Our study illustrates the intertwined challenges associated
with both the translation of chronic illness interventions to
community practices as well as the scientific study of that
translation. While small gains in clinical outcomes may add
up to an important public health impact over a large popula-
tion, the study of a modest intervention by traditional trial
methods may not be feasible. Future studies will want to start
with more potent interventions, perhaps with more frequent
contact, so that their effects can be measured even after poten-
cy is lost in translation. Alternatively, they will want to have a
greatly increased sample size such that smaller effects among
more statistically diverse samples can be detected