community guide, diffusion, dissemination,



  1. Myers, Bradford A.


This article provides an overview and update on dissemination strategies regarding the Guide to Community Preventive Services (Community Guide), a federally sponsored and independently led initiative to develop evidence-based findings on the effectiveness of selected population-based interventions. Despite the innovative nature, barriers to dissemination and utilization of Community Guide findings exist. Terms and concepts used to guide dissemination efforts designed to address these barriers are identified and discussed.


Everyone is familiar with the adage, "the greatest thing since sliced bread," but even sliced bread had its critics and was not readily accepted. It was not until 1928, with the invention of a slicer that instantly wrapped loaves, that a commercial bakery started selling precut loaves. 1 Even if a new development is better than existing options, getting people to use it is not an automatic or certain process. In public health, diffusion of innovations is an equally difficult task.


In 1753, James Lind, a British Naval surgeon, published the results of his studies on the efficacy of fresh lemons and oranges in curing scurvy. Despite the promising results reported, it was another 42 years until the British Admiralty formally recognized Dr. Lind's recommendations as the best preventive measure against scurvy and required a daily ration of citrus for all shipboard sailors. 2 The difficulty of gaining acceptance for new ideas or products was expressed by Howard Aiken, a 20th century mathematician and computer pioneer when he said, "Don't worry about people stealing your ideas. If your ideas are any good, you'll have to ram them down people's throats." Although physical force is certainly one option, a more effective and professional method of promoting and increasing use of innovative ideas or products is through diffusion and dissemination strategies.


In the six years since work began on the Guide to Community Preventive Services (Community Guide), 3 and the six years since the first results were published, findings have been welcomed in many quarters-not to the extent of sliced bread, but thankfully without having to ram them down people's throats either. Since first reporting on dissemination efforts in this journal in January 2001, dissemination objectives, strategies, and tools have been developed, implemented, and replicated in a variety of settings and among various audiences; dissemination resources continue to be refined as new findings are released; and new dissemination strategies and partners continue to be identified. 4