A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project

Abstract

BackgroundIdentifying, developing, and testing implementation strategies are important goals of implementation science. However, these efforts have been complicated by the use of inconsistent language and inadequate descriptions of implementation strategies in the literature. The Expert Recommendations for Implementing Change (ERIC) study aimed to refine a published compilation of implementation strategy terms and definitions by systematically gathering input from a wide range of stakeholders with expertise in implementation science and clinical practice.MethodsPurposive sampling was used to recruit a panel of experts in implementation and clinical practice who engaged in three rounds of a modified Delphi process to generate consensus on implementation strategies and definitions. The first and second rounds involved Web-based surveys soliciting comments on implementation strategy terms and definitions. After each round, iterative refinements were made based upon participant feedback. The third round involved a live polling and consensus process via a Web-based platform and conference call.ResultsParticipants identified substantial concerns with 31% of the terms and/or definitions and suggested five additional strategies. Seventy-five percent of definitions from the originally published compilation of strategies were retained after voting. Ultimately, the expert panel reached consensus on a final compilation of 73 implementation strategies.ConclusionsThis research advances the field by improving the conceptual clarity, relevance, and comprehensiveness of implementation strategies that can be used in isolation or combination in implementation research and practice. Future phases of ERIC will focus on developing conceptually distinct categories of strategies as well as ratings for each strategy’s importance and feasibility. Next, the expert panel will recommend multifaceted strategies for hypothetical yet real-world scenarios that vary by sites’ endorsement of evidence-based programs and practices and the strength of contextual supports that surround the effort.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0209-1) contains supplementary material, which is available to authorized users.

Dissemination of a Web-Based Tool for Supporting Health Insurance Plan Decisions (Show Me Health Plans): Cross-Sectional Observational Study (Preprint)

“…From the experience, we can conclude that disseminating the web-based tool is feasible as it was able to attract potential users, educate them on basic health insurance terms, and make recommendations based on personal information and preference. In addition, it also provides an example of a successful adaption of evidence-based recommendations for implementing change [25,26]. However, future research is needed to investigate the factors that impact online users' information-seeking behaviors when using a public health information tool, as well as to explore the strategies to engage low income populations.…”

“…Furthermore, this study actively integrated evidence-based strategies for implementing change [25,26], built coalitions with local stakeholders and communities, and created a feedback loop in developing tool content to transform a research tool to a regular use online tool. Damschroder et al [35] suggested that implementing a research tool in a particular setting requires the preservation of the essential and core elements of the tool, but also the modification of the adaptable elements based on the dissemination settings.…”

“…Damschroder et al [35] suggested that implementing a research tool in a particular setting requires the preservation of the essential and core elements of the tool, but also the modification of the adaptable elements based on the dissemination settings. The evidence-based strategies [25,26] were helpful in engaging stakeholders and community members to identify the core and adaptable elements in order to assess the likelihood of adoption of the website, along with potential barriers and facilitators to implementation. In addition, formatting visual and written context in a research study is different because research participants are more engaged in the study procedures and interventions, thus seeking feedback from stakeholders could potentially reduce user burden and make the tool robust across broader populations, especially for audience with low health literacy.…”

“…The study team relied on several expert recommendations for implementation of evidence-based interventions [25,26]. Key strategies are summarized and displayed in Table 1.…”

Intentional research design in implementation science: implications for the use of nomothetic and idiographic assessment

“…Implementation research is also inherently multilevel, focusing on individuals, groups, organizations, and systems to change professional behavior and enact service quality improvements [3]. Frequently, the objectives of implementation science include the identification of multilevel variables that impact the uptake of evidence-based practices as well as specific strategies for improving adoption, implementation, and sustainment [4,5]. …”