Development

Creating and initially evaluating an innovation. An innovation can be an idea, technology, treatment or method.

Innovation Example: Motivational interviewing is a counseling practice developed by William Miller and Stephen Rollnick (1991). Research shows that MI has a positive effect on retention in care (Carroll et al., 2006), and the effectiveness of MI in the field has been explored through NIDA's CTN (Carroll et al., 2002)

Translation

Explaining the essential elements and relevance of an innovation, then packaging it to facilitate dissemination.

Innovation Example: ATTC Network, in conjunction with the NIDA Clinical Trials Network, developed the training package Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency (MIA:STEP)

Dissemination

Promoting awareness of an innovation with the goal of facilitatingadoption and implementation. Dissemination strategies include raising awareness, building knowledge, and distributing materials.

Innovation Example: ATTC Regional Centers conduct awareness and/or skill-building trainings with clinical staff around MI.

Adoption

The process of deciding whether to use an innovation. Adoption may or may not lead to implementation.

Innovation Example: During the adoption process, the ATTC Network supports organizations and works to make sure they have the information necessary to "try on" MI so that they can authentically decide whether or not to implement the innovation.

Implementation

Incorporating an innovation into routine practice. Implementation ideally includes a range of strategies designed to address individual, organizational, and systemic characteristics (e.g., skills training, administrative buy-in, and policy changes).

Innovation Example:During early implementation, Regional Centers: provide training on the MIA:STEP product with clinical supervisors in order to sustain the use of MI in clinical settings; provide ongoing technical assistance to program administrators around implementation; provide periodic coaching sessions with clinical staff to enhance their MI skills.

Bi-directionality

The the diffusion of an innovation is meant to be represented in the ATTC model as a bi-directional, iterative process. In other words, the practices are shapedby their actual use in real-world settings, changes are made as necessary and then evaluated through research. In this way, evidence-based practices also become practice-based evidence. Dialogue between researchers, clinicians, change agents, and technology transfer specialists is key to this process.