Table 6.

Updated Competencies by Domain and Level of Trainee Expertise Needed to Attain.

D&I competency	D&I expertisea
Section A: definition, background, and rationale
Define and communicate dissemination and implementation (D&I) research terminology	B
Define what is and what is not D&I research	B
Differentiate between D&I research and other related areas, such as efficacy research and effectiveness research	B
Identify the potential impact of disseminating, implementing, and sustaining effective interventions, including assessments of equity and representativeness	Bb
Describe the range of expertise needed to conduct D&I research (e.g., mixed-methods experience, economic, organizational, policy, clinical)	B
Examine the importance of rapid research to advance D&I science concepts and directions	Bc
Determine which evidence-based interventions are worth disseminating and implementing	I
Assess, describe, and quantify (where possible) the context for effective D&I (setting characteristics, culture, capacity, and readiness)	I
Identify existing gaps in D&I research	I
Identify the potential impact of scaling down (aka de-implementing) an ineffective but often used intervention	I
Formulate methods to address barriers and facilitators of D&I research	Ib
Section B: theory and approaches
Describe a range of D&I strategies, models, and frameworks	B
Design strategies to address the multi-level influences of health inequities as it relates to the implementation of an evidence-based intervention	Ic
Identify appropriate conceptual models, frameworks, or program logic for D&I change	I
Identify core elements (effective ingredients) of effective interventions, and recognize risks of making modifications to these	I
Describe a process for designing for dissemination (planning for adoption, implementation, and sustainability during the intervention development stage)	I
Describe the relationships between various organizational dimensions (e.g., climate, culture) and D&I research	I
Characterize process models that support iterative cycles of implementation and adaptation based on learning	Ic
Explain how knowledge from disciplines outside of health (e.g., business, marketing, and engineering) can help inform further transdisciplinary efforts in D&I research	I
Identify and articulate the interplay between policy and organizational processes in D&I	I
Section C: design and analysis
Describe the core components of external validity and their relevance to D&I research	B
Identify common D&I measures and analytic strategies relevant to your research question(s)	B
Identify and measure outcomes that matter to stakeholders, adopters, and implementers	I
Describe the application and integration of mixed-method (quantitative and qualitative) approaches in D&I research	I
Apply common D&I measures and analytic strategies relevant for your research question(s) within your model/framework	I
Identify possible methods to address external validity in study design reporting and implementation	I
List the potential roles of mediators and moderators in a D&I study	I
Identify and articulate the trade-offs between a variety of different study designs for D&I research	I
Describe how to frame and analyze the context of D&I as a complex system with interacting parts	I
Effectively integrate the concepts of sustainability/sustainment and the rationale behind them in D&I study design	I
Describe gaps in D&I measurement and critically evaluate how to fill them	A
Operationalize hybrid effectiveness-implementation designs when appropriate to accelerate the implementation of evidence-based interventions in real-world settings	Ac
Develop and assess processes and outcomes that support iterative cycles of implementation and bidirectional flow of information (e.g., learning health systems)	Ac
Effectively explain and incorporate concepts of de-adoption and de-implementation into D&I study design	A
Incorporate methods of economic evaluation (e.g., implementation costs, cost-effectiveness) in D&I study design	A
Evaluate and refine innovative scale-up and spread methods (e.g., technical assistance, interactive systems, novel incentives, and “pull” strategies)	A
Section D: practice-based considerations
Describe the importance of incorporating the perspectives of different stakeholder groups (e.g., patient/family, employers, payers, healthcare settings, public organizations, community, and policy makers)	B
Summarize the importance of ethically and culturally competent clinical and community-based research in D&I science	Bc
Describe the concept and measurement of fidelity	B
Articulate the strengths and weaknesses of participatory research in D&I research	B
Integrate strategies within D&I research to facilitate meaningful stakeholder engagement (e.g., shared power, shared decision-making, co-learning)	Bc
Determine when engagement in participatory research is appropriate with D&I research	I
Describe the appropriate process for eliciting input from community-based practitioners for adapting an intervention	I
Identify and apply techniques for stakeholder analysis and engagement when implementing evidence-based practices	I
Identify a process for adapting an intervention and implementation strategy prior to and during implementation	Ib
Describe how adaptations will be documented throughout the D&I research project	Ib
Explain how to maintain fidelity of original interventions during the adaption process	I
Identify sites to participate in D&I studies, and negotiate or provide incentives to secure their involvement	I
Identify and develop sustainable partnerships for D&I research	I
Develop strategies to promote equity in resource distribution across all external research partners, including community partners or other external organizations and the researcher's institution	Ic
Describe how to measure successful partnerships for D&I research	I
Use evidence to evaluate and adapt D&I strategies for specific populations, settings, contexts, resources, and/or capacities	A

Note. D&I = dissemination and implementation.

^a Expertise levels: B  =  beginner; I  =  intermediate; A  =  advanced; ^b Updated competency; ^c Novel/emerging competency.