Stakeholder engagement in implementation research: a qualitative study of VA implementation scientist perspectives.

Abstract

Background: Stakeholder engagement improves the quality, clinical relevance, and contextual fit of healthcare interventions. However, there is limited work characterizing how researchers approach stakeholder engagement in practice, and which organizational supports they most value.

Purpose: The objective of this study is to describe how experienced researchers engaged multilevel stakeholders in implementation studies, and the benefits, challenges, and needs they encountered.

Methods: We identified Veterans Affairs (VA) healthcare system researchers with histories of stakeholder-engaged implementation research through a combination of literature review and snowball sampling. We conducted semi-structured telephone interviews with 28 participants in 2016. Two research team members analyzed interview data using a hybrid inductive-deductive approach.

Results: Participants described how multilevel stakeholder input substantively improved their research. Common engagement approaches varied in intensity and included interviews and focus groups, advisory committees, and stakeholder membership on research teams. Although participants expressed a desire-even a moral imperative-to increase stakeholder engagement, their efforts were limited by organizational constraints. Participants suggested that VA can support stakeholder engagement in research by reconceptualizing funding mechanisms, providing resources, and fostering an organizational culture that aligns with engagement principles.

Conclusions: Experienced researchers perceived multilevel stakeholder engagement as both critical for implementation research and difficult to achieve. Findings highlight that stakeholder engagement is shaped not only by researcher commitment and skill but also by organizational constraints, incentives, and power structures. Results offer actionable suggestions for improving alignment between engagement activities, professional incentives, and organizational infrastructure that may strengthen stakeholder-engaged implementation research in VA and other healthcare settings.