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EDITORIAL |
In 1982, the Gerontological Society of America (GSA) introduced a new section, Practice Concepts, to The Gerontologist. The new journal section aimed to provide articles that appealed directly to the practice community and an outlet for the dissemination of cutting-edge practice ideas. Dr. Hiram Friedsam, editor-in-chief of The Gerontologist at the time, described the section as "devoted to brief articles describing innovative approaches to working with older people that may be readily transferred from one practice setting to another. The emphasis of manuscripts written for this section should be on the rationale for the approach, its utility and implementation" (Friedsam, 1982). Almost 25 years after its inception, we are authoring this editorial to promote submissions to Practice Concepts, to correct what we perceive as a misunderstanding about it, and to call for an even higher standard for manuscripts submitted to Practice Concepts.
The misunderstanding we would like to dispel is that the quality of the section is different, perhaps lacking in comparison with research articles and thus of lesser status. We certainly would not want authors to regard Practice Concepts as a default option for work that would not make the cut as research articles. Practice Concepts articles are neither poorly executed intervention studies nor weak research studies that have important practice implications. All research studies published in this journal must have important practice or policy implications that are clearly articulated rather than tacked on as a concluding paragraph. Clearly, this challenge applies to all authors who submit to The Gerontologist.
Articles published in Practice Concepts are different in nature and are judged by different, but not lower, standards. The heart of a Practice Concepts article is a description of an innovative intervention. It is foremost a venue for the dissemination of new practice ideas. These practices or interventions should be presented in sufficient detail to allow replication. Instructions call for the articulation of the conceptual framework supporting the intervention and essential features of the practice. Finally, evidence regarding its promise must be presented. (Clearly, some practices may not yield positive findings; we need to learn what has been tried and what may have to be modified if further development or testing is warranted.) This information does not have to be presented in the same format as a regular research article. In fact, the presentation should highlight the key components of innovation, conceptual basis, essential features, and the empirical support justifying its replication and refinement.
Even though innovation is key, the intervention cannot be presented without evidence that the practice is worth replicating, testing under more stringent conditions, or modifying from its current form. Many types of empirical support are appropriate, but there must be enough data in hand to convince reviewers that there is reason to present this practice to the readers of the journal. It should be noted that Practice Concepts reviewers are drawn from the Editorial Board and the same expert list of reviewers as for other manuscripts submitted to The Gerontologist.
We are well aware that, in today's practice world, there is a persistent and growing demand for evidence. Thus, we strive to put forth a new practice idea only if there is some empirical basis, whether qualitative, quantitative, or both, for recommending it or modifying it.
In this edition, Newcomer, Kang, and Graham describe an intervention aimed at assisting newly admitted nursing home residents in returning home. The discharge rates and lengths of stays of those residents receiving the intervention did not differ significantly from usual care. The authors give important insights into the challenges of discharging nursing home residents and provide recommendations that might increase the effectiveness of the model as well as the accuracy of outcome assessment.
Evidence-based interventions are typically developed in stages. Demonstration or pilot studies usually precede larger intervention and implementation studies. The Practice Concepts section is an appropriate outlet for intervention development work in its earlier stages. Authors can dedicate space to a description of the practice, space that is limited in regular research articles. Authors can present various types of evidence that are appropriate for the stage of development of the practice and that justify the next phase of work. In this issue, Marziali and Donahue present a video-conferencing intervention for family caregivers; evidence that this practice is worth pursuing relies on content analyses of archived video sessions in addition to preliminary outcome assessment. A full intervention study with comparison conditions, adequate statistical power, and standardized measures is more appropriately submitted as a regular research article. It is often helpful to be able to cite an article published in Practice Concepts that more fully describes the intervention (see, e.g., the Practice Concepts article by Rantz et al., 2003, and the related research article by Rantz et al., 2004).
As we reviewed the articles published in the Practice Concepts section over the past 10 years, we were impressed with the wide range of interesting practices presented. There are promising practices about technology and equipment available to consumers and service providers; educational programs for older adults, caregivers, service providers, and children; physical health promotion programs for the most fit to the most frail; service delivery and partnership models. Much of the work comes from practitioner–researcher partnerships that we hope will continue to generate manuscripts for submission to Practice Concepts.
We also encourage a broad conceptualization of practice, including the following: new assessment or communication techniques; electronic and mechanical technologies, new behavioral or psychosocial approaches, and educational programs; new service coordination, financial, or management models; new housing and transportation developments; and new implementation strategies for public policies. Targets of intervention include well and frail older adults, families, service providers, communities, and the public. In this edition, Bolda, Saucier, Maddox, Wetle, and Lowe present models of local community-based partnerships aimed at improving long-term-care services. With the two Practice Concepts articles already mentioned, various levels of intervention are represented in this volume. The mission of The Gerontologist is to disseminate multidisciplinary knowledge; thus, the Practice Concepts section strives to offer new practice ideas to a wide variety of disciplines.
We put forth in this edition of The Gerontologist revised instructions to authors for Practice Concepts submissions that we hope clarify the nature of the articles and the presentation format. We also aim to raise the bar, again, in terms of the initial evidence presented to justify the dissemination of the innovative practice concept or to recommend modifications. We encourage authors to use this section of the most widely read journal of the Gerontological Society of America to put forth their best practice developments, include empirical evidence that is convincing, and present it with the high quality that is expected for publication in this journal.
Appendix
From the Revised Instructions for Authors
A Practice Concepts manuscript describes, in 4,000 words or fewer, an innovative practice amenable to replication. Authors must clearly specify the following information about the practice: (a) uniqueness or innovativeness, (b) theoretical or conceptual basis, (c) essential components or features, and (d) evidence that supports replication or suggests modifications. The article should be structured to highlight these points (the structure of a research article does not necessarily apply). An important goal is to provide enough information about the practice to allow its replication.
References
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