Hybrid Designs

Designing with Implementation and Dissemination in Mind

Section 3

Hybrid Designs


David Chambers, DPhil

Gloria Coronado, PhD

Beverly Green, MD, MPH

Jeffrey Jarvik, MD, MPH

Edward J Septimus, MD, FACP

Leah Tuzzio, MPH

Douglas Zatzick, MD


Contributing Editor

Karen Staman, MS

Trials that take this dual focus of assessing outcomes and implementation—designed to establish efficacy and change practice—are called hybrid trials (Curran et al. 2012). Curran et al. propose three types of hybrid trials:

  1. Testing effects of a clinical intervention on relevant outcomes while observing and gathering information on implementation;
  2. Dual testing of clinical and implementation interventions/strategies; and
  3. Testing of an implementation strategy while observing and gathering information on the clinical intervention’s impact on relevant outcomes.”

Use of the hybrid designs described above could speed the translation of knowledge into practice (Curran et al. 2012).

  • How does the healthcare system I am conducting the trial within learn?




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Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. 2012. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 50:217–226. doi:10.1097/MLR.0b013e3182408812. PMID: 22310560.

Version History

December 4, 2018: Added key question (change made by K. Staman).

Published August 25, 2017


Chambers D, Coronado G, Green B, et al. Designing with Implementation and Dissemination in Mind: Hybrid Designs. In: Rethinking Clinical Trials: A Living Textbook of Pragmatic Clinical Trials. Bethesda, MD: NIH Health Care Systems Research Collaboratory. Available at: https://rethinkingclinicaltrials.org/chapters/design/designing-implementation-dissemination-mind-top/post-5598/. Updated January 3, 2019. DOI: 10.28929/051.