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Let's Discuss: The Exploration, Preparation, Implementation, Sustainment (EPIS) framework: A phased and multilevel approach to implementation

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To kick off our discussion for the March Advanced Topics Webinar we've invited Dr. Rachel Tabak to share with us her thoughts and to clarify the distinction between models and frameworks. That said we would love to hear your thoughts about the EPIS seminar. We look forward to the discussion!


In light of the series of

In light of the series of webinars that stemmed from January’s “Applying Models and Frameworks to D&I Research” session, focused on the Bridging research and practice: Models for dissemination and implementation researchreview (AJPM 2012; 43: 337-350), I thought it would be helpful to touch on our word choice and clarify what we mean when we say (and said) theories and frameworks.

The use of theories and frameworks in D&I research is increasingly recognized as an important component of study design. Although theories and frameworks are often presented as synonymous, they are distinct concepts. Different fields use these words differently, which can further complicate the terminology in a field already overwhelmed with terms.

For the purposes of the work we completed we used the following definitions for terms:

Theories present a systematic way of understanding events or behaviors by providing inter-related concepts, defınitions, and propositions that explain or predict events by specifying relationships among variables (1). Moreover, theories are abstract, broadly applicable, and not content- or topic specifıc (4). On the other hand, frameworks are strategic or action-planning models that provide a systematic way to develop, manage, and evaluate interventions (2).

Despite their differences, theories and frameworks both enhance effectiveness of interventions by helping to focus interventions on the essential processes of behavioral change, which can be quite complex (1, 3-6). To avoid additional confusing and for simplicity, our review referred to theories and frameworks (both of which are important for dissemination and implementation research) collectively as models.

I hope this is helpful in clarifying the way we framed our research. Do you find that these terms are used interchangeably in your field?


1. Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health 2010;31:399–418.

2. Green LW, Kreuter MW. Health program planning: an educational and ecological approach. 4th ed. New York: McGraw-Hill, 2005.

3. Ammerman AS, Lindquist CH, Lohr KN, Hersey J. The effıcacy of behavioral interventions to modify dietary fat and fruit and vegetable intake: a review of the evidence. Prev Med 2002;35(1):25– 41.

4. Noar SM, Benac CN, Harris MS. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol

Bull 2007;133(4):673–93.

5. Glasgow RE, Goldstein MG, Ockene JK, Pronk NP. Translating what we have learned into practice—principles and hypotheses for interventions addressing multiple behaviors in primary care. Am J Prev Med 2004;27(2):88 –101.

6. Bartholomew LK, Parcel GS, Kok G, Gottlieb NH, Fernandez ME. Planning health promotion programs: an intervention mapping approach. 3rd ed. San Francisco CA: Jossey-Bass, 2011.

For those that missed the

For those that missed the live session.  Here is the archive.  We hope you will view and then engage in the discussion and share your thoughts/comments here on R2R.