissemination Materials That Persuade Policymakers: Framing, Tailoring, and Audience Segmentation

Framing

The effectiveness of dissemination materials can potentially be enhanced by framing mental health evidence in ways that are persuasive to policymakers.⁷⁶ Framing involves selectively emphasizing certain aspects of an issue to alter specific opinions among a target audience.⁷⁷ Framing is particularly important when communicating with policymakers because they rely heavily on heuristics (i.e., cognitive shortcuts) to make decisions, even more so than the general public.⁷⁸ For example, a report published by the FrameWorks Institute identifies heuristics that the public and policymakers might use when thinking about children’s mental health—including the notions that “children can’t have mental health” because their emotional capacities are undeveloped and that mental illness is solely caused by genetic factors and thus cannot be prevented or treated.⁷⁹

The use of strategic frames that account for heuristics can improve the effectiveness of dissemination materials and at a minimum, reduce the risk of dissemination materials reinforcing inaccurate ideas about children’s mental health. Frames can be created, for example, through choices about the evidence that is emphasized in dissemination materials or through the inclusion of brief narratives (i.e., stories) that illustrate how policy and system-level issues affect children with mental health conditions and their families.^80,81 Numerous experiments conducted with the general public have manipulated narratives to generate policy support for behavioral health issues,^28,82–84 although none of this research has focused on children.

Framing decisions about children’s mental health issues can be informed by Corrigan and Watson’s conceptual model of how policymakers make decisions about the allocation of resources for mental health services.⁵⁵ One of the four factors in the model is the extent to which policymakers perceive people as being responsible for their mental health problems. The more policymakers view the problems as being the result of factors beyond a person’s control, the more likely they are to allocate resources to help them.^85,86 Within the context of children’s mental health, an effective frame might emphasize the role of trauma, abuse, and neglect (factors beyond a child’s control) in the development of children’s mental health problems.⁵⁰ Such a frame could also emphasize the role of biogenetic risk factors for mental illness, but caution should be exercised when emphasizing this because such frames can potentially increase stigma towards people with mental illness.^87,88

All frames related to children’s mental health should be sensitive to the fact that stigma towards children with mental illness is common among the US public and policymakers.^89–91 Among state legislators, levels of mental illness stigma are similar to those of the general public.⁴⁸ Relatedly, frames related to children’s mental health should be sensitive to the fact that the public and policymakers’ concerns about mental illness are often linked to concerns about mass shootings,^{29,30,92–94} despite the reality that most people with mental illness are not at increased risk for inter-personal violence perpetration.⁹⁵ Framing investments in children’s mental health as a strategy to prevent mass shootings could potentially cultivate political support among some policymakers, but also produce and perpetuate stigma. For example, a public opinion experiment found that a frame which emphasized systems-level barriers to mental health treatment was as effective as a frame that emphasized violence perpetration at increasing willingness to pay additional taxes for mental health system improvements.²⁹ However, the systems-level barriers did not produce mental illness stigma while the violence perpetration frame did.

Message Tailoring and Audience Segmentation

Strategic frames can be most effective, and avoid undesirable messaging effects, when they are tailored for groups of policymakers with shared characteristics.^96,97 Audience segmentation analysis can help achieve this by identifying discrete groups of policymakers that are similar in terms of their knowledge, attitudes, and behaviors.^98,99 An audience segmentation analysis identified three distinct groups of state legislators for whom tailored frames might be warranted when disseminating evidence about children’s mental health issues. (Figure 1).⁴⁷ “Budget-Oriented Skeptics with Stigma” (comprising 47% of legislators) are characterized by high levels of mental illness stigma, not thinking that behavioral health treatments are effective, being strongly influenced by budget considerations, and ideological conservativism. In contrast, “Action-Oriented Supporters” (24% of legislators) are characterized by perceiving behavioral health issues as policy priorities, introducing behavioral health bills, and being strongly influenced by the strength of evidence. Finally, “Passive Supporters” (29% of legislators) are characterized by having the most faith in the effectiveness of behavioral health treatments, the least mental illness stigma, but being least likely to introduce behavioral health bills. While the audience segmentation analysis was not specifically focused on children’s mental health, findings suggest a need to tailor messages for legislators in the Budget-Oriented Skeptics with Stigma group that emphasize the cost-savings that can be produced by investments in children’s mental health^56,100,101 and be cautious to not amplify stigma towards children with mental illness and their families.

Figure 1.

Three Behavioral Health Audience Segments of State Legislators and Considerations for Tailoring Dissemination Materials with Findings from Children’s Mental Health Services Research

Ensuring that Evidence Reaches Policymakers: The Roles of Intermediaries and Relationships

The content and framing of dissemination materials matter little if they fail to reach policymakers. Thus, it is important to consider where policymakers turn to for mental health research and disseminate evidence to those sources. Data suggest that the primary sources of behavioral health evidence vary between elected and administrative policymakers.

Among legislators, mental health advocacy organizations are the primary source for behavioral health research (53%), while only 16% of SMHA officials turn to these organizations as a primary source.^46,49 Professional organizations (e.g. National Association of State Mental Health Program Directors) are the primary source that SMHA officials turn to (77%), while only 38% of legislators turn to their respective professional organization (e.g., National Conference of State Legislatures) for behavioral health research. Universities are generally not a primary source that policymakers turn to for behavioral health research. Only 27% of legislators and 56% of SMHA officials report turning to universities for this research, and among Republican legislators the proportion is only 19%.

Given that universities are major producers of children’s mental health research, initiatives that foster relationships between university researchers and policymakers could increase the chances that evidence reaches and is used by policymakers. Facilitating social processes and inter-organizational linkages have been identified as important aspects of such strategies.^102–104 Recent research also has found that inter-agency collaboration, broad representation of stakeholders on decision-making bodies, and presence of state-focused, university-affiliated research and evaluation centers were robust predictors of state-level funding and policy supports for evidence-based mental health services.¹⁰⁵

At the state-level, Family Impact Seminar model is one approach to connecting children’s mental health researchers and policymakers which demonstrated promising results.^106–109 The William T. Grant Foundation has also produced guidance about models of research-practice-policy partnerships that can improve the dissemination and use of research evidence in the areas of child mental health and welfare.¹¹⁰ At the federal-level, the Research-to-Policy Collaboration model—which involves legislative needs assessments and a rapid response researcher network—is an example of a model that shows promising at increasing the uptake of findings from prevention science.¹¹¹ Outside of the U.S., intermediary organizations in Canada are supported by government funds to help facilitate connections between mental health researchers and policymakers.¹¹² In Australia, the Supporting Policy In health with evidence from Research: an Intervention Trial (SPIRIT)—which included interactions between researchers and policymakers—found that the intervention improved policymakers perceptions of, and capacity for, research use.¹¹³ With appropriate funding or incentive structures, such models could be adapted for the U.S. context and the area of children’s mental health.

Limitations and Future Directions

As noted above, the focus this article is limited to dissemination strategies that push children’s mental health research findings to policymakers. There are many complementary strategies that may also facilitate the translation of children’s mental health research into policy—such as those that encourage the pull research findings by policymakers, cultivate public demand for evidence-supported children’s mental health policies, and foster coalition building around children’s mental health issues. Research and scholarships that provides concrete guidance about how to execute these strategies would benefit the field.

The data presented in this article about the dissemination preferences of administrative policymakers are limited to those in state mental health agencies and, as noted above, policymakers across a range of executive branch agencies make decisions that affect children’s mental health. There would be value in future research that characteristics these policymakers’ preferences for, and practices of using, children’s mental health research.

There is also a need for research that sheds light on the dynamics of children’s mental health policymaking processes. Such studies can generate insights that could enhance dissemination strategies, such as by elucidating the factors that result in the opening of a “policy window” for children’s mental health and identifying the ideal times in policy cycles to disseminate evidence. While some prior works has been conducted in this area,^60,114,115 there could be benefit future research with a specific eye-towards implications for dissemination strategies. Finally, there is a need for experimental research that tests the effects of different dissemination strategies on policymakers’ engagement with and uses of children’s mental health research, knowledge and attitudes about children’s mental health issues, and ultimately policymaking behaviors (e.g., volume and content of children’s mental health policy proposals).

Conclusions

Like most issues in the realm of children’s mental health, the problem that policymaker-focused dissemination seeks to solve is extremely complex. It would be naive to think that dissemination strategies, even if designed and executed with absolute precision, would transform the policy environment. That said, the effectiveness of dissemination strategies can certainly be enhanced. Specifically, policymaker-focused dissemination strategies can be improved by using empirical data to inform decisions about what information is included in dissemination materials, how evidence is framed for different audiences, and the entities that deliver dissemination materials. Dissemination science can generate these data and help accelerate the policy impact of children’s mental health services research.