ORIGINAL PAPER Applying the Interactive Systems Framework to the Dissemination and Adoption of National and State Recommendations for Hypertension Rashon I. Lane • Judy M. Berkowitz • Steven T. Sullivan • John Rose • Tiffiny Bernichon • Alessandra Favoretto • Pat Shifflett • Eileen Miles • MaryCatherine Jones Published online: 13 April 2012 Ó Society for Community Action and Research (outside the USA) 2012 Abstract The Centers for Disease Control and Preven- tion (CDC), Division for Heart Disease and Stroke Pre- vention (DHDSP), commissioned an Institute of Medicine (IOM) report to identify the highest priority action areas for CDC, state health departments, and other public health partners in their efforts to reduce and control hypertension. To assess the dissemination and adoption of the IOM report recommendations, DHDSP developed an evaluation based on the Interactive Systems Framework for Dissemination and Implementation (ISF). The evaluation incorporates data collection at critical points across 3 years. In this article, we focus on the ISF systems to describe the role of funded state partners and their relationship with CDC in implementing public health recommendations. We describe baseline results for three data collection activities: (1) key informant interviews, (2) a Web-based survey, and (3) content analysis of state workplans to determine the degree of alignment with IOM recommendations. For example, currently 30 % of surveyed programs are implementing most (or all) of the recommendations in the IOM report, however 76 % intend to change hypertension program priorities based on the recommendations of the IOM report. Qualitative data suggest that there are several facilitators and barriers in implementing public health policy recom- mendations. DHDSP will use these baseline results to provide additional technical assistance and support to state health departments in their efforts to implement the IOM report’s recommendations. Keywords Evaluation Á Interactive Systems Á Framework Á ISF Á Hypertension Á Mixed methods Á Public health Introduction Hypertension affects approximately one in three American adults and is the leading risk factor for heart disease and stroke, which are the first and fourth leading causes of death in the United States [Centers for Disease Control and Pre- vention (CDC) 2008; Minin ˜o et al. 2010]. In recent years, rates of hypertension have increased by as much as 20 %, and deaths from hypertension have increased by 56.4 % (Lloyd-Jones et al. 2010). Hypertension accounts for one out of every six deaths in the United States and for almost half of all cardiovascular deaths (Danaei et al. 2009). The estimated direct and indirect cost of hypertension was approximately $73 billion in 2009 (Lloyd-Jones et al. 2010). Hypertension is one of the most costly health problems facing the United States today, yet it’s also among the most The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. R. I. Lane (&) National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, M/S-K-72, Atlanta, GA 30341, USA e-mail: rlane@cdc.gov J. M. Berkowitz Á J. Rose Á T. Bernichon Á A. Favoretto Á E. Miles Centers for Public Health Research and Evaluation, Battelle Memorial Institute, Atlanta, GA, USA S. T. Sullivan Cloudburst Consulting Group, Inc., Landover, MD, USA P. Shifflett Abt Associates Inc., Atlanta, GA, USA M. Jones Heart Disease and Stroke Prevention Program, Utah Department of Health, Salt Lake City, UT, USA 123 Am J Community Psychol (2012) 50:541–552 DOI 10.1007/s10464-012-9511-0