Dissemination and Implementation Theories, Models, or Frameworks Utilized in International Aging Research: A Citation Analysis

Abstract Dissemination and implementation (D&I) theories, models, and frameworks (TMFs) guide the translation of evidence into practice, yet their use in international aging research remains understudied. To examine which D&I TMFs are most frequently used in international aging research and how they are applied across different settings and implementation stages. We conducted a citation review of articles citing 83 D&I TMFs identified from a public repository. Articles focusing on adults aged ≥ 60 years published through January 2022 in non-US settings were included. We assessed TMF citation patterns, application across implementation processes, application across article sections, and meaningful use. Of 451 included articles from 41 countries, most originated from: Canada (21%), England/Great Britain (17%), Australia (15%), and the Netherlands (12%), representing 69% of articles. Publications increased ten-fold from 2012 to 2021, with 49 unique TMFs utilized. Five TMFs accounted for 51% of citations: Behavior Change Wheel (16%); Consolidated Framework for Implementation Research (11%); Promoting Action on Research Implementation in Health Services (9%); Reach, Effectiveness, Adoption, Implementation, Maintenance 1.0 (9%); and Explaining Behavior Change in Evidence-Based Practice (8%). Most articles (81%) used only one TMF and 39% demonstrated meaningful use. Most studies focused on pre-implementation (41%) or implementation (46%) stages, with fewer addressing intervention adaptation (4%) or sustainment (9%). While TMF use in international aging research is growing, meaningful application remains limited. The concentration in specific countries and dominance of few frameworks reveal areas for future work. Improving TMF selection, adaptation for international contexts, and application across all implementation stages has the potential to enhance global translation of aging research into practice.