BackgroundLittle is known about how well or under what conditions health innovations are sustained and their gains maintained once they are put into practice. Implementation science typically focuses on uptake by early adopters of one healthcare innovation at a time. The later-stage challenges of scaling up and sustaining evidence-supported interventions receive too little attention. This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work.MethodsA multi-method, multi-stage approach, was used: (1) identifying and recruiting experts in sustainability as participants, (2) conducting research on sustainability using concept mapping, (3) action planning during an intensive working conference of sustainability experts to expand the concept mapping quantitative results, and (4) consolidating results into a set of recommendations for research, methodological advances, and infrastructure building to advance understanding of sustainability. Participants comprised researchers, funders, and leaders in health, mental health, and public health with shared interest in the sustainability of evidence-based health care.ResultsPrompted to identify important issues for sustainability research, participants generated 91 distinct statements, for which a concept mapping process produced 11 conceptually distinct clusters. During the conference, participants built upon the concept mapping clusters to generate recommendations for sustainability research. The recommendations fell into three domains: (1) pursue high priority research questions as a unified agenda on sustainability; (2) advance methods for sustainability research; (3) advance infrastructure to support sustainability research.ConclusionsImplementation science needs to pursue later-stage translation research questions required for population impact. Priorities include conceptual consistency and operational clarity for measuring sustainability, developing evidence about the value of sustaining interventions over time, identifying correlates of sustainability along with strategies for sustaining evidence-supported interventions, advancing the theoretical base and research designs for sustainability research, and advancing the workforce capacity, research culture, and funding mechanisms for this important work.

The scientific literature relevant to social work practice has grown expansively in recent years. Corollary developments, including the widespread availability of electronic bibliographic databases, improved indexing services, and increased acceptance of systematic reviews and evidence-based practice guidelines, have made research findings increasingly accessible to practitioners. For the first time in the history of the profession, social work educators are confronted with the challenges posed, and opportunities afforded, by this accumulating body of practice-relevant scientific information. Evidence-based practice is a new paradigm that promotes more effective social interventions by encouraging the conscientious, judicious, and explicit use of the best available scientific evidence in professional decision making. Pedagogically, evidence-based practice involves teaching students the values and skills they need to identify, critically appraise, and apply practice-relevant scientific evidence over the course of their professional careers. This article describes the potential benefits of evidence-based social work professional education and ongoing efforts of the George Warren Brown School of Social Work at Washington University to implement curriculum-wide changes supportive of evidencebased professional practice education.The last generation of the 20th century-the "information age"-witnessed an unprecedented expansion of the research base and technologies supporting social service interventions (Howard, Bricout

People often report perceptions of benefit from adverse life experiences. In this study, adult perceptions of benefit from child sexual abuse were examined in a sample of 154 low-income women who were sexually abused as children. Almost half reported some perceived benefit. The benefits fell into 4 main categories: protecting children from abuse, self-protection, increased knowledge of child sexual abuse, and having a stronger personality. Degree of perceived benefit was associated with several indicators of adult adjustment. In addition, those who perceived themselves as stronger had higher self-esteem, and those who perceived increased sexual abuse knowledge viewed others more favorably and were more comfortable getting close to others, when compared with other respondents.

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Few studies have focused on identifying characteristics that discriminate between parents who break versus those who perpetuate intergenerational cycles of child maltreatment. Both the dose and the attachment hypotheses were examined in this study of 213 mothers maltreated as children in one of three ways (beatings, neglect, or sexual abuse). Maltreatment continuity versus discontinuity was assessed through substantiated reports to a Child Protective Services (CPS) agency over a 7-year period. Findings were consistent with the attachment hypothesis. Poorer quality attachment relationships in childhood increased the probability of transmission. Findings were consistent with the dose hypothesis for only one conceptualization of dose. Those mothers who had experienced severe forms of sexual abuse (experienced coitus vs. did not) were more likely to have a maltreated child. These findings are discussed in terms of current theory and research on intergenerational maltreatment.