A conceptual framework of the adoption of innovations in organizations: a meta-analytical review of the literature

Exploring the Configuration of Institutional Practices—A Case Study of Innovation Implementation in Healthcare

In this study we provide a fine-grained description of the micro-processes of innovation through a qualitative study of the implementation of telemedicine innovation in a healthcare organization. Our qualitative analysis uses a mix of participant interviews, observation techniques and archival data sources. We use the concept of translation to describe the movement of ideas and practices through social interrelationships. Our results suggest that the implementation of innovation involving changes in extant institutional practices is a result of a translation during which actors assess not only their specific role within a given institutional practice but also how their actions influence the broad outcome. Our results bring to the fore the role that interactions between organizational actors and institutional practices play in the implementation of innovation. Consistent with the translation perspective, our results suggest that the implementation of innovation is mainly an organizational change process facilitated by a concurrence of meaning or the lack of it lack among organizational actors. Our study provides new evidence on the institutional practices that are created, maintained, modified as well as disrupted during the implementation of externally developed innovation.

Multiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial

BACKGROUND

This study aimed to evaluate the effectiveness of a) a Multiple Health Behaviour Change (MHBC) intervention on reducing smoking, increasing physical activity and adherence to a Mediterranean dietary pattern in people aged 45-75 years compared to usual care; and b) an implementation strategy.

METHODS

A cluster randomised effectiveness-implementation hybrid trial-type 2 with two parallel groups was conducted in 25 Spanish Primary Health Care (PHC) centres (3062 participants): 12 centres (1481 participants) were randomised to the intervention and 13 (1581 participants) to the control group (usual care). The intervention was based on the Transtheoretical Model and focused on all target behaviours using individual, group and community approaches. PHC professionals made it during routine care. The implementation strategy was based on the Consolidated Framework for Implementation Research (CFIR). Data were analysed using generalised linear mixed models, accounting for clustering. A mixed-methods data analysis was used to evaluate implementation outcomes (adoption, acceptability, appropriateness, feasibility and fidelity) and determinants of implementation success.

RESULTS

14.5% of participants in the intervention group and 8.9% in the usual care group showed a positive change in two or all the target behaviours. Intervention was more effective in promoting dietary behaviour change (31.9% vs 21.4%). The overall adoption rate by professionals was 48.7%. Early and final appropriateness were perceived by professionals as moderate. Early acceptability was high, whereas final acceptability was only moderate. Initial and final acceptability as perceived by the participants was high, and appropriateness moderate. Consent and recruitment rates were 82.0% and 65.5%, respectively, intervention uptake was 89.5% and completion rate 74.7%. The global value of the percentage of approaches with fidelity ≥50% was 16.7%. Eight CFIR constructs distinguished between high and low implementation, five corresponding to the Inner Setting domain.

CONCLUSIONS

Compared to usual care, the EIRA intervention was more effective in promoting MHBC and dietary behaviour change. Implementation outcomes were satisfactory except for the fidelity to the planned intervention, which was low. The organisational and structural contexts of the centres proved to be significant determinants of implementation effectiveness.

TRIAL REGISTRATION

ClinicalTrials.gov , NCT03136211 . Registered 2 May 2017, "retrospectively registered".

Pathways of influences leading to adoption of the Faith, Activity and Nutrition (FAN) program in a statewide initiative

RE-AIM (Reach, effectiveness, Adoption, Implementation, Maintenance) and CFIR (Consolidated Framework for Implementation Research) are complementary frameworks guiding research on dissemination and implementation of evidence-based interventions and factors influencing this process. Faith, Activity, and Nutrition (FAN) is an evidence-based program that increased physical activity and fruit and vegetable intake in faith-based settings. The aims of this adoption study were to quantify state-wide church level adoption rates and congregant reach of FAN in accordance with RE-AIM guidelines, and to explore the association of CFIR-derived constructs of the church inner setting and pastor characteristics with FAN adoption. Church recruitment was documented, and data were collected via telephone-administered surveys from 93 pastors in adopting churches and 60 pastors in non-adopting churches. Qualitative Comparative Analysis (QCA) identified combinations of CFIR-derived church and pastor characteristics sufficient for FAN adoption. As defined by RE-AIM, church-level FAN adoption was 11.7 % and congregant-level reach was 20.0 %. Fourteen pathways to adoption were identified; seven of these featured the presence of a culture of concern for congregant health along with openness to new ideas. Results suggest early assessment of these two CFIR-derived inner setting constructs may help identify faith-based organizations predisposed to undertake a comprehensive, environmental intervention to promote congregant health.

Factors Influencing the Adoption of Mobile Application Development Platforms

Mobile application development platforms (MADPs) vary in terms of their development capabilities and competency to fulfill the specific needs of organizations. Therefore, acknowledging the most appropriate MADP to adopt remains a challenging task for many organizations. Aiming to investigate the key factors of MADPs adoption in organizations, this study analyzed 1200 online evaluation reviews for six widely used MADPs posted by mobile applications developers. Based on the content analysis of online reviews, 26 factors emerged as significant contributors to the adoption decision of MADPs from the standpoint of developers. These factors were integrated into a conceptual framework of MADPs adoption based on the technology-organization-environment (TOE) framework. The results of this study indicate that in addition to the technological capabilities, the adoption decision of MADPs depends on several organizational and environmental factors. These results provide not only a theoretical foundation for further research on MADPs adoption but also offers actionable guidance for practical implementation.