A Citation Review of 83 Dissemination and Implementation Theories, Models, or Frameworks Utilized in U.S.-Based Aging Research

Abstract

Background and objectives Dissemination-implementation.org outlines 110 Theories, Models, and Frameworks (TMFs): we conducted a citation analysis on 83 TMFs, searching Web of Science and PubMed databases. Research design and methods Search terms were broad and included “aging,” “older,” “elderly” and “geriatric.” We extracted how each TMF in identified articles from inception through January 28, 2022. Included articles must have used a TMF in research or quality improvement work directly linked to older adults within the United States. Results We reviewed 2,677 articles of which 295 articles cited at least one of 56 theories, models, and frameworks (TMFs). Five TMFs represented 50% of the citations: Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) 1.0, Consolidated Framework for Implementation Research (CFIR), Greenhalgh Diffusion of Innovation in Service Organizations, Quality Enhancement Research Initiative (QUERI), Community-based Participatory Research (CBPR) and Promoting Action on Research Implementation in Health Services (PARIHS). TMF application varied and there was a steady increase in TMF citations over time, with a 2-to-3-fold increase in citations in 2020-2021. We identified that only 41% of TMF use was meaningful. Discussion and implications Our results suggest TMF utilization is increasing in aging research, but there is a need to more meaningful utilize TMFs. As the population of older adults continues to grow, there will be increasing demand for effective evidence-based practices and models of care to be quickly and effectively translated into routine care. Use of TMFs is critical to building such evidence and to identifying and evaluating methods to support this translation.

Factors that influence the implementation of innovation in aged care: a scoping review

“…We identified that the CFIR 202 and iPARIHS 214 were among the most used frameworks. This was also consistent with the findings of Sullivan et al 213 However, these authors also identified another commonly used framework (Greenhalgh's Diffusion of Innovation in Service Organizations 215 ) that we did not. We also identified Normalization Process Theory 216 among the most common, which Sullivan et al also did not.…”

“…Our findings are consistent with those of Sullivan et al, 213 whose citation review identified low but increasing use of implementation theories, models, and frameworks in aging research (not necessarily in the aged care setting) in the USA. Our study builds on this work by examining the aged care context specifically, and including studies from any country.…”

“…212 While we did not assess the appropriateness or quality of the use of implementation frameworks, the finding that some 70% of papers in our study made no mention of any implementation framework is a clear indication that framework use is lacking in the field of aged care implementation research. Our findings are consistent with those of Sullivan et al, 213 whose citation review identified low but increasing use of implementation theories, models, and frameworks in aging research (not necessarily in the aged care setting) in the USA. Our study builds on this work by examining the aged care context specifically, and including studies from any country.…”

“…There are several possible explanations for the limited use of frameworks. The ability to follow clear steps in the implementation process rather than adapting and applying broader concepts has been posited as a reason that some frameworks are applied more than others 213 . This is consistent with input from our advisory group, suggesting that a clear, simple, step-by-step process would be more likely to be used.…”

Scoping review of interventions to de-implement potentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) in healthcare settings

“…Although there appeared to be no difference in the effectiveness of interventions that did versus did not use such a theory, framework or model, their use facilitates a thorough exploration of factors that led or did not lead to an effective intervention. Furthermore, the use of these theories, frameworks and models can guide successful implementation, adaptation and dissemination of interventions and should be applied in future efforts 64–66. One excellent example is provided by the intervention reported by Pinto et al 67 who included their TIDieR checklist68 in their published manuscript.…”