Implementation Science : IS最新文献

{"title":"Explaining variable effects of an adaptable implementation package to promote evidence-based practice in primary care: a longitudinal process evaluation.","authors":"Liz Glidewell,&nbsp;Cheryl Hunter,&nbsp;Vicky Ward,&nbsp;Rosemary R C McEachan,&nbsp;Rebecca Lawton,&nbsp;Thomas A Willis,&nbsp;Suzanne Hartley,&nbsp;Michelle Collinson,&nbsp;Michael Holland,&nbsp;Amanda J Farrin,&nbsp;Robbie Foy","doi":"10.1186/s13012-021-01166-4","DOIUrl":"https://doi.org/10.1186/s13012-021-01166-4","url":null,"abstract":"<p><strong>Background: </strong>Implementing evidence-based recommendations is challenging in UK primary care, especially given system pressures and multiple guideline recommendations competing for attention. Implementation packages that can be adapted and hence applied to target multiple guideline recommendations could offer efficiencies for recommendations with common barriers to achievement. We developed and evaluated a package of evidence-based interventions (audit and feedback, educational outreach and reminders) incorporating behaviour change techniques to target common barriers, in two pragmatic trials for four \"high impact\" indicators: risky prescribing; diabetes control; blood pressure control; and anticoagulation in atrial fibrillation. We observed a significant, cost-effective reduction in risky prescribing but there was insufficient evidence of effect on the other outcomes. We explored the impact of the implementation package on both social processes (Normalisation Process Theory; NPT) and hypothesised determinants of behaviour (Theoretical Domains Framework; TDF).</p><p><strong>Methods: </strong>We conducted a prospective multi-method process evaluation. Observational, administrative and interview data collection and analyses in eight primary care practices were guided by NPT and TDF. Survey data from trial and process evaluation practices explored fidelity.</p><p><strong>Results: </strong>We observed three main patterns of variation in how practices responded to the implementation package. First, in integration and achievement, the package \"worked\" when it was considered distinctive and feasible. Timely feedback directed at specific behaviours enabled continuous goal setting, action and review, which reinforced motivation and collective action. Second, impacts on team-based determinants were limited, particularly when the complexity of clinical actions impeded progress. Third, there were delivery delays and unintended consequences. Delays in scheduling outreach further reduced ownership and time for improvement. Repeated stagnant or declining feedback that did not reflect effort undermined engagement.</p><p><strong>Conclusions: </strong>Variable integration within practice routines and organisation of care, variable impacts on behavioural determinants, and delays in delivery and unintended consequences help explain the partial success of an adaptable package in primary care.</p>","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":" ","pages":"9"},"PeriodicalIF":7.2,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39964233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework.","authors":"Marlena Klaic,&nbsp;Suzanne Kapp,&nbsp;Peter Hudson,&nbsp;Wendy Chapman,&nbsp;Linda Denehy,&nbsp;David Story,&nbsp;Jill J Francis","doi":"10.1186/s13012-021-01171-7","DOIUrl":"https://doi.org/10.1186/s13012-021-01171-7","url":null,"abstract":"<p><strong>Background: </strong>Implementation research may play an important role in reducing research waste by identifying strategies that support translation of evidence into practice. Implementation of healthcare interventions is influenced by multiple factors including the organisational context, implementation strategies and features of the intervention as perceived by people delivering and receiving the intervention. Recently, concepts relating to perceived features of interventions have been gaining traction in published literature, namely, acceptability, fidelity, feasibility, scalability and sustainability. These concepts may influence uptake of healthcare interventions, yet there seems to be little consensus about their nature and impact. The aim of this paper is to develop a testable conceptual framework of implementability of healthcare interventions that includes these five concepts.</p><p><strong>Methods: </strong>A multifaceted approach was used to develop and refine a conceptual framework of implementability of healthcare interventions. An overview of reviews identified reviews published between January 2000 and March 2021 that focused on at least one of the five concepts in relation to a healthcare intervention. These findings informed the development of a preliminary framework of implementability of healthcare interventions which was presented to a panel of experts. A nominal group process was used to critique, refine and agree on a final framework.</p><p><strong>Results: </strong>A total of 252 publications were included in the overview of reviews. Of these, 32% were found to be feasible, 4% reported sustainable changes in practice and 9% were scaled up to other populations and/or settings. The expert panel proposed that scalability and sustainability of a healthcare intervention are dependent on its acceptability, fidelity and feasibility. Furthermore, acceptability, fidelity and feasibility require re-evaluation over time and as the intervention is developed and then implemented in different settings or with different populations. The final agreed framework of implementability provides the basis for a chronological, iterative approach to planning for wide-scale, long-term implementation of healthcare interventions.</p><p><strong>Conclusions: </strong>We recommend that researchers consider the factors acceptability, fidelity and feasibility (proposed to influence sustainability and scalability) during the preliminary phases of intervention development, evaluation and implementation, and iteratively check these factors in different settings and over time.</p>","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":" ","pages":"10"},"PeriodicalIF":7.2,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39864586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Implementation of innovative medical technologies in German inpatient care: patterns of utilization and evidence development.","authors":"Marie Dreger,&nbsp;Helene Eckhardt,&nbsp;Susanne Felgner,&nbsp;Hanna Ermann,&nbsp;Hendrikje Lantzsch,&nbsp;Tanja Rombey,&nbsp;Reinhard Busse,&nbsp;Cornelia Henschke,&nbsp;Dimitra Panteli","doi":"10.1186/s13012-022-01187-7","DOIUrl":"https://doi.org/10.1186/s13012-022-01187-7","url":null,"abstract":"","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":" ","pages":"8"},"PeriodicalIF":7.2,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8787954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39732633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scale-up of prevention programmes: sustained state-wide use of programme delivery software is explained by normalised self-organised adoption and non-adoption.","authors":"Eileen Goldberg,&nbsp;Kathleen Conte,&nbsp;Victoria Loblay,&nbsp;Sisse Groen,&nbsp;Lina Persson,&nbsp;Christine Innes-Hughes,&nbsp;Jo Mitchell,&nbsp;Andrew Milat,&nbsp;Mandy Williams,&nbsp;Amanda Green,&nbsp;Penelope Hawe","doi":"10.1186/s13012-021-01184-2","DOIUrl":"https://doi.org/10.1186/s13012-021-01184-2","url":null,"abstract":"<p><strong>Background: </strong>Population-level health promotion is often conceived as a tension between \"top-down\" and \"bottom-up\" strategy and action. We report behind-the-scenes insights from Australia's largest ever investment in the \"top-down\" approach, the $45m state-wide scale-up of two childhood obesity programmes. We used Normalisation Process Theory (NPT) as a template to interpret the organisational embedding of the purpose-built software designed to facilitate the initiative. The use of the technology was mandatory for evaluation, i.e. for reporting the proportion of schools and childcare centres which complied with recommended health practices (the implementation targets). Additionally, the software was recommended as a device to guide the implementation process. We set out to study its use in practice.</p><p><strong>Methods: </strong>Short-term, high-intensity ethnography with all 14 programme delivery teams across New South Wales was conducted, cross-sectionally, 4 years after scale-up began. The four key mechanisms of NPT (coherence/sensemaking, cognitive participation/engagement, collective action and reflexive monitoring) were used to describe the ways the technology had normalised (embedded).</p><p><strong>Results: </strong>Some teams and practitioners embraced how the software offered a way of working systematically with sites to encourage uptake of recommended practices, while others rejected it as a form of \"mechanisation\". Conscious choices had to be made at an individual and team level about the practice style offered by the technology-thus prompting personal sensemaking, re-organisation of work, awareness of choices by others and reflexivity about professional values. Local organisational arrangements allowed technology users to enter data and assist the work of non-users-collective action that legitimised opposite behaviours. Thus, the technology and the programme delivery style it represented were normalised by pathways of adoption and non-adoption. Normalised use and non-use were accepted and different choices made by local programme managers were respected. State-wide, implementation targets are being reported as met.</p><p><strong>Conclusion: </strong>We observed a form of self-organisation where individual practitioners and teams are finding their own place in a new system, consistent with complexity-based understandings of fostering scale-up in health care. Self-organisation could be facilitated with further cross-team interaction to continuously renew and revise sensemaking processes and support diverse adoption choices across different contexts.</p>","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":" ","pages":"5"},"PeriodicalIF":7.2,"publicationDate":"2022-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39685223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iowa Implementation for Sustainability Framework.","authors":"Laura Cullen,&nbsp;Kirsten Hanrahan,&nbsp;Stephanie W Edmonds,&nbsp;Heather Schacht Reisinger,&nbsp;Michele Wagner","doi":"10.1186/s13012-021-01157-5","DOIUrl":"https://doi.org/10.1186/s13012-021-01157-5","url":null,"abstract":"<p><strong>Background: </strong>An application-oriented implementation framework designed for clinicians and based on the Diffusion of Innovations theory included 81 implementation strategies with suggested timing for use within four implementation phases. The purpose of this research was to evaluate and strengthen the framework for clinician use and propose its usefulness in implementation research.</p><p><strong>Methods: </strong>A multi-step, iterative approach guided framework revisions. Individuals requesting the use of the framework over the previous 7 years were sent an electronic questionnaire. Evaluation captured framework usability, generalizability, accuracy, and implementation phases for each strategy. Next, nurse leaders who use the framework pile sorted strategies for cultural domain analysis. Last, a panel of five EBP/implementation experts used these data and built consensus to strengthen the framework.</p><p><strong>Results: </strong>Participants (n = 127/1578; 8% response) were predominately nurses (94%), highly educated (94% Master's or higher), and from across healthcare (52% hospital/system, 31% academia, and 7% community) in the USA (84%). Most (96%) reported at least some experience using the framework and 88% would use the framework again. A 4-point scale (1 = not/disagree to 4 = very/agree) was used. The framework was deemed useful (92%, rating 3-4), easy to use (72%), intuitive (67%), generalizable (100%), flexible and adaptive (100%), with accurate phases (96%), and accurate targets (100%). Participants (n = 51) identified implementation strategy timing within four phases (Cochran's Q); 54 of 81 strategies (66.7%, p < 0.05) were significantly linked to a specific phase; of these, 30 (55.6%) matched the original framework. Next, nurse leaders (n = 23) completed a pile sorting activity. Anthropac software was used to analyze the data and visualize it as a domain map and hierarchical clusters with 10 domains. Lastly, experts used these data and implementation science to refine and specify each of the 75 strategies, identifying phase, domain, actors, and function. Strategy usability, timing, and groupings were used to refine the framework.</p><p><strong>Conclusion: </strong>The Iowa Implementation for Sustainability Framework offers a typology to guide implementation for evidence-based healthcare. This study specifies 75 implementation strategies within four phases and 10 domains and begins to validate the framework. Standard use of strategy names is foundational to compare and understand when implementation strategies are effective, in what dose, for which topics, by whom, and in what context.</p>","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":" ","pages":"1"},"PeriodicalIF":7.2,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39784870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing the preschool setting to promote healthy energy balance-related behaviours of preschoolers: a qualitative and quantitative process evaluation of the SuperFIT approach.","authors":"Ilona van de Kolk,&nbsp;Sanne Gerards,&nbsp;Anke Verhees,&nbsp;Stef Kremers,&nbsp;Jessica Gubbels","doi":"10.1186/s13012-021-01161-9","DOIUrl":"https://doi.org/10.1186/s13012-021-01161-9","url":null,"abstract":"<p><strong>Background: </strong>The Early Care and Education (ECE) setting plays an important role in the promotion of a healthy lifestyle in young children. SuperFIT is a comprehensive, integrated intervention approach designed to promote healthy energy balance-related behaviours in preschoolers. Insight in the process of implementation and the context in which SuperFIT was implemented supports the understanding of how the intervention works in practice. This process evaluation examined factors that influenced the implementation and maintenance, as well as the (perceived) changes in the ECE setting.</p><p><strong>Methods: </strong>A mixed-methods study was conducted. SuperFIT was implemented at twelve preschools in the south of the Netherlands. The process evaluation was performed among preschool teachers, managers of the preschool organisation, and implementers. Semi-structured in-depth (group) interviews, quantitative process questionnaires, the Child-care Food and Activity Practices Questionnaire (CFAPQ) and the Environmental and Policy Assessment and Observation (EPAO) were used to evaluate the implementation and maintenance of SuperFIT and the changes in the preschool setting. The interviews were analysed using a theoretical framework based on the Implementation Framework of Fleuren and Damschröder's Consolidated Framework for Implementation Research. Descriptive analyses were performed on the quantitative data.</p><p><strong>Results: </strong>Various intervention activities were implemented in the preschool setting. Although the intention to maintain SuperFIT was present, this was hindered by time constraints and lack of financial resources. Important factors that influenced implementation and maintenance were incongruence with current practice, limited perceived capabilities to integrate SuperFIT in daily practice, group composition at the preschools, and the perceived top-down implementation. Organizational vision and societal attention regarding healthy behaviour in general were perceived to be supportive for implementation and maintenance. Predominantly, favourable changes were seen in the nutrition- and physical activity-related practices of preschool teachers and other aspects of the social preschool environment such as the use of play materials. Limited changes were observed in the physical preschool environment.</p><p><strong>Conclusions: </strong>Several factors influenced the implementation and maintenance of SuperFIT in the preschool setting. Some factors evolved over time from hindering to facilitating, emphasising the importance of allowing sufficient time for intervention implementation. SuperFIT changed mainly the social preschool environment.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov, NCT03021980 , date registered: January 16, 2017, prospectively registered.</p>","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":" ","pages":"101"},"PeriodicalIF":7.2,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39958602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation Science and Implementation Science Communications: a refreshed description of the journals' scope and expectations.","authors":"Michel Wensing,&nbsp;Anne Sales,&nbsp;Paul Wilson,&nbsp;Rebecca Armstrong,&nbsp;Roman Kislov,&nbsp;Nicole M Rankin,&nbsp;Rohit Ramaswamy,&nbsp;Dong Roman Xu","doi":"10.1186/s13012-021-01175-3","DOIUrl":"https://doi.org/10.1186/s13012-021-01175-3","url":null,"abstract":"<p><p>This editorial provides a comprehensive consolidated overview of the scope and expectations of Implementation Science and Implementation Science Communications. We remain most interested in rigorous empirical studies of the implementation of evidence-based healthcare practices (including interventions, technologies, and policies) and the de-implementation of practices that are demonstrated to be of low or no benefit. Implementation strategies (e.g., continuing professional education, organizational changes, and financial incentives to enhance the uptake of evidence-based practices) are of central interest to the journals. We see the field as large and complex, with a wide literature that is published in many venues. We urge people for whom it is new to spend some time reading the existing literature, and learning the scope of the work that has already been done, and published, in our journals and in an increasing number of other journals in the field.</p>","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":" ","pages":"103"},"PeriodicalIF":7.2,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39944005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and enablers in the implementation of a quality improvement program for acute coronary syndromes in hospitals: a qualitative analysis using the consolidated framework for implementation research","authors":"Shuduo Zhou, Junxiong Ma, Xuejie Dong, Na Li, Y. Duan, Zongbin Wang, Liqun Gao, Lu Han, Shu-Yun Tu, Zhisheng Liang, Fangjing Liu, K. Labresh, Sidney C. Smith, Yinzi Jin, Zhijie Zheng","doi":"10.1186/s13012-022-01207-6","DOIUrl":"https://doi.org/10.1186/s13012-022-01207-6","url":null,"abstract":"","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117219623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Market viability: a neglected concept in implementation science.","authors":"Enola K Proctor,&nbsp;Emre Toker,&nbsp;Rachel Tabak,&nbsp;Virginia R McKay,&nbsp;Cole Hooley,&nbsp;Bradley Evanoff","doi":"10.1186/s13012-021-01168-2","DOIUrl":"https://doi.org/10.1186/s13012-021-01168-2","url":null,"abstract":"<p><p>This debate paper asserts that implementation science needs to incorporate a key concept from entrepreneurship-market demand-and demonstrates how assessing an innovation's potential market viability might advance the pace and success of innovation adoption and sustainment. We describe key concepts, language distinctions, and questions that entrepreneurs pose to implementation scientists-many of which implementation scientists appear ill-equipped to answer. The paper concludes with recommendations about how concepts from entrepreneurship, notably market viability assessment, can enhance the translation of research discoveries into real-world adoption, sustained use, and population health benefits. The paper further proposes activities that can advance implementation science's capacity to draw from the field of entrepreneurship, along with the data foundations required to assess and cultivate market demand.</p>","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":" ","pages":"98"},"PeriodicalIF":7.2,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8605560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39752298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor on \"the implementation research logic model: a method for planning, executing, reporting, and synthesizing implementation projects\" (Smith JD, Li DH, Rafferty MR. the implementation research logic model: a method for planning, executing, reporting, and synthesizing implementation projects. Implement Sci. 2020;15 (1):84. Doi:10.1186/s13012-020-01041-8).","authors":"Anne E Sales,&nbsp;Douglas P Barnaby,&nbsp;Victor Cattani Rentes","doi":"10.1186/s13012-021-01169-1","DOIUrl":"https://doi.org/10.1186/s13012-021-01169-1","url":null,"abstract":"","PeriodicalId":417097,"journal":{"name":"Implementation Science : IS","volume":" ","pages":"97"},"PeriodicalIF":7.2,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8596800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39899856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}