Making dissemination a two-way process

Despite repeated expressions of concern, both academic researchers and programme delivery practitioners have neglected the dissemination of new knowledge about health promotion programmes. This has meant that effective programmes are often not implemented as widely as they could be and that health promotion programmes are not achieving their full potential. This paper analyses what has been written in the published literature about dissemination and discusses the problems from the point of view of practitioners who are involved in programme delivery. Factors influencing dissemination have been well described; yet the dominant notion in the literature is of dissemination as a one-way process, a downstream transfer from a group who produce knowledge to a group who implement programmes. At the same time, there is considerable theoretical and practical evidence that linkage systems between researcher and implementer groups can foster more effective transfer of programmes. From the perspective of those involved in programme delivery, it appears that dissemination is most likely to be influential if it is based on a two-way process of exchanging knowledge between researcher and implementer groups. While linkage systems offer the kind of structure or process to support two-way exchange, they need to overcome significant barriers if they are to become a feature of the health promotion system we work in. Linkage systems must span different organisations, and these organisations do not necessarily have compatible purposes. A two-way construction of dissemination also has implications for how research on dissemination is tackled, and makes apparent how such research could benefit from collaboration with programme delivery practitioners. The irony of dissemination researchÐ that the existing publications and ideas do not have wide currencyÐitself indicates that a new approach that genuinely tackles dissemination as a two-way exchange is essential, if we are to achieve the full benefits of our knowledge in health promotion.