Gaining market share for health: A social marketing framework for implementation science

Implementation science struggles to bridge the evidence-to-practice gap because market dynamics at the T3 (translation to practice) and T4 (translation to populations) stages remain unaddressed. This commentary advances three theoretical claims: implementation stages constitute distinct markets where adoption failures are market failures; exchange theory must extend to multi-level ecosystems; and system dynamics-based interactive learning environments (SD-ILEs) enable mental model restructuring via co-created narrative experiences. I propose a social marketing framework across the T3-T4 continuum, differentiating it from leading implementation frameworks. The approach is illustrated through Pb-ROADS, a narrative-computational ILE for lead (Pb) exposure prevention. Implications include new outcome metrics (e.g., market share of evidence-based practices), practitioner competencies like "systems fluency," and a reassessment of academic training infrastructure.