实施科学是一个越来越多的领域，旨在将科学加速加入现实世界实践，这一事件可以often times take 17 years to achieve.当我们探索影响科学翻译的因素时，我们还需要了解为什么无效的做法继续持续存在以及为什么有效实践结束。这就是对误解的研究寻求回答。特别是在美国，据估计只有60% of public health practices are actually evidence based。这留下了有关其他40％的做法正在发生的事情的问题。

In our research published inBMC公共卫生，我们的团队对国家卫生部门的慢性病员工进行了全国调查，以收集更多信息，以了解他们部门中发生错误实施的频率，以及影响这些类型决策的可能因素。正如美国过去一年所见证的那样，州卫生部门是公共卫生干预措施的重要驱动力。慢性疾病被认为是癌症的相当大危险因素，据估计每年将11亿美元用于州癌症控制和慢性病预防计划。But despite this large number, a small amount of that is actually used towards primary prevention programs such as physical activity and nutritional intervention programs. Given the scarce resources available, it is crucial to know that every dollar is being used towards the most effective and wide-reaching programs. And unfortunately, that may not always be the case.

50.7％的州卫生部门慢性病雇员报告说，他们的工作单位有时，通常或总是结束应该继续进行的有效计划。

从我们的调查,我们发现,50.7%的年代tate health department chronic disease employees reported that their work unit sometimes, often or always ended effective programs that should have continued. Not surprisingly, the overwhelming reason being funding priorities changed or ended. State Health Department funding is based heavily on time limited grants and it’s not always guaranteed that a successful program will continue to see its funding continue. This is consistent with the literature around evidence-based decision making that与政策制定者进行编程资金，可以增强基于证据的计划的维持。

On the flip side of the mis-implementation coin, 48.5% of state health department employees stated that sometimes, often or always continued programs that should have ended. While funding was still a prominent factor with inappropriately continued programs, policymakers and agency leadership were also significant factors in this decision making outcome.

围绕计划实施和管理变革的毅力的领导才能也会对计划的延续结果产生影响。

当进一步被问及影响这些结果的因素时，参与者透露组织和代理因素会产生重大影响。最重要的是，州卫生机构中太多的组织层次会阻碍决策。同样，围绕计划实施和管理变更的毅力也会对计划的延续结果产生影响。组织能力对计划成果的成功可能是重大影响。仅仅拥有有效的公共卫生计划是不够的。我们还需要具有组织能力的公共卫生机构，以有效地交付它们并了解何时不应继续计划。

研究团队通过进行定性案例研究来强调实施这些计划时已经遇到的国家机构所面临的误解挑战和成功，从而继续基于此最初数据。该团队还与布鲁金斯学院的一个小组合作，创建了基于代理的模型，可以进一步描述和突出这些决策过程如何在州机构中发挥作用。这些模型最终可以成为促进更好决策的工具，因为它最终希望它有助于降低州卫生部门慢性病计划中错误实施的普遍性。

There is still much to learn about mis-implementation and how implementation science can improve our public health systems. Our study is one of the firsts to really identify these factors across state public health agencies in the United States. We hope that lessons learned from this study can eventually contributed to improved chronic disease health outcomes locally, nationally and globally.