Factors influencing implementation of evidence-based interventions in public health systems - a model

Abstract

Objectives: Evidence that health interventions work is not enough to ensure implementation into policy and practice. The complexity of public health systems requires more diverse actions. This paper proposes a conceptual model to enhance understanding of interlinking factors that influence the evidence implementation process. Methods: A literature review was conducted to explore factors that influence the process of evidence implementation in complex public health systems, including research findings and observations from 32 case studies of injury prevention interventions underway in 24 countries and results from evidence research networks. Concepts and themes identified through a critical review were organised, ordered and interlinked to build the model. Results: An Evidence Implementation Model for Public Health Systems and four concepts or themes: Evidence implementation target; Actors involved in implementation; Knowledge transfer; and Barriers and facilitators to evidence implementation were developed to provide a simplified, yet broad framework that highlights multiple factors and back and forth inter-linkages within and between the concepts that influence the uptake of evidence into public health systems policy and practice. Conclusions: Understanding the factors discussed within and amongst the four concepts of this model should ultimately help to positively influence the uptake of evidence into real world public health systems. This model has relevance for decision makers, researchers, knowledge brokers, and implementers.

Priorities for improving chemicals management in the WHO European Region—stakeholders’ views

“…Here, academics can provide support to enhance knowledge translation. 18 As well, common knowledge of agreed facts by all stakeholders is also an important foundation for information and determining priority needs. 35 …”

“…14 , 17 The Evidence Implementation Model for Public Health Systems was utilized to formulate questions addressing key stakeholders involvement, knowledge transfer,and barriers and facilitators to the uptake of effective strategies. 18 Furthermore, categories of the theory of diffusion were included. 19 Three main questions were asked in the questionnaire:…”

Barriers and Facilitators to the Elimination of Asbestos Related Diseases—Stakeholders’ Perspectives

“…Enhanced, early engagement and cooperation of diverse sectors and stakeholders throughout the entire process of adoption, implementation, and monitoring of evidence-based policies and programmes to eliminate ARDs, based on a whole-of-government and whole-of-society approach, will support the knowledge translation process, as seen in other evidence implementation research [ 11 ]. Overall, empowering a lead agency so initiatives and actions can be coordinated is essential [ 17 ].…”

“…The research method was qualitative and explorative, combining interviews and discussions with stakeholders. The questionnaire for the semi-structured interviews was developed based on information from a current ARDs WHO report [ 6 ] and the Evidence Implementation Model for Public Health Systems that offers insights into barriers and facilitators of uptake of effective strategies [ 11 ]. Furthermore, categories of the theory of diffusion were taken into account in formulating the interview questions [ 12 ].…”

“…Content analysis of the interviews was undertaken to provide concise summaries of participants’ responses. Findings were grouped corresponding to the three interview themes noted above [ 11 , 13 ].…”