WashU Public Health launches research network to bridge evidence and practice

Modern HIV/AIDS therapies are a scientific and medical triumph. In the 1980s, people infected with HIV nearly always died within 10 years; today, those who are properly treated can live normal lives and avoid passing the virus to others. But despite the availability of lifesaving, transmission-stopping drugs, the global HIV epidemic persists: An estimated 41 million people were living with HIV and 630,000 people died of HIV-related illness in 2024. We have therapies that work — but how do we get them to everyone who needs them?  

This is the kind of problem dissemination and implementation (D&I) science was created to solve. D&I scientists are dedicated to moving innovations — medicines, technologies, programs, practices, policies — out of academic journals and controlled trials and into the real world, where they can improve people’s lives. 

Washington University in St. Louis is one of the world’s leading hubs of D&I science. And now, the School of Public Health at WashU has launched the Dissemination & Implementation Science Innovation Research Network (DISIRN) to pull together the university’s thriving but decentralized D&I community. Co-directed by the cross-campus team of Ross Brownson, PhD, the Steven H. and Susan U. Lipstein Distinguished Professor at WashU Public Health; Elvin Geng, MD, MPH, a professor of medicine at WashU Medicine; and Byron Powell, PhD, an associate professor at the Brown School, the network will connect researchers across the university, as well as nonacademic partners, empowering them to apply rigorous, innovative D&I methods to their work and convert evidence into action. Ashley Sturm, MA, serves as the network’s manager. DISIRN is one of six research networks established at WashU Public Health to foster collaboration and promote innovative solutions to the world’s most critical public health challenges.  

“WashU is possibly the most exciting place to be in the world right now for D&I science,” Powell said. “It started with a small but mighty group of people in public health and social work, and now there are faculty members who came to WashU because they wanted to join the D&I community here. There is an eagerness to collaborate and build this field. We have a real opportunity to shape D&I science through DISIRN.”

Bridging the gap between evidence and practice

Historically, researchers have done a much better job of devising creative solutions to critical health challenges than getting such solutions into routine practice and policy. D&I scientists like to quote a 2001 Institute of Medicine report that stated it takes an average of 17 years for evidence to change practice – a delay that results in avoidable illness and death. 

Speed, therefore, is one of the three S’s of implementation science. The second is to “scale up” – interventions that work well under limited, controlled conditions often falter when implemented on a large scale in the messiness of the real world. The third S is sustainability, because even successful interventions can fall by the wayside without ongoing funding and buy-in from stakeholders. And then, of course, there is the flip side: de-implementation, which involves identifying practices that don’t work and removing them from routine practice and policy. 

D&I science has perhaps unmatched potential to transform human health and welfare. Take HIV. To end the HIV epidemic, the Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a global testing and treatment goal of 95/95/95 by 2030: for 95% of people with HIV to know their status; 95% of those diagnosed to be on antiretroviral therapy; and 95% of those on therapy to have achieved viral suppression. Achieving those global goals requires every country to commit to identifying members of its population who are infected and ensuring that they receive ongoing treatment. 

In the 2010s, despite a robust HIV care system, Zambia was struggling to keep people in treatment. Geng joined a group — led by Kombatende Sikombe, MPH, a research manager at the Center for Infectious Disease Research in Zambia and a PhD candidate at the London School of Hygiene & Tropical Medicine — that formed to investigate why some people stopped coming in for their monthly visits, despite knowing that doing so threatened their health. The answer was simple but surprising: People didn’t like their providers. A nice provider was more important than travel distance or wait time; people were willing to go 40 kilometers out of their way and wait an extra 10 hours to see a provider who treated them with respect. Guided by these findings, the researchers developed a training program for HIV care providers in the capital city of Lusaka, aimed at making HIV clinics more welcoming to patients. The training worked; in a 2024 paper in The Lancet HIV, Sikombe, Geng and colleagues estimated that the intervention led to 14,000 fewer missed visits and 6,200 fewer people lost to follow-up. 

“This is how we end the global HIV epidemic — not with a dramatic new blockbuster drug, but through many thoughtful, systematic D&I studies in many different contexts that collectively show us how to get the HIV therapies we already have to every last person who needs them,” Geng said. “This is the power of D&I science.” 

D&I science’s deep WashU roots

WashU is one of the birthplaces of D&I science, with pioneering figures from across both campuses. Back in the early 2000s, when the field was just coalescing, Enola Proctor, PhD, the Shanti K. Khinduka Distinguished Professor Emerita at the Brown School, was working on the question of how to move proven mental health treatments into care. Douglas Luke, MA, PhD, the Distinguished Professor in Public Health Systems Science, developed widely used tools to gauge the sustainability of programs and clinical practices. Brownson teamed up with Proctor and Graham A. Colditz, MD, DrPH, the Niess-Gain Professor of Surgery and director of the Public Health Sciences Division in the WashU Medicine Department of Surgery, to edit the seminal textbook in the field.

Today, an estimated 50 WashU faculty-led teams focus on D&I science, spread primarily across the School of Public Health, the Brown School and WashU Medicine. The university boasts 11 groups that employ D&I science as a core part of their missions. 

One of those groups is WUNDIR, the Washington University Network of Dissemination and Implementation Researchers. WUNDIR was founded almost accidentally in 2010 by Proctor, Luke and Brownson.  

“Enola, Doug and I were literally talking in a bar one day, and we said, ‘We’re doing similar work. Why don’t we get our groups together?’” Brownson recalled. “That was the first WUNDIR meeting, and then it started getting traction, and more and more people started coming.”

WUNDIR grew into a forum for WashU faculty, trainees, and staff who were using D&I in their work to share ideas and methods, find collaborators, and get feedback from peers on work in progress and project proposals. It became a uniquely interdisciplinary, creative hub for intellectual exchange and serves as a foundation for the DISIRN network.

“When we were thinking of ways to create a truly interdisciplinary research community that facilitates innovation and collaboration, the model that came to mind was WUNDIR,” Geng said. “We knew that a network structure could work because WUNDIR works.”

Building strength upon strength

WUNDIR is now a core element of DISIRN (Sturm oversees WUNDIR as well as managing DISIRN). However, the new network’s ambitions are broader. DISIRN’s aims include cultivating the next generation of implementation scientists and evidence-driven practitioners; advancing the theory and methodology that underpin the field; partnering with communities, practitioners and policymakers to accelerate the adoption of evidence-based practices; and demonstrating the real-world impact of D&I science. 

A key focus of DISIRN is to build networks and capacity. This includes strengthening interdisciplinary proposals through coordinated peer review at WUNDIR and through the D&I Bootcamp, an annual intensive day of individualized consultations designed to support investigators preparing competitive D&I grants.

Many of the core D&I concepts and methods were developed at WashU, and DISIRN plans to maintain and enhance that methodological leadership. The network will support faculty time and collaboration for systematic reviews, methods development, theory-building, and other strategic-thinking activities that shape the scientific foundations of the field.

In addition, DISIRN will convene meetings and symposia that bring together WashU scholars and external partners to collectively define emerging directions in D&I science. The network’s first annual convening will be February 10, with the theme “Implementation Science & the Public Health Information Ecosystem.” The convening is free and open to the public, but registration is required.

Equally important is DISIRN’s commitment to demonstrating how D&I research influences policy, practice, and people’s day-to-day lives. This includes developing data dashboards and tools that tell clear, compelling stories about why D&I matters, highlighting return on investment, societal relevance, and pathways from evidence to action.

“For a long time, biomedical and public health research has focused on finding solutions, and implementing those solutions has been too often an afterthought,” Brownson said. “What we’re doing is putting implementation front and center. If we can figure out how to effectively implement even half of what we know works, we can make enormous improvements to human health. I am confident that this research network will be invaluable in making that happen.”