Response to Bridger

I appreciate the opportunity to respond to the letter by Bridger. There are several points in her letter with which I agree. As noted by Bridger, it is increasingly clear that the difference between efficacy in clinical trials and effectiveness in public health practice can be large. It is also abundantly apparent that many research studies are missing a dissemination and implementation component. For too many researchers, there is sparse planning for dissemination over the life of a research study and once a new finding is published in a scientific journal, they move on to the next study.

Bridger suggests the people in the ivory towers of academe need to "spend some time in our shoes." I agree that academic public health can be disconnected from "real-world" public health practice. One of the articles in this issue1 is a direct spin-off of my time with the Missouri Department of Health and Human services, where I worked for 8 years before entering academe. Our intent was not to reprimand practitioners but rather to remind researchers of their obligations of conducing practice-relevant research and engaging with a range of stakeholders.

She also is concerned that none of the articles were authored by local public health practitioners. While representation was small, at least one article included a local practitioner.2 We sought to span a continuum from research to practice and we involved practice-based researchers, funders, and leaders of local agencies. This is illustrated in the article by Arrington and colleagues,2 which included a broad range of authors and reached out to nearly 500 practitioners and researchers to develop a local agenda for moving research to practice.

Previous work attempting to move research to practice has shown that while both researchers and practitioners believe that dissemination is important, neither group believes it is their responsibility.3 Themes in the March/April 2008 issue highlight central issues that will accelerate the movement from research to practice, including the need for a tangible and specific agenda,2 collaborative training,4 engagement of policymakers,5 and effective partnerships between researchers and practitioners.6 To succeed, this must be a shared responsibility of researchers, practitioners, policymakers, organizations, and funders.

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