Perceptions of barriers and facilitators to engaging in implementation science: a qualitative study

Partnership-building considerations for implementation science in learning health systems: a case study of the Implementation Science Collaborative in Alberta, Canada

Introduction

Implementation of health innovations is inherently collaborative, requiring trans-sectoral partnerships between implementation researchers, innovation teams, and implementation practitioners. Implementation science has been shown to improve implementation successes; however, challenges that hinder partnerships to advance implementation science continue to persist. Using a whole-system approach to assess and respond to implementation science partnership barriers may shed light on effective responses.

Methods

We conducted a case study of Alberta's learning health system, using semi-structured group and individual interviews to create a nuanced understanding of the considerations required for implementation research collaborations. We interviewed 53 participants representing 21 offices in the health system, academia, professional associations, and government who regularly plan, evaluate, and/or study health system implementation initiatives in Alberta. Using the Partnership Model for Research Capacity Building, we identified current facilitators and challenges for partnerships for conducting and using implementation science, at different levels of Alberta's health-research ecosystem.

Results

Alberta's healthcare system is well set up to readily embed intervention effectiveness and efficacy research. Infrastructure was also in place to strengthen implementation practice. However, weaknesses around exchanging knowledge and skills, providing feedback and mentoring, and accommodating diversity affected the ability of both individuals and teams to build implementation science capacity. Without this capacity, teams could not participate in embedded implementation research collaborations. We report the response of the Alberta Strategy for Patient-Oriented Research SUPPORT Unit to these barriers to provide practical guidance on various program options to strengthen individual- and organization-level implementation science capacity.

Discussion

This study applied a whole-system approach to assess factors across Alberta's health-research ecosystem, which affect partnerships to advance implementation science. Our findings illustrated that partnership considerations go beyond interpersonal factors and include system-wide considerations. With the results, health organization leaders have (1) a method for assessing organizational capability to readily embed implementation research and (2) a catalog of potential responses to create conditions to readily engage with implementation science in their day-to-day implementation processes.

A network analysis of dissemination and implementation research expertise across a university: Central actors and expertise clusters

Background:

Although dissemination and implementation (D&I) science is a growing field, many health researchers with relevant D&I expertise do not self-identify as D&I researchers. The goal of this work was to analyze the distribution, clustering, and recognition of D&I expertise in an academic institution.

Methods:

A snowball survey was administered to investigators at University of Rochester with experience and/or interest in D&I research. The respondents were asked to identify their level of D&I expertise and to nominate others who were experienced and/or active in D&I research. We used social network analysis to examine nomination networks.

Results:

Sixty-eight participants provided information about their D&I expertise. Thirty-eight percent of the survey respondents self-identified as D&I researchers, 24% as conducting D&I under different labels, and 38% were familiar with D&I concepts. D&I researchers were, on average, the most central actors in the network (nominated most by other survey participants) and had the highest within-group density, indicating wide recognition by colleagues and among themselves. Researchers who applied D&I under different labels had the highest within-group reciprocity (25%), and the highest between-group reciprocity (29%) with researchers familiar with D&I. Participants significantly tended to nominate peers within their departments and within their expertise categories.

Conclusions:

Identifying and engaging unrecognized clusters of expertise related to D&I research may provide opportunities for mutual learning and dialog and will be critical to bridging across departmental and topic area silos and building capacity for D&I in academic settings.

Applying Implementation Science to Support Active Collaboration in Noninvasive Brain-Computer Interface Development and Translation for Augmentative and Alternative Communication

PURPOSE

The purpose of this article is to consider how, alongside engineering advancements, noninvasive brain-computer interface (BCI) for augmentative and alternative communication (AAC; BCI-AAC) developments can leverage implementation science to increase the clinical impact of this technology. We offer the Consolidated Framework for Implementation Research (CFIR) as a structure to help guide future BCI-AAC research. Specifically, we discuss CFIR primary domains that include intervention characteristics, the outer and inner settings, the individuals involved in the intervention, and the process of implementation, alongside pertinent subdomains including adaptability, cost, patient needs and recourses, implementation climate, other personal attributes, and the process of engaging. The authors support their view with current citations from both the AAC and BCI-AAC fields.

CONCLUSIONS

The article aimed to provide thoughtful considerations for how future research may leverage the CFIR to support meaningful BCI-AAC translation for those with severe physical impairments. We believe that, although significant barriers to BCI-AAC development still exist, incorporating implementation research may be timely for the field of BCI-AAC and help account for diversity in end users, navigate implementation obstacles, and support a smooth and efficient translation of BCI-AAC technology. Moreover, the sooner clinicians, individuals who use AAC, their support networks, and engineers collectively improve BCI-AAC outcomes and the efficiency of translation, the sooner BCI-AAC may become an everyday tool in the AAC arsenal.

Barriers and Facilitators for Conducting Implementation Science in German-Speaking Countries: Findings from the Promote ImpSci Interview Study

On a global scale, implementation science has developed considerably as a discipline in recent years. In German-speaking countries, the field has been gaining significance as well, but respective efforts in building capacity and advancing the research infrastructure are still rare. The present study investigates barriers and facilitators for conducting implementation science in German-speaking countries with the goal of formulating recommendations for creating a more supportive research infrastructure. We conducted an interview study with nine well-established implementation researchers affiliated with universities in Austria, Germany, or Switzerland. The interviews were held via Zoom or phone in November and December 2020, transcribed verbatim and analyzed using thematic analysis. Barriers that relate to characteristics of the discipline were difficulties in building a common understanding of the field and the complexity of implementation research projects. Although supportive scientific networks were important facilitators, interviewees mentioned challenges in connecting with likeminded researchers. A further barrier was the lack of opportunities for education and training in implementation science, especially in the German language. Also, participants reported a missing readiness in academia for establishing implementation science that should be addressed by advocacy of the discipline toward academic decision makers. Moreover, since most national funding agencies prioritize basic research over applied research, some interviewees named flexibility in handling research funds as a facilitator for implementation research. The results inform an agenda for promoting implementation science in German-speaking countries and can be beneficial to other countries that are currently advancing their implementation research capacity and infrastructure.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43477-022-00046-3.