Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition

Am J Public Health. 2003 Aug;93(8):1261-7. doi: 10.2105/ajph.93.8.1261.


The gap between research and practice is well documented. We address one of the underlying reasons for this gap: the assumption that effectiveness research naturally and logically follows from successful efficacy research. These 2 research traditions have evolved different methods and values; consequently, there are inherent differences between the characteristics of a successful efficacy intervention versus those of an effectiveness one. Moderating factors that limit robustness across settings, populations, and intervention staff need to be addressed in efficacy studies, as well as in effectiveness trials. Greater attention needs to be paid to documenting intervention reach, adoption, implementation, and maintenance. Recommendations are offered to help close the gap between efficacy and effectiveness research and to guide evaluation and possible adoption of new programs.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Diffusion of Innovation
  • Evidence-Based Medicine
  • Health Promotion*
  • Health Services Research / methods*
  • Humans
  • Information Dissemination
  • Outcome Assessment, Health Care / methods*
  • Practice Patterns, Physicians'*
  • Public Health Practice*
  • Research Design
  • United States