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Buchanan GJR, Filiatreau LM, Moore JE. Organizing the dissemination and implementation field: who are we, what are we doing, and how should we do it? Implement Sci Commun 2024; 5:38. [PMID: 38605425 PMCID: PMC11007902 DOI: 10.1186/s43058-024-00572-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/20/2024] [Indexed: 04/13/2024] Open
Abstract
Two decades into its tenure as a field, dissemination and implementation (D&I) scientists have begun a process of self-reflection, illuminating a missed opportunity to bridge the gap between research and practice-one of the field's foundational objectives. In this paper, we, the authors, assert the research-to-practice gap has persisted, in part due to an inadequate characterization of roles, functions, and processes within D&I. We aim to address this issue, and the rising tension between D&I researchers and practitioners, by proposing a community-centered path forward that is grounded in equity.We identify key players within the field and characterize their unique roles using the translational science spectrum, a model originally developed in the biomedical sciences to help streamline the research-to-practice process, as a guide. We argue that the full translational science spectrum, from basic science research, or "T0," to translation to community, or "T4," readily applies within D&I and that in using this framework to clarify roles, functions, and processes within the field, we can facilitate greater collaboration and respect across the entire D&I research-to-practice continuum. We also highlight distinct opportunities (e.g., changes to D&I scientific conference structures) to increase regular communication and engagement between individuals whose work sits at different points along the D&I translational science spectrum that can accelerate our efforts to close the research-to-practice gap and achieve the field's foundational objectives.
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Affiliation(s)
- Gretchen J R Buchanan
- Department of Family Medicine and Community Health, Hennepin Healthcare Research Institute, Minneapolis, MN and University of Minnesota Medical School, MN, Minneapolis, USA.
| | - Lindsey M Filiatreau
- Division of Infectious Diseases, School of Medicine, Washington University in St. Louis, MO, St. Louis, USA
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Moore R, Callaghan-Koru J, Vincenzo JL, Patton SK, Spear MJ, Riklon S, Alik E, Padilla Ramos A, Takamaru S, McElfish PA, Curran GM. External relationships as implementation determinants in community-engaged, equity-focused COVID-19 vaccination events. Front Health Serv 2024; 4:1338622. [PMID: 38533190 PMCID: PMC10964718 DOI: 10.3389/frhs.2024.1338622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/21/2024] [Indexed: 03/28/2024]
Abstract
Background While relationships and connectedness among organizations have been included in implementation theories, models, and frameworks, the increased attention to health equity in implementation science raises the urgency of understanding the role of relationships external to the implementing organization. This paper addresses this gap through an exploration of the role of external relationships in community-based, equity-focused interventions. Methods This study focuses on an equity-focused, community-based COVID-19 vaccination intervention in Arkansas, drawing upon long-term community-engaged relationships among University of Arkansas for Medical Sciences and the Hispanic and Marshallese Islander communities. We used an exploratory qualitative descriptive design to examine barriers and facilitators to implementation of COVID-19 vaccination events analyzing in-depth qualitative interviews with implementation team members (n = 17). Results All participants described pre-existing relationships among the implementing organization, partner organizations, and communities as a key implementation determinant for this equity-focused program. At the inter-organizational level, external relationships included formal connections and informal relationships among staff (e.g., communication channels from prior partnerships). At the individual level, strong external relationships with the community were facilitators leveraging long-term engagement, community familiarity, and staff from the communities of focus. Strong external relationships facilitated program reach in underserved communities through three mechanisms: (1) reduced time required to establish functional working relationships among partners; (2) accessibility and cultural congruence of health services; and (3) increased trust among community members. Barriers to implementation also existed in external relationships, but had less influence than facilitators. Conclusions Achieving health equity in implementation science requires greater understanding of external relationships as implementation determinants. This exploratory study makes a significant contribution to the literature by describing the types of external relationships that facilitate equitable implementation and identifying the mechanisms through which they may work. We argue that approaches to community engagement drawn from community-engaged research approaches may be useful, as these processes require investment in building/maintaining formal and informal organizational and interpersonal relationships. Further research is needed to understand connections among external relationships and other implementation determinants.
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Affiliation(s)
- Ramey Moore
- Office of Community Health and Research, College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, United States
| | - Jennifer Callaghan-Koru
- Office of Community Health and Research, College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, United States
| | - Jennifer L. Vincenzo
- Geriatrics, College of Health Professions, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, United States
| | - Susan K. Patton
- Nursing, College of Education and Health Professions, University of Arkansas, Fayetteville, AR, United States
| | - Marissa J. Spear
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, United States
| | - Sheldon Riklon
- Department of Family Medicine, Family Medicine Residency Training Program, College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, United States
| | - Eldon Alik
- Consulate General of Arkansas, Republic of the Marshall Islands, Springdale, AR, United States
| | - Alan Padilla Ramos
- Department of Family Medicine, Family Medicine Residency Training Program, College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, United States
| | | | - Pearl A. McElfish
- Office of Community Health and Research, College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, United States
| | - Geoffrey M. Curran
- Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, AR, United States
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Boaz A, Baeza J, Fraser A, Persson E. 'It depends': what 86 systematic reviews tell us about what strategies to use to support the use of research in clinical practice. Implement Sci 2024; 19:15. [PMID: 38374051 PMCID: PMC10875780 DOI: 10.1186/s13012-024-01337-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/05/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND The gap between research findings and clinical practice is well documented and a range of strategies have been developed to support the implementation of research into clinical practice. The objective of this study was to update and extend two previous reviews of systematic reviews of strategies designed to implement research evidence into clinical practice. METHODS We developed a comprehensive systematic literature search strategy based on the terms used in the previous reviews to identify studies that looked explicitly at interventions designed to turn research evidence into practice. The search was performed in June 2022 in four electronic databases: Medline, Embase, Cochrane and Epistemonikos. We searched from January 2010 up to June 2022 and applied no language restrictions. Two independent reviewers appraised the quality of included studies using a quality assessment checklist. To reduce the risk of bias, papers were excluded following discussion between all members of the team. Data were synthesised using descriptive and narrative techniques to identify themes and patterns linked to intervention strategies, targeted behaviours, study settings and study outcomes. RESULTS We identified 32 reviews conducted between 2010 and 2022. The reviews are mainly of multi-faceted interventions (n = 20) although there are reviews focusing on single strategies (ICT, educational, reminders, local opinion leaders, audit and feedback, social media and toolkits). The majority of reviews report strategies achieving small impacts (normally on processes of care). There is much less evidence that these strategies have shifted patient outcomes. Furthermore, a lot of nuance lies behind these headline findings, and this is increasingly commented upon in the reviews themselves. DISCUSSION Combined with the two previous reviews, 86 systematic reviews of strategies to increase the implementation of research into clinical practice have been identified. We need to shift the emphasis away from isolating individual and multi-faceted interventions to better understanding and building more situated, relational and organisational capability to support the use of research in clinical practice. This will involve drawing on a wider range of research perspectives (including social science) in primary studies and diversifying the types of synthesis undertaken to include approaches such as realist synthesis which facilitate exploration of the context in which strategies are employed.
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Affiliation(s)
- Annette Boaz
- Health and Social Care Workforce Research Unit, The Policy Institute, King's College London, Virginia Woolf Building, 22 Kingsway, London, WC2B 6LE, UK.
| | - Juan Baeza
- King's Business School, King's College London, 30 Aldwych, London, WC2B 4BG, UK
| | - Alec Fraser
- King's Business School, King's College London, 30 Aldwych, London, WC2B 4BG, UK
| | - Erik Persson
- Federal University of Santa Catarina (UFSC), Campus Universitário Reitor João Davi Ferreira Lima, Florianópolis, SC, 88.040-900, Brazil
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Brooks SP, Alba C, Thomson D, Davison SN, Storey K. Partnership-building considerations for implementation science in learning health systems: a case study of the Implementation Science Collaborative in Alberta, Canada. Front Health Serv 2024; 4:1327395. [PMID: 38433991 PMCID: PMC10904619 DOI: 10.3389/frhs.2024.1327395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024]
Abstract
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.
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Affiliation(s)
- Stephanie P. Brooks
- Learning Health System Team, Alberta SPOR SUPPORT Unit, Department of Medicine, University of Alberta, Edmonton, AB, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Cody Alba
- Learning Health System Team, Alberta SPOR SUPPORT Unit, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Denise Thomson
- Learning Health System Team, Alberta SPOR SUPPORT Unit, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Sara N. Davison
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Callaghan-Koru J, Farzin A, Ridout E, Curran G. Integrating Implementation Science with Quality Improvement to Improve Perinatal Outcomes. Clin Perinatol 2023; 50:343-361. [PMID: 37201985 DOI: 10.1016/j.clp.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Implementation science is an interdisciplinary field that seeks to contribute generalizable knowledge that can improve the translation of clinical evidence in routine care. To promote the integration of implementation science approaches with health care quality improvement, the authors offer a framework that links the Model for Improvement with implementation strategies and methods. Perinatal quality improvement teams can leverage the robust frameworks of implementation science to diagnose implementation barriers, select implementation strategies, and assess the strategies' contribution to improving care. Partnerships between implementation scientists and quality improvement teams could accelerate efforts by both groups to achieve measurable improvements in care.
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Affiliation(s)
- Jennifer Callaghan-Koru
- Department of Internal Medicine, University of Arkansas for Medical Sciences, 1125 North College Avenue, Fayetteville, AR 72703, USA.
| | - Azadeh Farzin
- Pediatrix of Maryland/Adventist Healthcare, 9901 Medical Center Drive, Rockville, MD 20850, USA
| | - Erick Ridout
- American Academy of Pediatrics, 1380 East Medical Center Drive, St George, UT 84790, USA
| | - Geoffrey Curran
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 West Markham Street, Little Rock, AR 72205, USA
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Cairney P, Boaz A, Oliver K. Translating evidence into policy and practice: what do we know already, and what would further research look like? BMJ Qual Saf 2023; 32:251-253. [PMID: 36948543 DOI: 10.1136/bmjqs-2023-015911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Affiliation(s)
- Paul Cairney
- Division of History, Heritage, and Politics, University of Stirling Faculty of Arts and Humanities, Stirling, UK
| | - Annette Boaz
- Department of Health Services Research and Policy (Faculty of Public Health and Policy), LSHTM, London, UK
| | - Kathryn Oliver
- Department of Health Services Research and Policy (Faculty of Public Health and Policy), LSHTM, London, UK
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Jensen TM, Metz AJ, Disbennett ME, Farley AB. Developing a practice-driven research agenda in implementation science: Perspectives from experienced implementation support practitioners. Implement Res Pract 2023; 4:26334895231199063. [PMID: 37790169 PMCID: PMC10478532 DOI: 10.1177/26334895231199063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
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.
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Affiliation(s)
- Todd M. Jensen
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison J. Metz
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Amanda B. Farley
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Stahmer AC, Suhrheinrich J, Yu Y, Melgarejo M, Schetter P, Young GA. Implementation readiness for evidence-based autism practices in school systems. Implement Res Pract 2023; 4:26334895231199465. [PMID: 37790182 PMCID: PMC10486229 DOI: 10.1177/26334895231199465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Background The increase in the number of autistic children being identified has led to increased demand on public schools to provide high-quality services. Effectively scaling up evidence-based practice (EBP) use for autistic students is challenging, given the complicated organization of special education. Teachers have significant challenges implementing autism EBP with fidelity. Factors such as implementation leadership and climate and attitudes toward EBP are linked to successful EBP use and may vary at different levels of the education system. Examining mechanisms of successful implementation is a critical step to support scale-up. Method In this observational study, conducted from September 2018 to March 2020, California school personnel (n = 2273) at multiple levels of the system completed surveys related to implementation climate, leadership, and attitudes toward EBP. Data were collected throughout California at the Special Education Local Plan Areas, County Office of Education, and district and school levels from educators and administrators working in public schools supporting autistic students. Multi-level modeling was conducted to characterize implementation readiness. Results Overall, implementation climate and leadership scores are low across levels with regional levels rated more positively than districts or schools. Attitudes toward EBP were moderate, with those working in schools having the poorest ratings and specialists/trainers and related service providers (e.g., speech-language pathologists) having the highest ratings. Conclusions Outcomes provide a unique opportunity to compare implementation factors across organizational levels with a large, statewide sample. These data provide guidance for developing implementation interventions at multiple levels of the education system to increase readiness for effective scale-up of autism EBP in schools. Personnel and leaders at different organizational levels may need differentiated training targeting improved implementation climate and leadership. Personnel within districts and schools may experience a particular benefit from leadership support for EBP implementation.
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Affiliation(s)
- Aubyn C Stahmer
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis Health Center, Sacramento, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Jessica Suhrheinrich
- Department of Special Education, San Diego State University, San Diego, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Yue Yu
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis Health Center, Sacramento, CA, USA
| | - Melina Melgarejo
- Department of Special Education, San Diego State University, San Diego, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Patricia Schetter
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis Health Center, Sacramento, CA, USA
- California Autism Professional Training and Information Network (CAPTAIN)
| | - Greg A Young
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis Health Center, Sacramento, CA, USA
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Herawati DMD, Sunjaya DK. Implementation Outcomes of National Convergence Action Policy to Accelerate Stunting Prevention and Reduction at the Local Level in Indonesia: A Qualitative Study. Int J Environ Res Public Health 2022; 19:13591. [PMID: 36294173 PMCID: PMC9602846 DOI: 10.3390/ijerph192013591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/11/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
The study aims to explore the implementation outcome variables of Indonesia's national policy convergence action in the stunting reduction intervention at district, sub-district, and village levels. The study design was qualitative with an implementation research approach at District Cirebon, Indonesia. Data were collected through in-depth interviews, focus group discussions, study documents, and 6 months of participant observation. We recruited 172 respondents. The assessment instrument used was formed on was implementation outcomes variables. Data were analyzed through coding, categorizing and thematic content analysis based on a predetermined theme. Comparative cross district activity-site analysis was applied between sub-districts and villages. The implementation outcome variables for the convergence action policy were performed well at the district level, in line with the central government's adequate regulation, control, and budget. Meanwhile, the sub-district and village levels only performed aspects of acceptability, appropriateness, and coverage for specific interventions. The acceptability level in the village was only partially running. The barriers at the sub-district and village levels were issues of commitment, staff capacity, and poor coordination. Superficial understanding and capacity weaknesses drove the convergence of the stunting reduction responsibility back into the burden of the health sector at the forefront. Local politics also colored the implementation in the village.
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Metz A, Jensen T, Farley A, Boaz A, Bartley L, Villodas M. Building trusting relationships to support implementation: A proposed theoretical model. Front Health Serv 2022; 2:894599. [PMID: 36925800 PMCID: PMC10012819 DOI: 10.3389/frhs.2022.894599] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022]
Abstract
This paper presents a theory of change that articulates (a) proposed strategies for building trust among implementation stakeholders and (b) the theoretical linkages between trusting relationships and implementation outcomes. The theory of change describes how trusting relationships cultivate increases in motivation, capability, and opportunity for supporting implementation among implementation stakeholders, with implications for commitment and resilience for sustained implementation, and ultimately, positive implementation outcomes. Recommendations related to the measurement of key constructs in the theory of change are provided. The paper highlights how the development of a testable causal model on trusting relationships and implementation outcomes can provide a bridge between implementation research and implementation practice.
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Affiliation(s)
- Allison Metz
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Todd Jensen
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Amanda Farley
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Annette Boaz
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Leah Bartley
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Melissa Villodas
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Metz A, Kainz K, Boaz A. Intervening for sustainable change: Tailoring strategies to align with values and principles of communities. Front Health Serv 2022; 2:959386. [PMID: 36925846 PMCID: PMC10012724 DOI: 10.3389/frhs.2022.959386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/05/2022] [Indexed: 01/19/2023]
Abstract
This paper presents a rationale for tailoring implementation strategies within a values-driven implementation approach. Values-driven implementation seeks to organize implementers around clarifying statements of their shared values in ways that harmonize implementation dynamics related to individual and group mental models, relationships among implementers, and the implementation climate. The proposed approach to tailoring strategies is informed by systems theory and emphasizes the need to focus on both tangible events and behaviors, as well deeper patterns, structures, relationships, and mental models, in order to increase the likelihood of sustaining implementation efforts and improving outcomes for people and communities. We offer for consideration three specific sets of context determinants that are under-represented in the implementation literature and that emerge as especially relevant within a systems approach to identifying and successfully tailoring implementation strategies in the implementation setting including relationships, mental models, and implementation climate.
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Affiliation(s)
- Allison Metz
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kirsten Kainz
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Annette Boaz
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, England
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