The Critical Role of State Agencies in the Age of Evidence-Based Approaches: The Challenge of New Expectations.

Evidence-based approaches only benefit individuals when fully and effectively implemented. Since funding and monitoring alone will not ensure the full and effective implementation of effective strategies, state agencies have the opportunity to assess and modify current roles, functions, and policies to align with the requirements of evidence-based strategies. Based on a growing body of knowledge to guide effective implementation processes, state agencies, or designated partner organizations, can develop the capacity, mechanisms, and infrastructure to effectively implement evidence-based strategies. This article describes a framework that can guide this process. Informed by the literature and shaped by "real-world experience," the Active Implementation Frameworks provide a stage-matched approach to purposeful, active, and effective implementation.

Women's reactions to HPV diagnosis: insights from in-depth interviews.

Research links certain types of the human papillomavirus (HPV) to subsequent development of cervical cancer. Women (n=52) recently diagnosed with HPV following an abnormal Pap smear participated in in-depth interviews to explore their knowledge of HPV, their emotional responses to diagnosis, and the extent of their disclosure of their HPV diagnosis to others. Women had many knowledge deficits about HPV. Emotions related primarily to stigma, fear, self-blame, powerlessness, and anger. Most women disclosed their disease to significant others, usually to a sexual partner. Women's lack of accurate knowledge may contribute to the array of emotions they experience. Whereas education about HPV may reduce the potency of these emotions, information alone may be inadequate for achieving optimal patient care. Health care providers can be important in treating the emotional elements associated with diagnosis as well as the condition itself.