Implementation science communications最新文献

{"title":"The sustainability of health interventions implemented in Africa: an updated systematic review on evidence and future research perspectives.","authors":"Ucheoma Nwaozuru, Patrick Murphy, Ashley Richard, Chisom Obiezu-Umeh, Thembekile Shato, Ifeoma Obionu, Titilola Gbajabiamila, David Oladele, Stacey Mason, Bryce P Takenaka, Lateef Akeem Blessing, Alexis Engelhart, Susan Nkengasong, Innocent David Chinaemerem, Onyekachukwu Anikamadu, Ebenezer Adeoti, Pranali Patel, Temitope Ojo, Olufunto Olusanya, Donna Shelley, Collins Airhihenbuwa, Gbenga Ogedegbe, Oliver Ezechi, Juliet Iwelunmor","doi":"10.1186/s43058-025-00716-x","DOIUrl":"https://doi.org/10.1186/s43058-025-00716-x","url":null,"abstract":"<p><strong>Background: </strong>Sustaining evidence-based interventions in resource-limited settings is critical to optimizing gains in health outcomes. In 2015, we published a review of the sustainability of health interventions in African countries, highlighting gaps in the measurement and conceptualization of sustainability in the region. This review updates and expands upon the original review to account for developments in the past decade and recommendations for promoting sustainability.</p><p><strong>Methods: </strong>First, we searched five databases (PubMed, SCOPUS, Web of Science, Global Health, and Cumulated Index to Nursing and Allied Health Literature (CINAHL)) for studies published between 2015 and 2022. We repeated the search in 2023 and 2024. The review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Studies were included if they reported on the sustainability of health interventions implemented in African countries. Study findings were summarized using descriptive statistics and narrative synthesis, and sustainability strategies were categorized based on the Expert Recommendations for Implementing Change (ERIC) strategies.</p><p><strong>Results: </strong>Thirty-four publications with 22 distinct interventions were included in the review. Twelve African countries were represented in this review, with Nigeria (n = 6) having the most representation of available studies examining sustainability. Compared to the 2016 review, a similar proportion of studies clearly defined sustainability (52% in the current review versus 51% in the 2015 review). Eight unique strategies to foster sustainability emerged, namely: a) multi-sectorial partnership and developing stakeholder relationships, b) tailoring strategies to enhance program fit and integration, c) active stakeholder engagement and collaboration, d) capacity building through training, e) accessing new funding, f) adaptation, g) co-creation of intervention and implementation strategies and h) providing infrastructural support. The most prevalent facilitators of sustainability were related to micro-level factors (e.g., intervention fit and community engagement). In contrast, salient barriers were related to structural-level factors (e.g., limited financial resources).</p><p><strong>Conclusions: </strong>This review highlights some progress in the published reports on the sustainability of evidence-based intervention in Africa. The review emphasizes the importance of innovation in strategies to foster funding determinants for sustainable interventions. In addition, it underscores the need for developing contextually relevant sustainability frameworks that emphasize these salient determinants of sustainability in the region.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812987","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":"Using the IFASIS (Inventory of Factors Affecting Successful Implementation and Sustainment) to advance context-specific and generalizable knowledge of implementation determinants: case study of a digital contingency management platform.","authors":"Andrea Jakubowski, Briana Patrick, Kira DiClemente-Bosco, Sarah Salino, Kelli Scott, Sara Becker","doi":"10.1186/s43058-025-00708-x","DOIUrl":"https://doi.org/10.1186/s43058-025-00708-x","url":null,"abstract":"<p><strong>Background: </strong>Contingency management (CM) is the most effective treatment for stimulant use disorder but is underutilized by opioid treatment programs (OTPs) despite the high prevalence of stimulant use in this setting. As part of a state-wide initiative, we piloted a novel assessment, the Inventory of Factors Affecting Successful Implementation and Sustainment (IFASIS), to examine determinants of implementation of a digital CM platform across a set of OTPs. We describe how the IFASIS was used to elucidate both generalizable and context-specific implementation determinants, and to guide the provision of implementation facilitation.</p><p><strong>Methods: </strong>Six OTPs received a multi-level implementation strategy (including facilitation) to promote programmatic uptake of a digital CM platform. Pre-implementation, OTPs completed the IFASIS, a 27-item questionnaire that assesses both the valence (positive/negative) and importance of determinants across 4 domains: outside the organization, within the organization, about the intervention, and about intervention recipients. OTP staff completed the IFASIS as a team, identifying consensus ratings during recorded discussions. Transcripts of IFASIS recordings were analyzed using rapid qualitative analysis. Quantitative IFASIS results were aggregated into medians and ranges within and across organizations. A detailed review of implementation facilitation meeting notes was conducted to examine how the IFASIS was used to guide facilitation.</p><p><strong>Results: </strong>Quantitative ratings and qualitative feedback revealed common barriers to implementation of the digital CM platform, including a lack of sustainable funding sources, absence of external and organizational policies, insufficient higher-level leadership support, and mixed attitudes among staff members toward CM. Common implementation facilitators included enthusiasm and commitment among organization leadership and the perception that the digital CM platform would reduce the workload and burden on OTP counselors. The IFASIS was used to guide facilitation in several ways, including stimulating discussion about barriers and facilitators, brainstorming strategies to address barriers rated as \"very important\", and identifying facilitators that could be harnessed as part of implementation efforts.</p><p><strong>Conclusions: </strong>The IFASIS identified important determinants of CM implementation in OTPs and was instrumental in shaping facilitation. The IFASIS may be a valuable assessment for the implementation science community to identify and address generalizable and context-specific implementation determinants.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"35"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804946","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":"Integration and evaluation of implementation strategies to improve guideline-concordant bladder cancer surveillance: a prospective observational study.","authors":"Lisa Zubkoff, A Aziz Ould Ismail, Laura Jensen, David A Haggstrom, Soham Kale, Muta M Issa, Jeffrey J Tosoian, Mohummad Minhaj Siddiqui, Kennedi Bloomquist, Elisabeth R Kimball, Susan Zickmund, Florian R Schroeck","doi":"10.1186/s43058-025-00721-0","DOIUrl":"10.1186/s43058-025-00721-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite guideline recommendations, our prior work revealed more than half of low-risk bladder cancer patients within the Department of Veterans Affairs (VA) undergo too many surveillance procedures and about a third of high-risk patients do not undergo enough procedures. Thus, we developed and integrated implementation strategies to improve risk-aligned bladder cancer surveillance for the VA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Prior work used Implementation Mapping to develop nine implementation strategies: change record systems, educational meetings, champions, tailoring, preparing patients to be active participants, external facilitation, remind clinicians, audit & feedback, and a blueprint. We integrated these strategies as improvement approaches across four VA urology clinics. Primary implementation outcomes were qualitatively measured via coding of semi-structured interviews with clinicians and co-occurrence of codes. Implementation outcomes included: appropriateness, acceptability, and feasibility. Exploratory quantitative outcomes included clinicians' recommendations for guideline-concordant bladder cancer surveillance intervals and sustainability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eleven urologists were interviewed. Co-occurrence analysis of codes across strategies indicated that urologists most commonly reported on the acceptability and appropriateness of changing the record system, preparing patients to be active participants (\"surveillance grid\"), reminders (i.e., cheat sheet), and educational sessions. We confirmed feasibility of all implementation strategies. Urologists indicated that changing the record system had a high impact, reduced documentation time, and guided resident physicians. Preparing patients to be active participants using the \"surveillance grid\" was seen as an effective but time-consuming tool. Educational sessions were seen as critical to support implementation. In quantitative analyses, clinicians recommended guideline-concordant surveillance about 65% of the time at baseline for low-risk patients, and this improved to 70% during evaluation. Across all risk levels, the largest improvement was observed at site 2 while site 3 did not improve. All sites sustained use of the changed record system, while sustainability of other strategies was variable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Based on summative interpretation of results, the most appropriate, acceptable, and feasible strategies include changing record systems via a template and educational meetings focused on guideline-concordant surveillance. Future work should assess the impact of the improvement approaches on clinical care processes, particularly on reducing overuse of surveillance procedures among low-risk patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The implementation strategies were not considered a healthcare intervention on human participants by the governing funding agency and IRB. Rather, they were seen as quality","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"37"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805016","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":"Methods for community-engaged data collection and analysis in implementation research.","authors":"Lawrence A Palinkas, Benjamin Springgate, Leopoldo J Cabassa, Michelle Shin, Samantha Garcia, Benjamin F Crabtree, Jennifer Tsui","doi":"10.1186/s43058-025-00722-z","DOIUrl":"10.1186/s43058-025-00722-z","url":null,"abstract":"<p><strong>Background: </strong>Community engagement is widely recognized as critical to successful and equitable implementation of evidence-based practices, programs, and policies. However, there are no clear guidelines for community involvement in data collection and analysis in implementation research.</p><p><strong>Methods: </strong>We describe three specific methods for engaging community members in data collection and analysis: concept mapping, rapid ethnographic assessment, and Photovoice. Common elements are identified from a case study of each method: 1) selection and adaptation of evidence-based strategies for improving adolescent HPV vaccine initiation rates in disadvantaged communities, 2) strategies for implementing medication for opioid use disorders among low-income Medicaid enrollees during natural disasters, and 3) interventions to improve the physical health of adults with severe mental illness living in supportive housing.</p><p><strong>Results: </strong>In all three cases, community members assisted in participant recruitment, provided data, and validated preliminary findings created by researchers. In the Photovoice case study, community members participated in both data collection and analysis, while in the concept mapping, community members also participated in the initial phase of organizing and prioritizing evidence-based strategies during the data analysis.</p><p><strong>Conclusions: </strong>Community involvement in implementation research data collection and analysis contributes to greater engagement and empowerment of community members and validation of study findings. Use of methods that exhibit both scientific rigor and community relevance of implementation research also contributes to greater community investment in successful implementation outcomes. Nevertheless, the case studies point to the importance and efficiency of the division of labor embedded in community-engaged implementation research. Building capacity for community members to assume greater roles in obtaining and organizing data for preliminary analysis prior to interpretation is recommended.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804944","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":"Achieving health-promotion practice in primary care using a multifaceted implementation strategy: a non-randomized parallel group study.","authors":"Ylva Elisabet Nilsagård, Daniel Robert Smith, Fredrik Söderqvist, Emma Nilsing Strid, Lars Wallin","doi":"10.1186/s43058-025-00723-y","DOIUrl":"10.1186/s43058-025-00723-y","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based healthcare recommendations exist for tobacco use, harmful alcohol consumption, low physical activity, and poor diet. However, the uptake of these recommendations in Swedish primary healthcare is poor, and the potential benefits for patients are not fully realized. Our aim was to evaluate the effect (i.e. the uptake) of a 12-month multifaceted implementation strategy to achieve a more health-promoting practice. We hypothesized that primary healthcare centers receiving this strategy would increase and sustain their health-promotion practices to a significantly greater extent than control centers, from baseline to the 6-month follow-up.</p><p><strong>Methods: </strong>In a non-randomized parallel group study, 5 intervention centers and 5 matched control centers were compared regarding health-promotion activities delivered in relation to visits to each center. The intervention centers received a multifaceted implementation strategy over at least 12 months based on established strategies, the Astrakan model of leading change, and findings from pre-implementation studies. The main strategies were: using external and internal facilitators to combine bottom-up and top-down perspectives, and emphasizing leadership responsibility for change. Medical record data on health-promotion activities, including prescribed physical activity and use of lifestyle screening forms, were collected monthly for 2 years: 6 months before and after implementation, and during the implementation phase. The implementation strategy effect was estimated using generalized linear mixed models.</p><p><strong>Results: </strong>During the 12-month implementation phase, the intervention and control sites had 135 002 and 160 987 healthcare visits, respectively; conducted 8839 and 6171 health-promotion activities, respectively; and administered 2423 and 282 lifestyle screening forms, respectively. A statistically significant higher relative uptake rate of health-promotion activities was found in intervention sites compared to control sites after the implementation period compared to before. The effect increased during the active phase, with the intervention sites having on average 1.07 and 2.0 times the uptake rate of the control sites at 1 and 12 months, respectively; this effect was largely maintained during the 6-month post-intervention phase. A significant absolute effect, in terms of difference in predicted uptake per 1000 visits, was evident 7 months into the implementation phase.</p><p><strong>Conclusion: </strong>This multi-faceted implementation strategy was successful in achieving a more health-promoting practice. (ClinicalTrials.gov ref: NCT04 799,860, 03/04/2021, https://clinicaltrials.gov/study/NCT04799860 ).</p><p><strong>Trial registration: </strong>This study is part of the Act in Time project, registered at ClinicalTrials.gov on 4 March 2021 (ref: NCT04 799,860).</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"36"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805012","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":"A mapping review and critique of the literature on translation, dissemination, and implementation capacity building initiatives for different audiences.","authors":"Ana A Baumann, Danielle R Adams, Laura-Mae Baldwin, Rachel G Tabak, Sara Malone, Maura M Keeper, Anita D Misra-Hebert, Kathleen R Stevens, Maria E Fernandez, Sunil Kripalani","doi":"10.1186/s43058-025-00717-w","DOIUrl":"10.1186/s43058-025-00717-w","url":null,"abstract":"<p><strong>Background: </strong>Capacity building is critical for research and practice as the fields of dissemination, implementation and translation science continue to grow. Some scholars state that capacity building should be grounded in competencies. However, the fields are unclear in determining which competencies are relevant for whom, including the content and appropriate level of information and skills for different roles. The goal of this study was to catalogue competencies across current D&I capacity building initiatives.</p><p><strong>Methods: </strong>We conducted a mapping review to examine to what extent are theories or frameworks used to guide capacity building, who is being trained, to what extent do capacity building initiatives include a health equity focus, which competencies are being outlined or suggested, how are they being defined, and whether the competencies can be organized along different roles of participants. As a mapping review, we broadly searched for papers using the keywords \"training D&I\" OR \"training implementation\" OR \"training translation\" OR \"training dissemination\" and included debate and empirical papers about capacity building initiatives in the sample.</p><p><strong>Results: </strong>A total of 42 articles (from 2011 to 2024) were reviewed, including training development and/or evaluation (n = 25) and conceptual (n = 17) articles. Of the training articles, 13 (52%) specified a framework that guided training. Participants in training included graduate students, researchers, practitioners, and mixed audiences. Fourteen (56%) of the trainings were conducted in the USA, seven (28%) in Canada and other countries. The length of training ranged from two days to two years. Four trainings had an explicit focus on equity. A total of 307 unique competencies were identified and divided into themes: Knowledge, Skills, Engagement with Other Disciplines, Equity, Attitude and Relational Aspects, Capacity Building, Quality Improvement, and Mentorship.</p><p><strong>Conclusions: </strong>While there are many D&I capacity building initiatives, we found little consistency in competencies that guided training activities for diverse audiences. Few training activities explicitly identified guiding theories or frameworks or tailored competencies toward different levels of interest in D&I research. Even fewer had an explicit focus on health equity. As the fields continue to foster capacity building programs, it will be important to think critically about the types of competencies we are developing for whom, how, and why.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"34"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782182","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":"A stepped wedge cluster randomized implementation trial to increase outpatient management of low-risk pulmonary embolism from the emergency department - the MEDIC ALERT PE study.","authors":"Shawna N Smith, Colin F Greineder, Joshua Errickson, Jessica Burns, F Jacob Seagull, Keith E Kocher, Jeffrey A Kline, Jeffrey T Kullgren, Michael S M Lanham, Sarah L Krein, Geoffrey D Barnes","doi":"10.1186/s43058-025-00720-1","DOIUrl":"10.1186/s43058-025-00720-1","url":null,"abstract":"<p><strong>Background: </strong>Home-based care for patients diagnosed in emergency departments (EDs) with low-risk pulmonary embolism (PE) is an evidence-based, guideline-recommended practice that is not widely adopted in the US. Few studies demonstrate how this care pathway can be implemented effectively or test whether implementation strategies can address known barriers. Further, prior studies have lacked diversity in population and health system type and did not integrate theory-informed implementation frameworks. Although essential for establishing the evidence base for safe home management of low-risk acute PE, these studies have thus fallen short of guiding broad dissemination and equitable implementation. To bridge this gap, we are conducting a pragmatic multi-site implementation trial, guided by implementation science theory and frameworks, across twelve diverse hospital settings to assess the effectiveness of new care pathways for patients with low-risk PE presenting to EDs.</p><p><strong>Methods/design: </strong>The study uses a cluster-randomized stepped wedge trial design to investigate a set of implementation strategies to support establishing low-risk PE pathways in 12 EDs. Clusters of three hospitals were randomly assigned to one of four start dates, staggered over a 12-month period. During an initial three-month pre-implementation period, we will work with site champions to identify key site personnel and understand site barriers and facilitators. We will then tailor the care pathway to local needs and capabilities. During the six-month active implementation period, we will provide coaching to help sites implement a multi-component intervention informed by behavioral economics intended to address multi-level (site, provider, patient) barriers and integrate the new care pathway for discharging low-risk PE patients. Sites are then followed for a minimum of 12 months post-implementation. Our primary aim is to assess the change in discharge rates of patients with acute PE pre- and post-implementation. Secondary and exploratory aims will assess change in patient safety outcomes along with other key implementation outcomes guided by the RE-AIM framework.</p><p><strong>Discussion: </strong>This study expands upon prior effectiveness research to tailor, implement, and robustly evaluate a multi-component implementation intervention for diverse health systems aiming to increase guideline-based outpatient management of low-risk PE. Broad-scale implementation in the US could avert up to 100,000 hospitalizations annually.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (NCT06312332), registered on March 13, 2024.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775186","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":"Factors influencing normalisation and sustainment of the Birmingham Symptom-specific Obstetric Triage System (BSOTS): a qualitative implementation evaluation study with UK maternity health professionals.","authors":"Nimarta Dharni, Agnieszka Latuszynska, Sophie-Anna Dann, Nina Johns, Graeme Currie, Sara Kenyon","doi":"10.1186/s43058-025-00710-3","DOIUrl":"10.1186/s43058-025-00710-3","url":null,"abstract":"<p><strong>Background: </strong>Maternity triage is the emergency portal to access maternity services for pregnant or newly postnatal women experiencing unexpected complications or concerns. Traditionally women were seen in the order in which they attended maternity services without appropriate organisational and clinical systems in place to prioritise the clinical urgency of the women presenting. The Birmingham Symptom-specific Obstetric Triage System (BSOTS) is a standardised triage system co-developed by clinicians and researchers to address this need. Since its inception in 2013, BSOTS is now the recommended triage system and has been widely implemented in the UK with international adoption also occurring. This study aimed to explore the factors influencing the normalisation and sustainment of BSOTS in UK maternity units.</p><p><strong>Methods: </strong>A qualitative evaluation study involving semi-structured interviews with 43 maternity professionals across 9 sites representing a range of implementation experiences (normalised n=3, partially normalised n=3, and probably not normalised n= 3). Participants were maternity triage staff of varying levels including midwives, obstetricians and senior leaders. Interviews were held virtually, and recorded and transcribed verbatim. Analysis was based on Normalisation Process Theory.</p><p><strong>Results: </strong>Contextual factors were key to influencing implementation and sustainment of BSOTS. In sites where BSOTS was normalised and integrated into routine practice, organisational and leadership buy-in helped mobilise support for other contextual factors required for implementation fidelity and success, including establishing a clear identity of the triage department, sufficient midwifery and obstetric staffing, appropriate space, a dedicated and protected core team, adequate equipment and resources. Accommodating these factors often meant complex system-level changes were required to implement BSOTS for which strategic intentions and organisational support were integral. In some cases, such support was facilitated by Care Quality Commission regulatory recommendations.</p><p><strong>Conclusions: </strong>Our study found successful implementation and normalisation of BSOTS was driven by contextual factors, particularly organisational buy-in and leadership support. While regulatory requirements enabled the prioritisation of triage within maternity services, our evaluation emphasised the importance of both leadership and frontline staff support for effective integration and sustainment. Evaluation findings were used to inform an implementation toolkit for clinical triage teams seeking to implement or reinvigorate BSOTS in their sites.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756371","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":"Development and testing of an interactive evaluation tool: the Evaluating QUality and ImPlementation (EQUIP) Tool.","authors":"Laura McAlpine, Candace Ramjohn, Erin L Faught, Naomi Popeski, Eileen Keogh, Gabrielle L Zimmermann","doi":"10.1186/s43058-025-00715-y","DOIUrl":"10.1186/s43058-025-00715-y","url":null,"abstract":"<p><strong>Background: </strong>Evaluating implementation outcomes is gaining momentum in health service delivery organizations. Teams are increasingly recognizing the importance of capturing and learning from their implementation efforts, and Implementation Scientists have published extensively on implementation outcomes. However, Quality Improvement approaches and tools are more widely recognized and routinely used in healthcare to improve processes and outcomes. This article describes the development of an interactive online tool designed to help researchers and practitioners effectively design and develop appropriate evaluation plans that support the understanding of successful implementation.</p><p><strong>Methods: </strong>There were two main development phases. Phase 1, from January to October 2020, involved several design sessions with a small group of professionals leading implementation initiatives within the provincial health delivery system. This resulted in a testable prototype. Phase 2, from November 2020 to June 2021, focused on usability testing and interviews with a broader group of researchers and professionals leading implementation initiatives across the province.</p><p><strong>Results: </strong>The result is the EQUIP (Evaluating QUality and ImPlementation) Tool, an interactive online tool that integrates quality measures from the Alberta Quality Matrix for Health and implementation measures from widely used outcomes frameworks, such as the one developed by Proctor and colleagues and the RE-AIM planning and evaluation framework. The tool encourages users to explore implementation outcomes and quality dimensions from different perspectives and select questions and indicators relevant to their project.</p><p><strong>Conclusion: </strong>The EQUIP tool was designed and refined in collaboration with end users to create an accessible and practical online tool. This work addresses the call for greater integration of Quality Improvement and Implementation Science by combining approaches from both fields to strengthen evaluation processes within the health system.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756369","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 strategies used in policy, systems, and environmental interventions addressing obesity-related outcomes in early childhood education settings: a systematic review.","authors":"Cody D Neshteruk, Courtney T Luecking, Chelsea L Kracht, Sarah Burkart, Emily M Melnick, Robert E Anderson, Hannah G Lane","doi":"10.1186/s43058-025-00718-9","DOIUrl":"10.1186/s43058-025-00718-9","url":null,"abstract":"<p><strong>Background: </strong>Policy, systems, and environmental (PSE) approaches, including those enacted in early childhood education (ECE) settings, can improve child health outcomes. The use of implementation strategies, or the ways in which these approaches are enacted across settings, may modify intervention impact. Therefore, the purpose of this review was to examine the implementation strategies used among interventions utilizing PSE approaches in the ECE setting.</p><p><strong>Methods: </strong>Seven databases including MEDLINE, PubMed, Web of Science, and EMBASE, were searched for interventions in ECE settings including children (0-6 years) that utilized ≥ 1 PSE approach. Eligible studies included either a child-level outcome (i.e., weight, physical activity, or diet) or an environmental outcome (i.e., nutrition and physical activity environment). Data extracted included study characteristics, description of the intervention, and description of the implementation of the intervention. Implementation strategies were coded using the School Implementation Strategies Translating ERIC Resources (SISTER) taxonomy. The Downs and Black checklist was completed to assess study quality.</p><p><strong>Results: </strong>One hundred and four studies representing 97 interventions were identified. Fourteen (14%) did not report any implementation strategies. Of the remaining 83 interventions reporting implementation strategies, the mean number of implementation strategies employed per intervention was 3.8 (± 2.3) (range 1-11). However, few interventions (5/83, 6%) clearly named and defined implementation strategies. Most implementation strategies came from the \"train and educate stakeholders\" SISTER domain (177/318, 56%), and the most frequently used implementation strategy was \"conduct educational meetings (50/83, 60%). Most studies were classified as good (59/104, 57%) or fair (40/104, 38%) quality.</p><p><strong>Conclusions: </strong>In this review, many interventions appeared to use multiple implementation strategies to support ECE PSE interventions, though few explicitly documented or described those strategies. These findings suggest that more precise documentation of implementation strategies is needed to enhance replication and scalability of ECE interventions.</p><p><strong>Registration: </strong>PROSPERO# CRD42022306670.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":"6 1","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756374","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}