Bridging Research and Practice

Abstract

Context Theories and frameworks (hereafter called models) enhance dissemination and implementation (D&I) research by making the spread of evidence-based interventions more likely. This work organizes and synthesizes these models by: (1) developing an inventory of models used in D&I research; (2) synthesizing this information; and (3) providing guidance on how to select a model to inform study design and execution. Evidence acquisition This review began with commonly cited models and model developers and used snowball sampling to collect models developed in any year from journal articles, presentations, and books. All models were analyzed and categorized in 2011 based on three author-defined variables: construct flexibility, focus on dissemination and/or implementation activities (D/I), and the socio-ecological framework (SEF) level. Five-point scales were used to rate construct flexibility from broad to operational and D/I activities from dissemination-focused to implementation-focused. All SEF levels (system, community, organization, and individual) applicable to a model were also extracted. Models that addressed policy activities were noted. Evidence synthesis Sixty-one models were included in this review. Each of the five categories in the construct flexibility and D/I scales had/contained at least four models. Models were distributed across all levels of the SEF; the fewest models (n=8) addressed policy activities. To assist researchers in selecting and utilizing a model throughout the research process, the authors present and explain examples of how models have been used. Conclusions These findings may enable researchers to better identify and select models to inform their D&I work.

Translating evidence into healthcare policy and practice: Single versus multi-faceted implementation strategies – is there a simple answer to a complex question?

“…However, if the boundaries are more complex, so too more complex implementation strategies encompassing interactive and/or negotiated elements are called for. And as we move to these more complex translational and transformational approaches, we are likely to need a combination of different strategies, active facilitation of the process and conscious application of one or more theories and frameworks that have been developed to inform and guide implementation [see, for example, (23)(24)(25)]. The review by Squires and colleagues (7) has raised some timely and important questions.…”

Ready to deliver maternal and newborn care? Health providers’ perceptions of their work context in rural Mozambique

“…Theoretical frameworks within this field have been developed over the last two decades, often focusing on either the characteristics of the individuals targeted as users of the EBPs to be implemented (and how these characteristics can influence their ability to change routines) or the organization in which these individuals work (and how that organization can cope with change) [8,9]. Common to many of these frameworks is the recognition of the importance of understanding the healthcare context in which evidence is implemented [9].…”

A Comparative Analysis of Two Streams of Implementation Research

“…Yet, in these efforts, it is recognized that scant attention is paid to the organizational or policy environment. In a recent review of implementation science research, only 13 percent of the models incorporated policy activities even though they are widely understood as important (Tabak et al, 2012). In the widely used 'Consolidated Framework for Implementation Research,' organizational and policy factors are merely referred to as the "outer setting" (Damschroder, Aron, Keith, Kirsch, Alexander, & Lowery, 2009).…”

“…Like the study of policy implementation in the 1970s and 1980s, many models and theories have recently been developed to achieve this aim in the field of implementation science research (Tabak, Khoong, Chambers, & Brownson, 2012). Recent reviews are seeking to develop integrative frameworks or conceptual models (Durlak & DuPre, 2008;Fixsen et al, 2005;Greenhalgh et al, 2004;).…”

“…Though most implementation science articles do not address specific policies or larger governance issues, the research often introduces a multi-level approach by positioning frontline service delivery within organizational contexts (Damschroder et al, 2009;Durlak & DuPre, 2008;Fixsen et al, 2005;Greenhalgh et al, 2004;Tabak et al, 2012).…”