Leveraging academic initiatives to advance implementation practice: a scoping review of capacity building interventions

Harnessing Implementation Science in Clinical Psychology: Past, Present, and Future

Implementation science aspires to equitably accelerate the uptake of clinical research into practice to improve population health. The focus of implementation science includes individual behavior change mechanisms that are similar to those that drive the field of clinical psychology. For this reason, clinical psychologists are well-suited to take up implementation science methods in pursuit of improving the quality of behavioral health care. To do so, clinical psychologists must expand beyond individual behavior change to include a focus on organizations and systems. In this review, we reflect on ways that clinical psychologists can lead in the integration of implementation science principles and approaches into clinical psychology research and practice. We discuss the role clinical psychologists play in closing know-do gaps in behavioral health and describe how clinical psychologists can build implementation science competencies. We end with current controversies and opportunities for innovation to further improve the quality of behavioral health care.

Building the Road to End the HIV Epidemic Through Coordinating and Capacity-Building Hubs to Enhance the Science of HIV Implementation REsearch (CHESHIRE): Reflections and Directions

BACKGROUND

Because implementation remains the biggest challenge to Ending the HIV Epidemic in the United States (EHE), since 2019, the National Institutes of Health (NIH) has funded 248 supplements to identify best practices for delivering evidence-based HIV interventions. NIH also funded a coordination center [Implementation Science (IS) Coordination Initiative "ISCI"] and 9 consultation hubs ("Hubs") to provide technical assistance and cross-project information sharing, measure harmonization, and data synthesis. This article describes this unique capacity-building model, lessons learned from the first 5 years, and opportunities created by this infrastructure.

METHODS

Beginning in FY20, Hubs were assigned 7-9 funded supplement projects in EHE priority jurisdictions. Primary Hub services included direct coaching, multiproject meetings, communities of practice, and technical webinars. ISCI and the Hubs met monthly to reflect on project support, discuss ways to enhance HIV IS broadly, and assess projects' use of Hub services.

FINDINGS

Hub engagement strategies included grouping projects by HIV intervention type, setting data reporting expectations early, and tailoring engagement based on EHE team IS expertise. Support and coordination provided by the Hubs and ISCI have developed generalizable IS knowledge from local knowledge (e.g., publications and tools). The network of ISCI, the Hubs, and EHE projects have also led to infrastructure for conducting multisite HIV implementation research.

IMPLICATIONS FOR DI SCIENCE

The Hub model is a novel, systemwide approach for rapidly improving IS capacity in a field. Implementation of this model will continue to be refined through an ongoing evaluation and as the funding transitions to regular, nonsupplement NIH funding mechanisms.

Two Pilots of an Implementation Science Training Program for HIV Prevention and Care Service Providers: Lessons Learned and Future Directions

BACKGROUND

Development, implementation, and dissemination of HIV-related implementation strategies require partnerships with affected communities, government agencies, and HIV service organizations. Implementation science (IS) training for partners is needed to ensure they can benefit from, and equally contribute to, implementation research (IR). Building IS knowledge and expertise in real-world practice increases providers' ability to offer evidence-based HIV interventions and effectively implement them at scale to achieve the goals of the national Ending the HIV Epidemic (EHE) initiative.

METHODS

National Institutes of Health funds the Implementation Science Coordination Initiative (ISCI) and the Sociostructural Implementation Science Coordination Initiative (SISCI) to support studies in the conduct of rigorous HIV IR through technical assistance, development of IS tools, and trainings for researchers and implementers. As part of these efforts, we created and evaluated 2 pilot IS training courses for HIV service providers: the Practitioner-Oriented Implementation Science Education (POISE) and the Implementation Practitioner Training (IPT). We discuss the importance of training for implementers, the development of our curriculum, lessons learned, and future directions for IS trainings.

CONCLUSIONS

Implementers play a critical role in IR, because they are the beneficiaries of the knowledge produced and are responsible for effectively implementing HIV interventions to achieve EHE goals. Few training courses in IS are specifically designed to meet the needs of those implementing HIV evidence-based interventions and little is known about how to design and deliver them to maximize training benefit. Both training pilots increased participants' ability to apply IS to their work. Participant input provides valuable feedback to improve future training.

Implementation Science Competencies for Policy Transformation Framework (ISCPT)

Implementation science (IS) models play a crucial role in translating evidence-based practice (EBP) into sustainable policy reforms. However, the competencies required for nurses to lead these transformations remain poorly defined. Objective: This study develops a framework for implementation lead (IL) nurses, identifying the core competencies needed to drive evidence-based policy transformation within healthcare systems. Method: A secondary data analysis (SDA) was conducted using qualitative data from focus group interviews originally collected, recorded, and transcribed as part of the EQUIP (Evidence-based Quality Improvement Project). The dataset includes insights from 12 IL nurses who participated in PEACE-based training, addressing real-world clinical challenges. Their perspectives were thematically analyzed to generate a competency framework for policy leadership. Findings: The study developed the Implementation Science Competencies for Policy Transformation (ISCPT) framework, which highlights three pillars: (1) evidence appraisal and guideline development, (2) collaborative leadership for policy advocacy, and (3) continuous improvement through data-driven decision-making. Conclusions: Grounded in IL nurses' perspectives, the ISCPT framework provides a nurse-centric roadmap for policy transformation, integrating interdisciplinary collaboration, adaptive leadership, and evidence-based decision-making into nursing education and practice. While the findings reflect a single healthcare context, the framework offers actionable guidance for preparing nurses to lead policy-driven healthcare improvements.

Development of an Implementation Science Higher Diploma for Registered Nurses: Phase III of the EQUIP Initiative

Implementation science (ImpSci) programs are emerging in nursing postgraduate education. The Evidence-Based Quality Improvement Project (EQUIP) is a multiphase initiative aimed at equipping implementation lead nurses (IL nurses) with the skills necessary for practice changes. This study leveraged EQUIP's outcomes to develop a 1-year Higher Diploma in ImpSci for registered nurses, preparing graduates to conduct ImpSci projects that improve healthcare quality. Using a co-participatory design, the study engaged IL nurses (n = 10), clinician nurses (n = 3), clinical research nurses (n = 1), and academic staff (n = 2) in collaboratively developing the ImpSci Higher Diploma curriculum. Six co-designed learning domains were established, aligning with the program's mission to advance evidence-based education, research-driven clinical practice, and sustainable quality initiatives, with a focus on ImpSci. Nine program learning outcomes were mapped to eight domains of competence, creating a framework to prepare IL nurses to conduct ImpSci projects, address challenges, and improve patient outcomes. ImpSci Higher Diploma builds on previous work in evidence-based practice (EBP) implementation, equipping graduates to lead critical quality improvement efforts and advance nursing education and healthcare delivery.

Implementation processes and capacity-building needs in Ontario maternal-newborn care hospital settings: a cross-sectional survey

BACKGROUND

Maternal-newborn care does not always align with the best available evidence. Applying implementation science to change initiatives can help move evidence-informed practices into clinical settings. However, it remains unknown to what extent current implementation practices in maternal-newborn care align with recommendations from implementation science, and how confident nurses, other health professionals, and leaders are completing steps in the implementation process. We aimed to understand Ontario maternal-newborn teams' (1) approaches to implementing practice changes and the extent to which their implementation processes aligned with an implementation science planned-action framework; and (2) perceptions of importance and confidence completing implementation activities.

METHODS

We conducted a cross-sectional survey between September-November 2023. Using purposive sampling, we invited Ontario maternal-newborn nurses, other healthcare professionals, and leaders who had experience participating in or leading implementation projects to complete an online questionnaire. The questionnaire was informed by an implementation science framework, which includes three core phases (identify issue; build solutions; implement, evaluate, sustain). The questions probed respondents' perceptions of frequency of completion, importance, and confidence for each of the 28 implementation activities. We used descriptive statistics for the closed-ended questions and grouped the written responses into categories.

RESULTS

We received 73 responses from 57 Ontario maternal-newborn hospitals, the majority being nurses in point-of-care and leadership roles. Nearly all respondents agreed that each of the 28 implementation activities were important. Respondents reported always completing a median of 8 out of 28 activities, with the number of activities completed declining from phase 1 through to 3. Most respondents indicated they were somewhat confident completing the implementation activities and agreed their teams would benefit from increasing their knowledge and skills to use an evidence-informed approach to implementing practice changes.

CONCLUSIONS

Despite viewing implementation activities as important, many teams are not consistently doing them and lack confidence, particularly in later phases of the implementation process. These findings inform where further capacity-building and supports may be needed to enable maternal-newborn nurses, other healthcare professionals, and leaders to apply implementation science to their change initiatives.

Transforming dementia research into practice: a multiple case study of academic research utilization strategies in Dutch Alzheimer Centres

BACKGROUND

Non-pharmacological dementia research products, such as social and behavioural interventions, are generated in traditional university settings. These often experience challenges to impact practices that they were developed for. The Netherlands established five specialized academic health science centres, referred to as Alzheimer Centres, to structurally coordinate and facilitate the utilization of dementia research knowledge. This study leverages implementation science to systematically explore the research utilization strategies used by academic researchers from each Alzheimer Centre, on the basis of the "knowledge-to-action" (KTA) framework that includes knowledge creation, adaptation, dissemination and implementation.

METHODS

Individual semi-structured qualitative interviews were conducted with 29 respondents across the five Alzheimer Centres in the Netherlands. Participants were selected through purposive (snowball) sampling. Interviews were conducted in-person and virtually through Microsoft Teams, and all were audio-recorded and transcribed verbatim. Data analysis was guided by the dimensions of the KTA framework.

RESULT

There was a high variation in the strategies used across the five Alzheimer Centres to bring non-pharmacological dementia research into practice. Selected strategies in each Centre were influenced by the typology of research products produced and the Centres' organizational heritage. The knowledge creation and adaptation phases were mainly facilitated by funders' guidance towards research impact and research product co-creation with patients and implementing organizations. Dissemination and implementation phases were often facilitated through utilizing support from university-based technology transfer offices to facilitate implementation and valorization and establishing and strategically leveraging formal infrastructure, such as public-private partnerships and professional collaborative networks.

CONCLUSIONS

Successful research utilization requires evolving researcher competencies to meet environmental demands and facilitating co-creation with research end-users and implementing partners. Understanding external determinants influencing research utilization in the Dutch dementia research ecosystem is crucial for capacity-building and aligning cross-sector agendas. The KTA framework appears to reveal the intricacies of research utilization, guiding future studies to explore strategies employed across various contexts.

Aligning implementation research and clinical operations: a partnership to promote implementation research in primary care

The rigorous evaluation of the implementation of evidence into routine practice in a health system requires strong alignment between research and clinical operational teams. Implementation researchers benefit from understanding operational processes and contextual factors when designing data collection while operational teams gain an understanding of implementation frameworks and outcomes using both qualitative and quantitative data. However, interventions to build capacity for these evaluation partnerships-particularly those tailored for clinical operational practitioners-are limited. We developed a model for a research-clinical operational partnership to build capacity for rigorous implementation evaluation. The model incorporated didactic and interactive education alongside small group discussion. Using reflective qualitative analysis, we show how the year-long partnership resulted in an effective collaboration that built capacity for rigorous operational evaluation, informed plans for data collection to include provider and patient barriers to adoption and increased awareness of implementation cost barriers. Improved capacity for implementation evaluation was demonstrated by the knowledge acquisition that resulted for both teams as a result of the collaboration and the education that penetrated to other aspects of the operational team's work beyond the immediate project. Programme successes and improvement opportunities were also identified. The partnership model shows how a formal research-clinical operational collaboration can build capacity for rigorous implementation evaluation and close the gap between implementation researchers and practitioners in a large health system. While larger-scale process evaluation is common, creating space for project-specific capacity-building initiatives, with varying levels of research involvement, can also advance the field of implementation science, offering new perspectives and partnerships, as well as opportunities to advance learning even for smaller-scale evidence translation.

Protocol for leading health services innovation: a hybrid type 2 mixed method implementation trial for developing and assessing a codesigned graduate certificate program in health innovation

BACKGROUND

A significant issue with innovative problem-solving in healthcare is an existing deficiency in continuing education for many healthcare professionals, which hinders the successful implementation of inventive solutions and progress in the field. Educators play a crucial role in guiding students to cultivate the knowledge and skills necessary to confront these challenges, including problem solving, collaboration, and the use of rapidly advancing technologies. It is vital to design educational programs that empower and motivate students to develop the proficiency and knowledge they need to be effective problem solvers, collaborators, and cultivators of innovative solutions. This project aims to assess the implementation and effectiveness of a codesigned postgraduate university program for a multidisciplinary health workforce.

METHODS

The Leading Health Services Innovation Project is a hybrid type 2 mixed method implementation trial of a codesigned Graduate Certificate in Health Services Innovation. In collaboration with a large tertiary and quaternary health service, we developed a codesign process to guide the project, with time quarantined to create space for two-way learning between health sector partners and healthcare academics. Qualitative interviews and quantitative surveys for primary users will evaluate the implementation strategies. The reach, effectiveness, adoption implementation, and maintenance (RE-AIM) framework will guide the evaluation and maintenance of the program.

RESULTS

Integrating a codesign strategy complemented by a well-structured implementation and evaluation protocol that is a combination of implementation science theoretical frameworks (Knowledge to Action, Evidence-Based Co-design, RE-AIM) may lead to translational competence as a potential outcome.

ANTICIPATED OUTCOMES

The application, resourcing and commitment to codesigned tertiary-level learning and qualification will demonstrate the achievement of a contemporary and comprehensive postgraduate university degree program in health innovation management.

Assessing health technology implementation during academic research and early-stage development: support tools for awareness and guidance: a review

For successful health technology innovation and implementation it is key to, in an early phase, understand the problem and whether a proposed innovation is the best way to solve the problem. This review performed an initial exploration of published tools that support innovators in academic research and early stage development with awareness and guidance along the end-to-end process of development, evaluation and implementation of health technology innovations. Tools were identified from scientific literature as well as in grey literature by non-systematic searches in public research databases and search engines, and based on expert referral. A total number of 14 tools were included. Tools were classified as either readiness level tool (n = 6), questionnaire/checklist tool (n = 5) or guidance tool (n = 3). A qualitative analysis of the tools identified 5 key domains, 5 innovation phases and 3 implementation principles. All tools were mapped for (partially) addressing the identified domains, phases, and principles. The present review provides awareness of available tools and of important aspects of health technology innovation and implementation (vs. non-technological or non-health related technological innovations). Considerations for tool selection include for example the purpose of use (awareness or guidance) and the type of health technology innovation. Considerations for novel tool development include the specific challenges in academic and early stage development settings, the translation of implementation to early innovation phases, and the importance of multi-disciplinary strategic decision-making. A remaining attention point for future studies is the validation and effectiveness of (self-assessment) tools, especially in the context of support preferences and available support alternatives.

A longitudinal mixed methods evaluation of a facilitation training intervention to build implementation capacity

Background

There is a demand for facilitators who can ease the collaboration within a team or an organization in the implementation of evidence-based interventions (EBIs) and who are positioned to build the implementation capacity in an organization. This study aimed to evaluate the results the Building implementation capacity for facilitation (BIC-F) intervention had on the participants' perceived knowledge, skills, and self-efficacy to facilitate implementation and the normalization of a systematic implementation model into their work routines, and its use into their respective organizations.

Methods

The BIC-F intervention was delivered to 37 facilitators in six workshops, which focused on teaching participants to apply a systematic implementation model and various facilitation tools and strategies. A longitudinal mixed methods design was used to evaluate the intervention. Data was collected pre- and post-intervention using questionnaires and semi-structured interviews grounded on the Normalization Process Theory (NPT). Quantitative data were analyzed using descriptive (mean, SD) and inferential (paired t-tests) methods. Qualitative data were analyzed using deductive content analysis according to NPT.

Results

An increase in the participants' perceived knowledge, skills, and self-efficacy was observed post-intervention. Normalization of the systematic implementation model in the participants' work routines was in an early phase, facilitated by high coherence, however, other NPT mechanisms were not sufficiently activated yet to contribute to full normalization. In the organizations where participants initiated the normalization process, they were still working towards achieving coherence and cognitive participation among relevant stakeholders.

Conclusion

The intervention had positive results on the participants' perceived knowledge, skills, and self-efficacy and these recognized the value of a systematic implementation model for their practice. However, further efforts are needed to apply it consistently as a part of their work routines and in the organization. Future interventions should provide long-term support for facilitators, and include methods to transfer training between organizational levels and to overcome contextual barriers.

Development and psychometric evaluation of the Implementation Support Competencies Assessment

BACKGROUND

Implementation support practitioners (ISPs) are professionals that support others to implement evidence-informed practices, programs, and policies in various service delivery settings to achieve population outcomes. Measuring the use of competencies by ISPs provides a unique opportunity to assess an understudied facet of implementation science-how knowledge, attitudes, and skills used by ISPs affects sustainable change in complicated and complex service systems. This study describes the development and validation of a measure-the Implementation Support Competencies Assessment (ISCA)-that assesses implementation support competencies, with versatile applications across service contexts.

METHODS

Recently developed practice guide materials included operationalizations of core competencies for ISPs across three domains: co-creation and engagement, ongoing improvement, and sustaining change. These operationalizations, in combination with recent empirical and conceptual work, provided an initial item pool and foundation on which to advance measurement development, largely from a confirmatory perspective (as opposed to exploratory). The measure was further refined through modified cognitive interviewing with three highly experienced ISPs and pilot-testing with 39 individuals enrolled in a university-based certificate program in implementation practice. To recruit a sample for validation analyses, we leveraged a listserv of nearly 4,000 individuals who have registered for or expressed interest in various events and trainings focused on implementation practice offered by an implementation science collaborative housed within a research-intensive university in the Southeast region of the United States. Our final analytic sample included 357 participants who self-identified as ISPs.

RESULTS

Assessments of internal consistency reliability for each competency-specific item set yielded evidence of strong reliability. Results from confirmatory factor analyses provided evidence for the factorial and construct validity of all three domains and associated competencies in the ISCA.

CONCLUSIONS

The findings suggest that one's possession of high levels of competence across each of the three competency domains is strongly associated with theorized outcomes that can promote successful and sustainable implementation efforts among those who receive implementation support from an ISP. The ISCA serves as a foundational tool for workforce development to formally measure and assess improvement in the skills that are required to tailor a package of implementation strategies situated in context.

Closing the gap: advancing implementation science through training and capacity building

In their article on "Navigating the Field of Implementation Science Towards Maturity: Challenges and Opportunities," Chambers and Emmons describe the rapid growth of implementation science along with remaining challenges. A significant gap remains in training and capacity building. Formats for capacity building include university degree programs, summer training institutes, workshops, and conferences. In this letter, we describe and amplify on five key areas, including the need to (1) identify advanced competencies, (2) increase the volume and reach of trainings, (3) sustain trainings, (4) build equity focused trainings, and (5) develop global capacity. We hope that the areas we highlight will aid in addressing several key challenges to prioritize in future efforts to build greater capacity in implementation science.

Scaling-Out Digitally Enabled Integrated Care in Europe Through Good Practices Transfer: The JADECARE Study

Introduction

The absence of a coordinated approach to health and social care compromises the ability of health systems to provide universal, equitable, high-quality, and financially sustainable care. Transferring evidence-based practices focused on digitally-enabled integrated care to new contexts can overcome this challenge if implementation is satisfactory. This paper presents the scaling-out methodology that JADECARE has designed to spread effective innovative practices across Europe.

Methodology

The scaling-out methodology pretends to guide the Next Adopters in the transfer and adoption of practices, whereas increasing their implementation capacity and providing an evaluation framework to assess impact and success.

Discussion

JADECARE scaling-out effort is based on guiding principles found in the literature such as the balance between fidelity to the original practice and the degree of adaptation required to fit the new context, the need for capacity building in implementation to bridge the gap between research and routine practice and the focus on explaining why, for whom and in what circumstances an intervention works.

Conclusion

The JADECARE scaling-out methodology is theory-driven and pragmatic and aims to facilitate the transfer of complex interventions across different contexts.

How the experiences of implementation support recipients contribute to implementation outcomes

Introduction

There is a growing body of literature on the activities and competencies of implementation support practitioners (ISPs) and the outcomes of engaging ISPs to support implementation efforts. However, there remains limited knowledge about the experiences of implementation support recipients who engage with ISPs and how these experiences shape the trajectory of implementation and contribute to implementation outcomes. This study aimed to extend the research on ISPs by describing the experiences of professionals who received implementation support and inform our understanding of the mechanisms by which ISPs produce behavior change and contribute to implementation outcomes.

Methods

Thirteen individuals with roles in supporting implementation efforts at a private foundation participated in semi-structured interviews. Data were analyzed using qualitative narrative analysis and episode profile analysis approaches. Iterative diagramming was used to visualize the pathway of experiences of implementation support recipients evidenced by the interview data.

Results

The majority of recipients described how positive experiences and trusting relationships with ISPs increased acceptance of implementation science throughout the foundation and increased the perception of implementation science as both an appropriate and feasible approach for strengthening the impact of foundation strategies. As perceptions of appropriateness and feasibility increased, recipients of implementation support described increasing knowledge and application of implementation science in their funding engagements and internal foundation strategies. Finally, recipients reported that the application of implementation science across the foundation led to sustained implementation capacity and better outcomes.

Discussion

The experiences of implementation support recipients described in this paper provide a source for further understanding the mechanisms of change for delivering effective implementation support leading to better implementation quality. Insights from these experiences can enhance our understanding for building implementation capacity and the rationales for evolving approaches that emphasize the dynamic, emotional, and highly relational nature of supporting others to use evidence in practice.

Understanding the unique and common perspectives of partners engaged in knowledge mobilization activities within pediatric pain management: a mixed methods study

BACKGROUND

Knowledge mobilization (KM) is essential to close the longstanding evidence to practice gap in pediatric pain management. Engaging various partners (i.e., those with expertise in a given topic area) in KM is best practice; however, little is known about how different partners engage and collaborate on KM activities. This mixed-methods study aimed to understand what different KM partner groups (i.e., health professionals, researchers, and patient/caregiver partners) perceive as supporting KM activities within pediatric pain management.

METHODS

This study used a convergent mixed-methods design. Ten partners from each of the three groups participated in interviews informed by the Consolidated Framework for Implementation Research, where they discussed what impacted KM activities within pediatric pain. Participants then rated and ranked select factors discussed in the interview. Transcripts were analyzed within each group using reflexive thematic analysis. Group-specific themes were then triangulated to identify convergence and divergence among groups. A matrix analysis was then conducted to generate meta-themes to describe overarching concepts. Quantitative data were analyzed using descriptive statistics.

RESULTS

Unique themes were developed within each partner group and further analysis generated four meta-themes: (1) team dynamics; (2) role of leadership; (3) policy influence; (4) social influence. There was full agreement among groups on the meaning of team dynamics. While there was partial agreement on the role of leadership, groups differed on who they described as taking on leadership positions. There was also partial agreement on policy influence, where health professionals and researchers described different institutions as being responsible for providing funding support. Finally, there was partial agreement on social influence, where the role of networks was seen as serving distinct purposes to support KM. Quantitative analyses indicated that partner groups shared similar priorities (e.g., team relationships, communication quality) when it came to supporting KM in pediatric pain.

CONCLUSIONS

While partners share many needs in common, there is also nuance in how they wish to be engaged in KM activities as well as the contexts in which they work. Strategies must be introduced to address these nuances to promote effective engagement in KM to increase the impact of evidence in pediatric pain.

[Implementing systematically: To what extent can implementation science make an educational contribution to health care practice?]

BACKGROUND

Implementation science is currently struggling with the challenge to translate its findings into implementation practice in health care. Therefore, it is of interest to explore to what extent advanced trainings are relevant for health care practice to support knowledge circulation, and what needs to be considered in their design.

DESIGN OF EDUCATIONAL INITIATIVES AND TRAINING

Internationally, numerous initiatives have emerged in recent years to make implementation science more accessible to health care implementers. They focus, in particular, on the development of curricula for actors in health care practice and the widespread implementation of these qualification programs. In German-speaking countries, the interest in health services research is particularly evident at the level of Master's degree programs to make implementation science accessible to health care. However, these efforts need to be complemented by a participatory, needs-oriented and theory-based approach to advanced training for implementers in health care practice. This will enable the required competencies to be addressed on different levels of training and the further development of training formats.

DISCUSSION

Recent literature shows that implementers in German-speaking countries can benefit from a training program tailored to their needs. International experience in the field of advanced training in implementation science for health care practice allows us to derive essential components for the development of advanced training for the German-speaking region.

Enabling cross-country learning and exchange to support universal health coverage implementation

As countries transition from external assistance while pursuing ambitious plans to achieve universal health coverage (UHC), there is increasing need to facilitate knowledge sharing and learning among them. Country-led and country-owned knowledge management is foundational to sustainable, more equitable external assistance for health and is a useful complement to more conventional capacity-building modalities provided under external assistance. In the context of external assistance, few initiatives use country-to-country sharing of practitioner experiences, and link learning to receiving guidance on how to adapt, apply and sustain policy changes. Dominant knowledge exchange processes are didactic, implicitly assuming static technical needs, and that practitioners in low- and middle-income countries require problem-specific, time-bound solutions. In reality, the technical challenges of achieving UHC and the group of policymakers involved continuously evolve. This paper aims to explore factors which are supportive of experience-based knowledge exchange between practitioners from diverse settings, drawing from the experience of the Joint Learning Network (JLN) for UHC-a global network of practitioners and policymakers sharing experiences about common challenges to develop and implement knowledge products supporting reforms for UHC-as an illustration of a peer-to-peer learning approach. This paper considers: (1) an analysis of JLN monitoring and evaluation data between 2020 and 2023 and (2) a qualitative inquiry to explore policymakers' engagement with the JLN using semi-structured interviews (n = 14) with stakeholders from 10 countries. The JLN's experience provides insights to factors that contribute to successful peer-to-peer learning approaches. JLN relies on engaging a network of practitioners with diverse experiences who organically identify and pursue a common learning agenda. Meaningful peer-to-peer learning requires dynamic, structured interactions, and alignment with windows of opportunity for implementation that enable rapid response to emerging and timely issues. Peer-to-peer learning can facilitate in-country knowledge sharing, learning and catalyse action at the institutional and health system levels.

Design, delivery, and evaluation of a knowledge translation intervention for multi-stakeholders

BACKGROUND

Knowledge translation (KT) is a key competency for trainees (graduate students and post-doctoral fellows), the new generation of researchers who must learn how to synthesize, disseminate, exchange, and ethically apply knowledge to improve patient and health system services, products, and outcomes. KT training is a key enabler to support KT competency development. Yet, there is a dearth of research on the design, delivery, and evaluation of KT training for trainees.

METHODS

The study applied a QUAN(qual) mixed methods approach with an embedded experimental model design. A heart and lung patient was also recruited to participate as a partner and researcher in the study. A multi-faceted KT intervention for trainees was designed, delivered, and evaluated. Data were collected using surveys and focus groups. Quantitative data were analyzed using descriptive and inferential statistics in R Studio and MS Excel. Qualitative data were analyzed in NVivo using thematic analysis.

RESULTS

Participation in each KT intervention varied, with 8-42 participants attending KT webinars, 61 attendees in the Three Minute Thesis (3MT) Competition Heat, and 31 participants in the Patient & Public Forum. In total, 27 trainees and 4 faculty participated in at least one of the KT webinars. Trainee participants reported satisfaction, as well as statistically significant increases in 10/13 KT competencies after receiving one or more components of the KT intervention. Additionally, participating faculty, patients, and the public were satisfied with the intervention components they participated in. Several challenges and facilitators were also identified to improve the KT intervention.

CONCLUSIONS

The KT intervention is a promising initiative that can be adopted and adapted across various post-secondary settings to support trainees' competency development in KT. This evaluation demonstrates that trainees will respond to opportunities for KT training and that capacity for KT competencies can be advanced through a multi-faceted intervention that involves trainees, faculty, patients, and health system collaborators in its design and delivery. This evaluation study contributes the design and results of a novel KT intervention for multi-stakeholders.

TRIAL REGISTRATION

N/A.

Connecting the science and practice of implementation - applying the lens of context to inform study design in implementation research

The saying "horses for courses" refers to the idea that different people and things possess different skills or qualities that are appropriate in different situations. In this paper, we apply the analogy of "horses for courses" to stimulate a debate about how and why we need to get better at selecting appropriate implementation research methods that take account of the context in which implementation occurs. To ensure that implementation research achieves its intended purpose of enhancing the uptake of research-informed evidence in policy and practice, we start from a position that implementation research should be explicitly connected to implementation practice. Building on our collective experience as implementation researchers, implementation practitioners (users of implementation research), implementation facilitators and implementation educators and subsequent deliberations with an international, inter-disciplinary group involved in practising and studying implementation, we present a discussion paper with practical suggestions that aim to inform more practice-relevant implementation research.

Implementation Science for the Practice-Oriented Nurse Leader

Senior nurse leaders are accountable for improving patient outcomes efficiently and cost-effectively. Nurse leaders often find heterogeneous patient outcomes across comparable nursing units in the same enterprise, presenting a challenge for nurse leaders tasked with making system-wide quality improvements. Implementation science (IS) offers a promising new approach to guide nurse leaders in understanding why certain implementation efforts meet with success or failure and the barriers faced in making practice changes. Knowledge of IS builds upon evidenced-based practice and quality improvement knowledge, adding to the armamentarium of tools at nurse leaders' disposal for improving nursing and patient outcomes. In this article, we demystify IS, differentiate it from evidence-based practice and quality improvement, describe IS concepts every nurse leader should be familiar with, and outline nurse leaders' role in building IS in their organizations.

Using Implementation Science in Nursing Research

OBJECTIVES

Clinical research continues to build knowledge that can potentially improve clinical and health service outcomes; however, integrating evidence into routine care is challenging, resulting in a knowledge practice gap. The field of implementation science is a resource available for nurses to translate evidence into their practice. This article aims to provide nurses with an overview of implementation science, illustrate its value integrating evidence into practice, and show how it can be applied with high rigor in nursing research practice.

DATA SOURCES

A narrative synthesis of the implementation science literature was conducted. A series of case studies were purposively selected to demonstrate the application of commonly used implementation theories, models, and frameworks across health care settings relevant to nursing. These case studies demonstrate how the theoretical framework was applied and how the outcomes of the work reduced the knowledge practice gap.

CONCLUSION

Implementation science theoretical approaches have been used by nurses and multidisciplinary teams to better understand the gap between knowledge and practice for better informed implementation. These can be used to understand the processes involved, identify the determinants at play, and undertake an effective evaluation.

IMPLICATIONS FOR NURSING PRACTICE

By using implementation science research practice, nurses can also build a strong foundation of evidence about nursing clinical practice. As an approach, implementation science is practical and can optimize the valuable nursing resource.

Developing a practice-driven research agenda in implementation science: Perspectives from experienced implementation support practitioners

Background

Attention is being placed on the "ironic gap" or "secondary" research-to-practice gap in the field of implementation science. Among several challenges posited to exacerbate this research-to-practice gap, we call attention to one challenge in particular-the relative dearth of implementation research that is tethered intimately to the lived experiences of implementation support practitioners (ISPs). The purpose of this study is to feature a qualitative approach to engaging with highly experienced ISPs to inform the development of a practice-driven research agenda in implementation science. In general, we aim to encourage ongoing empirical inquiry that foregrounds practice-driven implementation research questions.

Method

Our analytic sample was comprised of 17 professionals in different child and family service systems, each with long-term experience using implementation science frameworks to support change efforts. Data were collected via in-depth, semi-structured interviews. Our analysis followed a qualitative content analysis approach. Our focal conceptual category centered on the desired areas of future research highlighted by respondents, with subcategories reflecting subsets of related research question ideas.

Results

Interviews yielded varying responses that could help shape a practice-driven research agenda for the field of implementation science. The following subcategories regarding desired areas for future research were identified in respondents' answers: (a) stakeholder engagement and developing trusting relationships, (b) evidence use, (c) workforce development, and (d) cost-effective implementation.

Conclusions

There is significant promise in bringing implementation research and implementation practice together more closely and building a practice-informed research agenda to shape implementation science. Our findings point not only to valuable practice-informed gaps in the literature that could be filled by implementation researchers, but also topics for which dissemination and translation efforts may not have yielded optimal reach. We also highlight the value in ISPs bolstering their own capacity for engaging with the implementation science literature to the fullest extent possible.

Proceedings from the Second Annual Conference of the Norwegian Network for Implementation Research

In 2019, Norwegian implementation researchers formed a network to promote implementation research and practice in the Norwegian context. On November 19th, 2021, the second annual Norwegian implementation conference was held in Oslo. Ninety participants from all regions of the country gathered to showcase the frontiers of Norwegian implementation research. The conference also hosted a panel discussion about critical next steps for implementation science in Norway. The conference included 17 presentations from diverse disciplines within health and welfare services, including schools. The themes presented included stakeholder engagement, implementation mechanisms, evaluations of the implementation of specific interventions, the use of implementation guidelines and frameworks, the development and validation of implementation measurements, and barriers and facilitators for implementation. The panel discussion highlighted several critical challenges with the implementation of evidence-informed practices in Norway, including limited implementation competence and capacity among practice leaders and workforces, few opportunities for education in implementation science, limited implementation research in the Norwegian context, scarce funding possibilities for implementation research, and a lack of long-term perspectives on implementation processes. Overall, the 2021 Norwegian implementation conference showed an encouraging sign of a maturing field of science in Norway. The more voluminous proceedings from the 2020 conference called for several important advancements to improve implementation science and practice in Norway, and the 2021 conference indicates that steps have already been taken in favorable directions in terms of, for instance, research designs and measurements. However, there are still unexploited potentials for improvements in implementation research, funding, policies, and practice. Norwegian implementation researcher should be mindful of the challenges and potential pitfalls implementation science currently face as a scientific discipline.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43477-022-00069-w.