scholarly journals Applying Principles of Implementation Science to Aging Programs and Policies

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 49-49
Author(s):  
Jaime Hughes ◽  
Nancy Morrow-Howell
Keyword(s):  
Implementation Science ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Services Research ◽  
Ongoing Research ◽  
Science And Policy ◽  
Research Education ◽  
The Third ◽  
Intervention Science

Abstract Implementation science, defined by NIH as “the scientific study of the use of strategies to adopt and integrate evidence-based health interventions,” continues to grow within research, education, and practice-based settings. Building on principles from organizational psychology, intervention science, health economics, and health services research, implementation science aims to explore how, and under what conditions, evidence-based interventions are successfully implemented and sustained in real-world settings. Applying implementation science to aging programs and settings may help to accelerate the translation of effective programs and policies into practice. This interdisciplinary symposium will provide an introduction to key principles and applications of implementation science. The first three presentations will focus on largescale spread of interventions while the last two presentations will focus on broader applications of implementation science. The first two presentations will focus on adapting interventions from delivery in one setting or population to another. The third presentation will discuss the role of implementation strategies in scaling an intervention from a controlled research setting into a large integrated healthcare system. The third presentation will focus on the intersection of implementation science and policy. The final presentation will discuss the role of implementation science in alleviating health disparities and advancing health equity. Each presentation will utilize examples from ongoing research studies to demonstrate principles. The session will close with an interactive discussion on the role of implementation science within aging, including challenges and considerations for aging programs, policies, and populations as well as opportunities for further training and education.

Implementation Strategies

2017 ◽  
Author(s):  
JoAnn E. Kirchner ◽  
Thomas J. Waltz ◽  
Byron J. Powell ◽  
Jeffrey L. Smith ◽  
Enola K. Proctor
Keyword(s):  
Implementation Science ◽  
Comparative Effectiveness ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Efficient Manner

As the field of implementation science moves beyond studying barriers to and facilitators of implementation to the comparative effectiveness of different strategies, it is essential that we create a common taxonomy to define the strategies that we study. Similarly, we must clearly document the implementation strategies that are applied, the factors that influence their selection, and any adaptation of the strategy during the course of implementation and sustainment of the innovation being implemented. By incorporating this type of rigor into our work we will be able to not only advance the science of implementation but also our ability to place evidence-based innovations into the hands of practitioners in a timely and efficient manner.

scholarly journals Application of an antiracism lens in the field of implementation science (IS): Recommendations for reframing implementation research with a focus on justice and racial equity

2021 ◽  
Vol 2 ◽  
pp. 263348952110494
Author(s):  
Rachel C. Shelton ◽  
Prajakta Adsul ◽  
April Oh ◽  
Nathalie Moise ◽  
Derek M. Griffith
Keyword(s):  
Implementation Science ◽  
Health Equity ◽  
Implementation Research ◽  
Implementation Strategies ◽  
Health Inequities ◽  
Evidence Based ◽  
Racial Equity ◽  
Structural Racism ◽  
Core Elements ◽  
Evaluation Approaches

Background Despite the promise of implementation science (IS) to reduce health inequities, critical gaps and opportunities remain in the field to promote health equity. Prioritizing racial equity and antiracism approaches is critical in these efforts, so that IS does not inadvertently exacerbate disparities based on the selection of frameworks, methods, interventions, and strategies that do not reflect consideration of structural racism and its impacts. Methods Grounded in extant research on structural racism and antiracism, we discuss the importance of advancing understanding of how structural racism as a system shapes racial health inequities and inequitable implementation of evidence-based interventions among racially and ethnically diverse communities. We outline recommendations for explicitly applying an antiracism lens to address structural racism and its manifests through IS. An anti-racism lens provides a framework to guide efforts to confront, address, and eradicate racism and racial privilege by helping people identify racism as a root cause of health inequities and critically examine how it is embedded in policies, structures, and systems that differentially affect racially and ethnically diverse populations. Results We provide guidance for the application of an antiracism lens in the field of IS, focusing on select core elements in implementation research, including: (1) stakeholder engagement; (2) conceptual frameworks and models; (3) development, selection, adaptation of EBIs; (4) evaluation approaches; and (5) implementation strategies. We highlight the need for foundational grounding in antiracism frameworks among implementation scientists to facilitate ongoing self-reflection, accountability, and attention to racial equity, and provide questions to guide such reflection and consideration. Conclusion We conclude with a reflection on how this is a critical time for IS to prioritize focus on justice, racial equity, and real-world equitable impact. Moving IS towards making consideration of health equity and an antiracism lens foundational is central to strengthening the field and enhancing its impact. Plain language abstract There are important gaps and opportunities that exist in promoting health equity through implementation science. Historically, the commonly used frameworks, measures, interventions, strategies, and approaches in the field have not been explicitly focused on equity, nor do they consider the role of structural racism in shaping health and inequitable delivery of evidence-based practices/programs. This work seeks to build off of the long history of research on structural racism and health, and seeks to provide guidance on how to apply an antiracism lens to select core elements of implementation research. We highlight important opportunities for the field to reflect and consider applying an antiracism approach in: 1) stakeholder/community engagement; 2) use of conceptual frameworks; 3) development, selection and adaptation of evidence-based interventions; 4) evaluation approaches; 5) implementation strategies (e.g., how to deliver evidence-based practices, programs, policies); and 6) how researchers conduct their research, with a focus on racial equity. This is an important time for the field of implementation science to prioritize a foundational focus on justice, equity, and real-world impact through the application of an anti-racism lens in their work.

scholarly journals Will climate change worsen your health?

2019 ◽  
Author(s):  
Joan Ballester
Keyword(s):  
Public Health ◽  
Policy Making ◽  
Heat Waves ◽  
Research Topic ◽  
Climate Factors ◽  
Social Differences ◽  
Ongoing Research ◽  
Science And Policy ◽  
Ambient Temperatures

Nearly 8% of deaths in Europe are due to ambient temperatures, and global warming represents an additional threat for public health. Despite the fact that we expect more frequent, intense and persistent heat waves during the present century, it is actually not clear whether the number of attributable deaths will also increase. Here I discuss why the role of early adaptation to temperature rise is a major ongoing research topic in science and policy-making, and how these eventual acclimatization processes depend on a myriad of non-climate factors such as the air quality in cities, social differences within and between societies, demographic changes or the evolution of the economy.

scholarly journals Implementation Science in Pediatric Psychology: The Example of Type 1 Diabetes

2019 ◽  
Vol 44 (9) ◽  
pp. 1068-1073 ◽  
Author(s):  
Julia Price ◽  
Rinad S Beidas ◽  
Courtney Benjamin Wolk ◽  
Kimberly Genuario ◽  
Anne E Kazak
Keyword(s):  
Type 1 Diabetes ◽  
Implementation Science ◽  
Psychosocial Care ◽  
Implementation Strategies ◽  
Well Being ◽  
Pediatric Psychology ◽  
Evidence Based ◽  
Children And Families ◽  
Integration Of Care

Abstract Objective Evidence-based screening, assessment, and intervention practices for youth with type 1 diabetes (T1D) are underutilized. Implementation science (IS) offers theoretical models and frameworks to guide rigorous mixed methods research to advance comprehensive care for children and families. Methods We conducted a targeted review of applications of IS to T1D. Results Pediatric T1D research offers initial, but still limited studies on implementation of evidence-based psychosocial care. IS designates approaches to understanding multi-level factors that influence implementation, ways to alter these factors, and methods to evaluate strategies to improve implementation. Conclusions IS is promising for advancing the translation of pediatric psychology approaches into clinical care. Following the science of implementation, further documentation of the reach of evidence-based care and establishing practice guidelines are important initial steps. Examining the barriers and facilitators of evidence-based psychosocial care can guide the development of testable implementation strategies to improve integration of care. Successful strategies can be evaluated through multi-site controlled implementation trials to explore their effectiveness. These lines of inquiry can be considered within pediatric populations, but may also be used to examine similarities and differences in effectiveness of implementation strategies across populations and settings. Such research has the potential to improve the health and well-being of children and families.

Implementation Science

2020 ◽  
Author(s):  
Enola Proctor ◽  
Alicia Bunger
Keyword(s):  
Social Work ◽  
Implementation Science ◽  
Implementation Strategies ◽  
Work Practice ◽  
Social Work Practice ◽  
Research Translation ◽  
Evidence Based ◽  
Implementation Studies ◽  
Specific Implementation ◽  
Key Terms

Implementation science seeks to inform how to deliver evidence-based interventions, programs, and policies in real-world settings so their benefits can be realized and sustained. The aim of implementation science is building a base of evidence about the most effective processes and strategies for improving service delivery. Implementation research builds upon effectiveness research and then seeks to discover how to use specific implementation strategies and to move interventions into specific settings, extending their availability, reach, and benefits to clients and communities. This article provides an overview of implementation science as a component of research translation with an emphasis on traditional social work practice settings. The article begins by defining key terms, including implementation and evidence-based interventions. To inform conceptualization of implementation studies, the article continues with an overview of guiding implementation theories, models, and frameworks that explain the role of the multi-level practice context for implementation. Next, the article defines implementation strategies, identifies sources of implementation strategies, and provides recommendations for specifying and describing strategies that allow for replication. The article then describes methodological issues, including variable measurement, research design, and stakeholder engagement. Given the importance of designing implementation studies that optimize both internal and external validity, there is special attention to creative alternatives to traditional randomized controlled trials, and the potential for participatory and systems approaches. Finally, the article concludes with a discussion of future directions for implementation science in social work.

scholarly journals Using Implementation Science Strategy Mapping on the Age-Friendly Health System's 4Ms Journey

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 365-365
Author(s):  
Mary Dolansky ◽  
Anne Pohnert ◽  
Sherry Greenberg
Keyword(s):  
Implementation Science ◽  
Scale Up ◽  
Implementation Strategies ◽  
Mapping Method ◽  
Evidence Based ◽  
Systematic Process ◽  
Implementing Change ◽  
Implementation Outcomes ◽  
Adoption And Implementation ◽  
And Performance

Abstract Background Implementation science is the study of methods to promote the adoption and integration of evidence-based practices into routine health care to improve the quality of care. The purpose of this study was to use Implementation Mapping to guide the implementation of The John A. Hartford evidence-based Age-Friendly Health Systems (AFHS) 4Ms Framework: What Matters, Medications, Mentation, and Mobility. Methods Implementation Mapping, a systematic process for planning implementation strategies, guided the 9-month integration of the 4Ms Framework in the 1,100 MinuteClinics across the US. Implementation Mapping includes five tasks: (1) conduct an implementation needs assessment and identify program adopters and implementers; (2) state adoption and implementation outcomes and performance objectives, identify determinants, and create matrices of change objectives; (3) choose theoretical methods (mechanisms of change) and select or design implementation strategies; (4) produce implementation protocols and materials; and (5) evaluate implementation outcomes. Results The implementation plan, developed by the implementation mapping method, was carried out over 9-months. Seven implementation strategies were identified from the Expert Recommendations for Implementing Change (ERIC) project including the provision of education, electronic health record integration, internal champion facilitation, cues to action, and a dashboard to monitor progress. To date, the implementation mapping has resulted in the adoption of the 4Ms by 1145 providers (37%). Monitoring of the adoption of the 4Ms Framework and consideration of future implementation strategies is ongoing. Conclusions Implementation Mapping provided a systematic process to develop strategies to improve the adoption, implementation, sustainment, and scale-up of the evidence-based 4Ms Framework.

Implementation of evidence-based practices for early childhood social learning: a viewpoint on the role of teacher attitudes

2020 ◽  
Vol 15 (2) ◽  
pp. 61-74
Author(s):  
Angeliki Kallitsoglou
Keyword(s):  
Early Childhood ◽  
Social Learning ◽  
Implementation Science ◽  
Individual Factors ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Content Type ◽  
Adoption And Implementation ◽  
Teachers Attitudes

Purpose Despite their documented benefits, evidence-based practices (EBPs) for early childhood social learning are not systematically implemented. Teachers are key players in the implementation process of intervention programs and instructional practices. This is a viewpoint about teachers’ attitudes towards EBPs and their role in the successful implementation of EBPs for early childhood social learning. Design/methodology/approach The viewpoint draws on theoretical models of intervention implementation and innovation adoption to explore the importance of individual factors for EBPs implementation and to inform the understanding of the relationship between teachers’ attitudes and EBPs implementation in the context of early childhood social learning. Additionally, it is informed by the literature on research-informed teaching to identify novel opportunities of cultivating positive views towards EBPs for early childhood social learning. Findings According to implementation science, in addition to macro-level social and organisation factors, micro-level individual factors that pertain to professionals’ attitudes towards EBPs are related to successful adoption and implementation of EBPs in organisations. Hence, it is important that the investigation of the adoption and implementation of EBPs for early childhood social learning considers the role of teachers’ attitudes towards EBPs. A conceptual model is proposed to explain that research-informed teaching could contribute to fostering positive attitudes towards EBPs for early childhood social learning by raising awareness of the value and potential of research to transform pedagogy. Originality/value This viewpoint draws on EBPs implementation science to identify important factors of EBPs adoption and implementation for early childhood social learning that have not been considered extensively and offers a conceptual framework to help understand how research-informed teaching could be an innovative avenue of promoting EBPs implementation in education.

scholarly journals Implementation Science Translation: Program Sustainment for Managing Distress Behavior in Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 537-538
Author(s):  
Kim Curyto ◽  
Ann Kolanowski
Keyword(s):  
Nursing Home ◽  
Usual Care ◽  
Implementation Science ◽  
Implementation Strategies ◽  
Care Practice ◽  
Evidence Based ◽  
Effective Management ◽  
Clinical Practices ◽  
Science Concepts ◽  
Evidence Based Programs

Abstract Distress behaviors in dementia (DBD) are common in nursing home settings, are distressing, and result in poorer outcomes for residents and staff. We present on the implementation of STAR-VA, an interdisciplinary intervention for effective management of DBD in Veterans Health Administration (VA) nursing home settings, called Community Living Centers (CLCs). A primary focus of this symposium is the use of implementation science concepts to improve and sustain evidence-based programs through tailored implementation strategies and key partnerships. Key implementation science concepts from conceptual frameworks, including the Consolidated Framework for Implementation Research (CFIR) and the use of organizational Knowledge Reservoirs (KR) for sustaining new clinical practices, formed the basis of this work. Their application in health care practice will be discussed using STAR-VA as an exemplar. Interdisciplinary CLC staff feedback during STAR-VA implementation and sustainment is presented, including feedback regarding barriers to integrating new program interventions into usual care processes. Mapping key implementation strategies onto reported barriers informed development of implementation tools and strategies designed to guide adaptions tailored to the needs of the residents and frontline staff, increasing the chances of successful sustainment. Finally, we highlight the importance of key leadership partnerships in implementation of evidence-based programs to improve care of residents with DBD and present strategies for developing these partnerships. Discussion will include the importance of using implementation science to implement evidence-based interventions for effective management of DBD and strategies for sustainment of these effective practices into usual care.

Using Stories to Institutionalize Lessons Learned

2014 ◽  
pp. 188-201 ◽  
Author(s):  
Kimiz Dalkir
Keyword(s):  
Professional Development ◽  
Organizational Behavior ◽  
Implementation Strategies ◽  
Development Strategies ◽  
Lessons Learned ◽  
Evidence Based ◽  
Simulation Games ◽  
Orientation Training ◽  
Specific Implementation

One of the major challenges of any lessons learned system is how to ensure that this content is actually implemented: by individual employees, by work teams, and by the organization as a whole. While we are guided by a number of theories on how newly acquired knowledge can become institutionalized such that it becomes “the way things are done,” there is very little theory or evidence-based practice to guide us on specific implementation strategies. This chapter presents specific strategies that were used to ensure that lessons learned became embedded in the organization including storytelling, narrative databases, simulation games, employee orientation, training, and professional development strategies. The role of technologies and the role of culture in the success or failure of these strategies are discussed together with recommendations on how to best ensure lessons learned result in learning and, ultimately, how they create changes in individual, group, and organizational behavior.

scholarly journals The Importance of Mental Models in Implementation Science

2020 ◽  
Author(s):  
Jodi Summers Holtrop ◽  
Laura Scherer ◽  
Daniel Matlock ◽  
Russell E Glasgow ◽  
Lee A Green
Keyword(s):  
Mental Models ◽  
Implementation Science ◽  
Cognitive Task ◽  
Implementation Strategies ◽  
Successful Implementation ◽  
Evidence Based ◽  
Structured Interviews ◽  
Implementation Challenges ◽  
The World ◽  
The Way

Abstract Background: Implementation science is concerned with the study of adoption, implementation and maintenance of evidence-based interventions and use of implementation strategies to facilitate translation into practice. Ways to conceptualize and overcome challenges to implementing evidence-based practice may enhance the field of implementation science. The concept of mental models may be one way to view such challenges and to guide selection, use and adaptation of implementation strategies. Methods: A mental model is an interrelated set of beliefs that shape how a person forms expectations for the future and understands the way the world works. Mental models can shape how an individual thinks about or understands how something or someone does, can, or should function in the world. We review the concepts of mental models and illustrate how they pertain to implementation of an example intervention, shared decision making. A range of methods to elicit and analyze mental models are reviewed, including formal methods developed specifically for a given project. Results: Mental models may be sparse or detailed, may be shared among actors in implementation or not, and may be substantially tacit, i.e., of limited accessibility to introspection. Actors’ mental models can determine what information they are willing to accept and what changes they are willing to consider. We describe and illustrate multiple methods for eliciting and analyzing mental models including semi-structured interviews, cognitive task analyses and Delphi methods. Conclusions: Understanding the mental models of actors in implementation can provide crucial information for understanding, anticipating, and overcoming implementation challenges. Successful implementation often requires changing actors’ mental models or the way in which interventions or implementation strategies are presented or implemented. Accurate elicitation and understanding can guide strategies for doing so.

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