scholarly journals A Comparative Analysis of Two Streams of Implementation Research

2017 ◽  
Vol 3 (1) ◽  
pp. 3 ◽  
Author(s):  
Stephen Roll ◽  
Stephanie Moulton ◽  
Jodi Sandfort
Keyword(s):  
Implementation Science ◽  
Program Implementation ◽  
Implementation Research ◽  
Public Affairs ◽  
Implementation Framework ◽  
Evidence Based Practices ◽  
Comparative Review ◽  
State Of Research ◽  
Research Stream ◽  
New Research

Increased pressure for evidence-based practices in policymaking and administration has led to the growth of a new research stream of implementation science. Little is known about how this new stream of research compares with scholarship on policy implementation within public administration. This paper provides a comparative review of more than 1,500 journal articles on policy and program implementation published between 2004-2013. Using bibliometric analysis and a content analysis of abstracts, implementation articles within public affairs journals and in the emerging implementation science stream are analyzed in terms of their content, methods, and focus. Following a multi-level implementation framework, this analysis considers the level at which research is taking place within the different venues of implementation research. Through this systematic review, this paper provides new insights about the current state of research, opening up new avenues for scholars to substantively engage with and contribute to this important area of study.

scholarly journals Implementation Science in Nutrition: Concepts and Frameworks for an Emerging Field of Science and Practice

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Alison Tumilowicz ◽  
Marie T Ruel ◽  
Gretel Pelto ◽  
David Pelletier ◽  
Eva C Monterrosa ◽  
...  
Keyword(s):  
Implementation Science ◽  
Program Implementation ◽  
Implementation Research ◽  
Scale Up ◽  
Implementation Process ◽  
Implementation Quality ◽  
Wide Range ◽  
Intervention Policy ◽  
Culture Of Inquiry ◽  
National Governments

AbstractMalnutrition in all its forms has risen on global and national agendas in recent years because of the recognition of its magnitude and its consequences for a wide range of human, social, and economic outcomes. Although the WHO, national governments, and other organizations have endorsed targets and identified appropriate policies, programs, and interventions, a major challenge lies in implementing these with the scale and quality needed to achieve population impact. This paper presents an approach to implementation science in nutrition (ISN) that builds upon concepts developed in other policy domains and addresses critical gaps in linking knowledge to effective action. ISN is defined here as an interdisciplinary body of theory, knowledge, frameworks, tools, and approaches whose purpose is to strengthen implementation quality and impact. It includes a wide range of methods and approaches to identify and address implementation bottlenecks; means to identify, evaluate, and scale up implementation innovations; and strategies to enhance the utilization of existing knowledge, tools, and frameworks based on the evolving science of implementation. The ISN framework recognizes that quality implementation requires alignment across 5 domains: the intervention, policy, or innovation being implemented; the implementing organization(s); the enabling environment of policies and stakeholders; the individuals, households, and communities of interest; and the strategies and decision processes used at various stages of the implementation process. The success of aligning these domains through implementation research requires a culture of inquiry, evaluation, learning, and response among program implementers; an action-oriented mission among the research partners; continuity of funding for implementation research; and resolving inherent tensions between program implementation and research. The Society for Implementation Science in Nutrition is a recently established membership society to advance the science and practice of nutrition implementation at various scales and in varied contexts.

Implementation Science

2014 ◽  
Vol 222 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Terje Ogden ◽  
Dean L. Fixsen
Keyword(s):  
Systematic Review ◽  
Implementation Science ◽  
Implementation Research ◽  
Scaling Up ◽  
Program Sustainability ◽  
Implementation Quality ◽  
Good Balance ◽  
Research Challenges ◽  
Research Outcomes ◽  
Comparative Review

The field of implementation research is remarkable in many ways and, even as a young discipline, it has expanded well beyond the expectations of even its most optimistic supporters and stakeholders. In this overview we provide a selective rather than systematic review to serve as a relevant introduction to the field of implementation science. We highlight central concepts, strategies, frameworks, and research outcomes. These highlights draw heavily on the seminal systematic reviews from Brownson, Colditz, and Proctor (2012) , Fixsen, Naoom, Blase, Friedman, and Wallace (2005) , and Greenhalgh, Robert, MacFarlane, Bate, and Kyriakidou (2004) and on a thorough comparative review of implementation frameworks conducted by Meyers, Durlak, and Wandersman (2012) . Looking ahead to future implementation research, we consider research challenges related to the scaling up of programs, striking a good balance between treatment integrity and local adaptation, measuring implementation quality, and program sustainability.

scholarly journals Implementation Research Methodologies for Achieving Scientific Equity and Health Equity

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 83-92
Author(s):  
Moira McNulty ◽  
J.D. Smith ◽  
Juan Villamar ◽  
Inger Burnett-Zeigler ◽  
Wouter Vermeer ◽  
...  
Keyword(s):  
Health Disparities ◽  
Implementation Science ◽  
Health Equity ◽  
Implementation Research ◽  
Design Research ◽  
Community Members ◽  
Scientific Enterprise ◽  
Health Domains ◽  
Implementation Method ◽  
New Research

Implementation science has great potential to improve the health of communities and individuals who are not achieving health equity. However, implementation science can exacerbate health disparities if its use is biased toward entities that already have the highest capacities for delivering evidence-based interventions. In this article, we ex­amine several methodologic approaches for conducting implementation research to ad­vance equity both in our understanding of what historically disadvantaged populations would need—what we call scientific equi­ty—and how this  knowledge can be applied to produce health equity. We focus on rapid ways to gain knowledge on how to engage, design research, act, share, and sustain successes in partnership with communities. We begin by describing a principle-driven partnership process between community members and implementation researchers to overcome disparities. We then review three innovative implementation method paradigms to improve scientific and health equity and provide examples of each. The first paradigm involves making efficient use of existing data by applying epidemiologic and simulation modeling to understand what drives disparities and how they can be overcome. The second paradigm involves designing new research studies that include, but do not focus exclusively on, popula­tions experiencing disparities in health domains such as cardiovascular disease and co-occurring mental health conditions. The third paradigm involves implementation research that focuses exclusively on popula­tions who have experienced high levels of disparities. To date, our scientific enterprise has invested disproportionately in research that fails to eliminate health disparities. The implementation research methods discussed here hold promise for overcoming barri­ers and achieving health equity.Ethn Dis. 2019;29(Suppl 1):83-92; doi:10.18865/ ed.29.S1.83.

scholarly journals A Practical Guide to Incorporating Health Equity Domains in Implementation Frameworks

2020 ◽  
Author(s):  
Eva N Woodward ◽  
Rajinder Sonia Singh ◽  
Phiwinhlanhla Ndebele-Ngwenya ◽  
Andrea Melgar Castillo ◽  
Kelsey S. Dickson ◽  
...  
Keyword(s):  
Implementation Science ◽  
Health Equity ◽  
Implementation Research ◽  
Clinical Encounter ◽  
Implementation Framework ◽  
Research And Practice ◽  
Practical Guide ◽  
Interview Guide ◽  
Practical Guidelines ◽  
Science Framework

Abstract Background: Due to limited systematic integration of health equity and implementation science, it is imperative to provide researchers and practitioners tools to guide implementation in settings where there is inequitable implementation of an intervention. Our prior work documented and piloted the first published adaptation of an existing implementation science framework with health equity determinants to create the Health Equity Implementation Framework. We suggested how others’ might adapt their preferred implementation science frameworks with three health equity domains: 1) cultural factors of recipients, 2) clinical encounter, or patient-provider interaction, and 3) societal influences (including but not limited to social determinants of health). This manuscript is a practical guide to utilize three health equity domains in implementation research and practice.Methods: We describe in greater depth than in our previous publication domains typical in implementation determinants frameworks and three adaptations: domains known to affect health equity. For each domain, we compiled definitions with supporting literature, defined relevant subdomains, showcased an illustrative example, and suggested sample measures, both quantitative and qualitative.Results: We describe how to incorporate the three health equity domains in one’s preferred implementation science framework, or how to use the Health Equity Implementation Framework specifically. Practical guidelines follow ten published recommendations on how to use frameworks in implementation research and practice. We describe a new case study in which the framework guided evaluation.Conclusions: Incorporating health equity domains within implementation frameworks may optimize the scientific yield and equity of implementation efforts by assessing and ideally, addressing, implementation and equity barriers simultaneously. The practical guidance and tools provided can assist implementation scientists and practitioners to concretely address inequity in implementation across populations to capture and analyze information used to assess health outcomes.Contributions to the LiteratureSpecific definitions of implementation and three health equity domains with examples of how they have been applied in published literature and sample measures.Practical tools, including a qualitative interview guide and codebookCase study of how the Health Equity Implementation Framework guided analysis in an implementation study

scholarly journals Implementation Research Methodologies for Achieving Scientific Equity and Health Equity

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 83-92 ◽  
Author(s):  
Moira McNulty ◽  
J.D. Smith ◽  
Juan Villamar ◽  
Inger Burnett-Zeigler ◽  
Wouter Vermeer ◽  
...  
Keyword(s):  
Health Disparities ◽  
Implementation Science ◽  
Health Equity ◽  
Implementation Research ◽  
Design Research ◽  
Community Members ◽  
Scientific Enterprise ◽  
Health Domains ◽  
Implementation Method ◽  
New Research

Implementation science has great potential to improve the health of communities and individuals who are not achieving health equity. However, implementation science can exacerbate health disparities if its use is biased toward entities that already have the highest capacities for delivering evidence-based interventions. In this article, we ex­amine several methodologic approaches for conducting implementation research to ad­vance equity both in our understanding of what historically disadvantaged populations would need—what we call scientific equi­ty—and how this  knowledge can be applied to produce health equity. We focus on rapid ways to gain knowledge on how to engage, design research, act, share, and sustain successes in partnership with communities. We begin by describing a principle-driven partnership process between community members and implementation researchers to overcome disparities. We then review three innovative implementation method paradigms to improve scientific and health equity and provide examples of each. The first paradigm involves making efficient use of existing data by applying epidemiologic and simulation modeling to understand what drives disparities and how they can be overcome. The second paradigm involves designing new research studies that include, but do not focus exclusively on, popula­tions experiencing disparities in health domains such as cardiovascular disease and co-occurring mental health conditions. The third paradigm involves implementation research that focuses exclusively on popula­tions who have experienced high levels of disparities. To date, our scientific enterprise has invested disproportionately in research that fails to eliminate health disparities. The implementation research methods discussed here hold promise for overcoming barri­ers and achieving health equity.Ethn Dis. 2019;29(Suppl 1):83-92; doi:10.18865/ed.29.S1.83.

Adaptation in Dissemination and Implementation Science

2017 ◽  
Author(s):  
Ana A. Baumann ◽  
Leopoldo J. Cabassa ◽  
Shannon Wiltsey Stirman
Keyword(s):  
Implementation Science ◽  
Implementation Research ◽  
Implementation Strategies ◽  
Dissemination And Implementation ◽  
Research And Practice ◽  
Implementation Outcomes ◽  
Dissemination And Implementation Science ◽  
Dissemination And Implementation Research

This chapter focuses on adaptations in the context of dissemination and implementation research and practice. Consistent with the existing literature, the authors recommend that adaptations be proactively and iteratively determined, strongly informed by a variety of stakeholders, and that efforts be made to carefully describe and document the nature of the adaptations and evaluate their impact on desired service, health, and implementation outcomes. While this chapter focuses on adaptations to interventions and the context of practice, the authors also note that adaptations may need to be made to implementation strategies. Following the call by Proctor and colleagues for further precision in defining and operationalizing implementation strategies, and based on evidence that scholars are not necessarily reporting what and how they are adapting the interventions, scholars are urged to define and evaluate the adaptations they are making not only to the interventions and context of practice but also to the implementation strategies.

Implementation of the Australasian Teletrial Model: Translating idea into action using implementation science frameworks

2021 ◽  
pp. 1357633X2110178
Author(s):  
Sabe Sabesan ◽  
Marie Malica ◽  
Chantal Gebbie ◽  
Clare Scott ◽  
David Thomas ◽  
...  
Keyword(s):  
Implementation Science ◽  
Pilot Project ◽  
Final Report ◽  
Rare Cancer ◽  
Government Investment ◽  
Implementation Framework ◽  
Advisory Groups ◽  
Regulatory Systems ◽  
Key Stakeholders ◽  
Strategic Implementation

Background: Despite Government investment, disparity in access to clinical trials continue between metropolitan and regional & rural sectors (RRR) in Australia and around the world. To improve trial access closer to home for RRR communities and rare cancer patients even in metro settings, the Australasian Teletrial Model (ATM) was developed by Clinical Oncology Society of Australia and implemented in four states. Aim of this paper is to describe the steps and processes involved in the development and implementation of ATM guided by implementation science frameworks. Method: Two implementation science frameworks namely iPARIHS and Strategic Implementation Framework were chosen to guide the project. Details of steps and processes were extracted from COSA final report. Results: ATM met the criteria for worthy innovation. For the development and implementation of the ATM, stakeholders were at national, statewide and clinical levels. A co-design with end-users and inclusion of key stakeholders in steering committees and advisory groups made the implementation smoother. Clinician levers including advocacy were useful to overcome system barriers. During the project, more patients, and clinicians at RRR participated in trials, more primary sites collaborated with RRR sites and more RRR sites gained trial capabilities. Conclusion: Pilot project achieved its objectives including improved access to patients locally, creation of linkages between metro and RRR sites and enhanced capabilities of and access to RRR sites. Implementation science frameworks were useful for identifying the necessary steps and processes at the outset. Ownership by governments and creation of streamlined regulatory systems would enable broader adoption.

scholarly journals Measures of organizational culture, organizational climate, and implementation climate in behavioral health: A systematic review

2021 ◽  
Vol 2 ◽  
pp. 263348952110188
Author(s):  
Byron J Powell ◽  
Kayne D Mettert ◽  
Caitlin N Dorsey ◽  
Bryan J Weiner ◽  
Cameo F Stanick ◽  
...  
Keyword(s):  
Organizational Culture ◽  
Organizational Climate ◽  
Psychometric Properties ◽  
Behavioral Health ◽  
Implementation Research ◽  
Learning Climate ◽  
Evidence Based ◽  
Implementation Climate ◽  
Relative Priority ◽  
Evidence Based Practices

Background: Organizational culture, organizational climate, and implementation climate are key organizational constructs that influence the implementation of evidence-based practices. However, there has been little systematic investigation of the availability of psychometrically strong measures that can be used to assess these constructs in behavioral health. This systematic review identified and assessed the psychometric properties of measures of organizational culture, organizational climate, implementation climate, and related subconstructs as defined by the Consolidated Framework for Implementation Research (CFIR) and Ehrhart and colleagues. Methods: Data collection involved search string generation, title and abstract screening, full-text review, construct assignment, and citation searches for all known empirical uses. Data relevant to nine psychometric criteria from the Psychometric and Pragmatic Evidence Rating Scale (PAPERS) were extracted: internal consistency, convergent validity, discriminant validity, known-groups validity, predictive validity, concurrent validity, structural validity, responsiveness, and norms. Extracted data for each criterion were rated on a scale from −1 (“poor”) to 4 (“excellent”), and each measure was assigned a total score (highest possible score = 36) that formed the basis for head-to-head comparisons of measures for each focal construct. Results: We identified full measures or relevant subscales of broader measures for organizational culture ( n = 21), organizational climate ( n = 36), implementation climate ( n = 2), tension for change ( n = 2), compatibility ( n = 6), relative priority ( n = 2), organizational incentives and rewards ( n = 3), goals and feedback ( n = 3), and learning climate ( n = 2). Psychometric evidence was most frequently available for internal consistency and norms. Information about other psychometric properties was less available. Median ratings for psychometric properties across categories of measures ranged from “poor” to “good.” There was limited evidence of responsiveness or predictive validity. Conclusion: While several promising measures were identified, the overall state of measurement related to these constructs is poor. To enhance understanding of how these constructs influence implementation research and practice, measures that are sensitive to change and predictive of key implementation and clinical outcomes are required. There is a need for further testing of the most promising measures, and ample opportunity to develop additional psychometrically strong measures of these important constructs. Plain Language Summary Organizational culture, organizational climate, and implementation climate can play a critical role in facilitating or impeding the successful implementation and sustainment of evidence-based practices. Advancing our understanding of how these contextual factors independently or collectively influence implementation and clinical outcomes requires measures that are reliable and valid. Previous systematic reviews identified measures of organizational factors that influence implementation, but none focused explicitly on behavioral health; focused solely on organizational culture, organizational climate, and implementation climate; or assessed the evidence base of all known uses of a measure within a given area, such as behavioral health–focused implementation efforts. The purpose of this study was to identify and assess the psychometric properties of measures of organizational culture, organizational climate, implementation climate, and related subconstructs that have been used in behavioral health-focused implementation research. We identified 21 measures of organizational culture, 36 measures of organizational climate, 2 measures of implementation climate, 2 measures of tension for change, 6 measures of compatibility, 2 measures of relative priority, 3 measures of organizational incentives and rewards, 3 measures of goals and feedback, and 2 measures of learning climate. Some promising measures were identified; however, the overall state of measurement across these constructs is poor. This review highlights specific areas for improvement and suggests the need to rigorously evaluate existing measures and develop new measures.

scholarly journals Application of a Preventive Training Program Implementation Framework to Youth Soccer and Basketball Organizations

2019 ◽  
Vol 54 (2) ◽  
pp. 182-191 ◽  
Author(s):  
Hayley J. Root ◽  
Barnett S. Frank ◽  
Craig R. Denegar ◽  
Douglas J. Casa ◽  
David I. Gregorio ◽  
...  
Keyword(s):  
Program Implementation ◽  
Administrative Support ◽  
Neuromuscular Control ◽  
Initial Step ◽  
Sport Performance ◽  
Implementation Framework ◽  
Injury Rates ◽  
Youth Soccer ◽  
Youth Athletes ◽  
Education Workshop

Context Preventive training programs (PTPs) can reduce injury rates and improve neuromuscular control and sport performance. However, PTPs must be implemented correctly and consistently over time for athletes to benefit. Coaches represent the best long-term option for implementing PTPs. Youth athletes are at the optimal age for developing good habits before maturation. Although frameworks have been proposed to guide implementation efforts, little is known regarding the feasibility and real-world context of PTP implementation at the youth sport level. Objective To evaluate the application of the 7-Step framework for promoting implementation of a preseason PTP workshop. Design Descriptive epidemiology study. Setting Youth soccer and basketball organizations. Patients or Other Participants Organizations with at least 1 team of athletes aged 8 to 14 years were invited to participate in a free preseason coaches' education workshop on PTP implementation. Intervention(s) The 7-Step framework was used to guide PTP education and implementation for each organization. Personnel at organizations that agreed to participate attended a single preseason workshop for coaches. Research staff were available as a resource throughout the season but did not actively implement or monitor the PTPs. Main Outcome Measure(s) Retrospective evaluation of each organization's completion of steps 1 through 5 of the 7-Step framework. Results A total of 62 youth soccer (n = 40) and basketball (n = 22) organizations were invited to participate. Twelve organizations completed steps 1 through 4 and steps 5a through 5d. The highest drop-off rate occurred during step 1, “Establishing Administrative Support.” No organization completed all components of steps 1 through 5. Conclusions To better understand how to successfully promote PTP adoption, we must identify the implementation steps that may present the most challenges. Because the highest drop-off rate was seen during the initial step, establishing administrative support and strengthening initial engagement are necessary to improve PTP implementation.

scholarly journals Speaking Softly and Listening Hard: The Process of Involving Young Voices from a Culturally and Linguistically Diverse School in Child Health Research

2021 ◽  
Vol 18 (11) ◽  
pp. 5808
Author(s):  
Nora Samir ◽  
Antonio Mendoza Diaz ◽  
Michael Hodgins ◽  
Simone Matic ◽  
Samira Bawden ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Linguistically Diverse ◽  
Research Strategy ◽  
Health Priorities ◽  
Culturally And Linguistically Diverse ◽  
Advisory Group ◽  
Student Preference ◽  
Research Stream ◽  
New Research

The involvement of young people in the planning of research continues to be rare, particularly for young people from culturally and linguistically diverse communities. This paper describes our experience in establishing a Youth Research Advisory Group (YRAG) in South West Sydney (SWS), including barriers and successful strategies. One hundred and fifteen students between school Years 7 and 12 (ages 11–18) took part in at least one of five sessions between 2019 and 2021. In total, we carried out 26 YRAG sessions, with between five and 30 students in each. Sessions focused on mapping the health priorities of the participants and co-developing research project proposals related to their health priorities. Our work with students revealed that their main areas of concern were mental health and stress. This led to material changes in our research strategy, to include “Mental Health” as a new research stream and co-develop new mental health-related projects with the students. Important strategies that enabled our research included maintaining flexibility to work seamlessly with organisational and individual preferences, and ensuring our processes were directed by the schools and—most importantly—the students themselves. Strategies such as maintaining an informal context, responding rapidly to student preference, and regularly renegotiating access enabled us to engage with the students to deepen our understanding of their experiences.

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