Adapting and disseminating effective public health interventions in another country: towards a systematic approach

BACKGROUND: Public health interventions that have proven effective in one country, are often adapted and disseminated in other countries. However, the process by which effective interventions are chosen for adaptation and dissemination in another country is often not conducted systematically. METHODS: We propose a more systematic approach and describe the main steps that have to be taken in the assessment of the usefulness of effective interventions in another national context. RESULTS: The following steps are proposed. Step 0: Point out the most relevant areas in public health (this is a collaborative effort by policy makers, scientists and practitioners). Step 1: Identification of potentially effective interventions (through systematic literature searches). Step 2: Assessing the levels of evidence and grades of recommendation for adoption. Step 3: Can the results of the trials be generalized to the national situation? Step 4: Can the intervention be implemented in the national situation? CONCLUSION: A more systematic approach to the adaptation and dissemination can be adopted. The basic steps described should be worked out in more detail before they can be used in practice.