An Agenda for Research on the Sustainability of Public Health Programs

TLDR

Funders of public health and community health programs are increasingly concerned about sustainability, yet the literature lacks a widely used paradigm for accumulating generalizable findings, and sustainability research is positioned as a further stage in the diffusion framework following adoption and implementation. The authors provide guidance for research and evaluation of health program sustainability, including definitions, dependent and independent variables, and design suggestions, and propose viewing sustainability research as a further stage in translating research‑based interventions into practice. They propose a framework that defines sustainability, specifies dependent and independent variables, and recommends research designs and data collection methods.

Abstract

Funders of programs in public health and community health are increasingly concerned about the sustainability of changes they initiate. Despite a recent increase in sustainability research and evaluation, this literature has not developed a widely used paradigm for conducting research that can accumulate into generalizable findings. We provide guidance for research and evaluation of health program sustainability, including definitions and types of sustainability, specifications and measurements of dependent variables, definitions of independent variables or factors that influence sustainability, and suggestions for designs for research and data collection. We suggest viewing sustainability research as a further stage in the translation or dissemination of research-based interventions into practice. This perspective emphasizes ongoing relationships with earlier stages of a broader diffusion framework, including adoption and implementation processes.