Implementation Science

Blasé, Karen A.; Dyke, Melissa Van; Fixsen, Dean L.; Bailey, Frances Wallace

doi:10.1017/cbo9781139013949.004

Cited by 91 publications

(50 citation statements)

References 62 publications

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“…As an alternative, we explored existing tools such as the Stages of Implementation Completion observational measure [ 35 , 39 ] and the Stages of Implementation Analysis [ 40 ], which track progress through implementation stages. Yet, their focus on achievement of pre-determined, observable implementation milestones (e.g.…”

Section: Methodsmentioning

confidence: 99%

Tracking implementation strategies: a description of a practical approach and early findings

Bunger

Powell

Robertson

et al. 2017

Health Res Policy Sys

136

156

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BackgroundPublished descriptions of implementation strategies often lack precision and consistency, limiting replicability and slowing accumulation of knowledge. Recent publication guidelines for implementation strategies call for improved description of the activities, dose, rationale and expected outcome(s) of strategies. However, capturing implementation strategies with this level of detail can be challenging, as responsibility for implementation is often diffuse and strategies may be flexibly applied as barriers and challenges emerge. We describe and demonstrate the development and application of a practical approach to identifying implementation strategies used in research and practice that could be used to guide their description and specification.MethodsAn approach to tracking implementation strategies using activity logs completed by project personnel was developed to facilitate identification of discrete strategies. This approach was piloted in the context of a multi-component project to improve children’s access to behavioural health services in a county-based child welfare agency. Key project personnel completed monthly activity logs that gathered data on strategies used over 17 months. Logs collected information about implementation activities, intent, duration and individuals involved. Using a consensus approach, two sets of coders categorised each activity based upon Powell et al.’s (Med Care Res Rev 69:123–57, 2012) taxonomy of implementation strategies.ResultsParticipants reported on 473 activities, which represent 45 unique strategies. Initial implementation was characterised by planning strategies followed by educational strategies. After project launch, quality management strategies predominated, suggesting a progression of implementation over time. Together, these strategies accounted for 1594 person-hours, many of which were reported by the leadership team that was responsible for project design, implementation and oversight.ConclusionsThis approach allows for identifying discrete implementation strategies used over time, estimating dose, describing temporal ordering of implementation strategies, and pinpointing the major implementation actors. This detail could facilitate clear reporting of a full range of implementation strategies, including those that may be less observable. This approach could lead to a more nuanced understanding of what it takes to implement different innovations, the types of strategies that are most useful during specific phases of implementation, and how implementation strategies need to be adaptively applied throughout the course of a given initiative.Electronic supplementary materialThe online version of this article (doi:10.1186/s12961-017-0175-y) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Tracking implementation strategies: a description of a practical approach and early findings

Bunger

Powell

Robertson

et al. 2017

Health Res Policy Sys

136

156

View full text Add to dashboard Cite

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“…Feedback loops inform ongoing program, staff and organizational development. This approach is particularly relevant in situations in which programs or models are being adapted to new conditions, contexts or target populations (30), that is, the exploration and installation stages outlined in the NIRN framework for the implementation of evidence-based programs and other innovation (9). The larger study methods combine three iterative approaches to program theory building (8): (a) a review of the academic and gray literature (deductive approach); (b) interviews with key informants (articulating stakeholder mental models); and (c) Implementation Team meetings as the potential program model is considered for installation at the community-based agency (inductive approach).…”

Section: Methodsmentioning

confidence: 99%

“…The investigators employed a semi-structured interview protocol informed by a series of open-ended questions as suggested in the NIRN Exploration Stage of innovation development (9). The questions were used to orient conversation.…”

Section: Methodsmentioning

confidence: 99%

“…Given the prevalence of parenthood among individuals with SMI (3, 4); the value placed on parenthood by these individuals (5, 6); and their diverse vulnerabilities (e.g., limited resources and supports) (7), a robust, theoretically sound, empirically tested model of peer supports for parents with SMI would likely provide a valuable complement to traditional psychiatric treatments. In this paper, we lay the groundwork for a model of peer supports for parents using a program theory development process (8) and guided by stages of evidence-informed innovation outlined by the National Implementation Research Network (NIRN) (9).…”

Section: Introductionmentioning

confidence: 99%

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Key Informants Specify Core Elements of Peer Supports for Parents With Serious Mental Illness

Nicholson

Valentine

2019

Front. Psychiatry

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Background: Researchers have documented the lack of evidence-based interventions for parents with serious mental illness (SMI). Given the prevalence of parenthood among individuals with SMI, the value placed on parenthood, and their diverse vulnerabilities, a robust, theoretically sound and empirically tested model of peer supports would likely provide a valuable complement to psychiatric services. In this paper, we lay the groundwork for a model of peer supports using a program theory development process and guided by stages of evidence-informed innovation outlined by the National Implementation Research Network. Methods: This study employed a developmental design in the initial stage of a larger study of the development, implementation, and testing of peer supports to address three questions: (1) What needs of parents with SMI are particularly well-suited to peer supports? (2) What do peers have to offer parents? and (3) What is unique about peer supports for parents? A purposeful sampling strategy was used to recruit key informants ( n = 22) familiar with peer supports, family-focused care and the experiences of families living with parental mental illness. Individual interviews were conducted face-to-face or on the telephone and a full-day group interview was conducted using a workshop format. Interview data were analyzed qualitatively to identify themes reflecting potential core program elements. Results: Consistent themes drawn from data comprise four core program elements: engage, explore, plan, and access and advocate. These core activities are likely founded on practice principles that include a focus on families and their strengths, cultural sensitivity, and acknowledgment of the trauma experienced by many parents. The findings raised a number of challenges in contemplating peer supports for parents with SMI, including the need for ongoing support for peers. Discussion: In developing this model, aspects of organizational context must be considered along with specification of the characteristics of parents with SMI suited to this approach and the attributes of peers providing support. A fully-articulated model must include parallel theories of change for the workforce, as well as for participating parents, to support well-being in the context of peer relationships and the success of parents with SMI in family life.

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“…To understand the needs of the FHTs and the importance of treating depression in the smoking cessation program, we developed a survey which measures organizational readiness and the extent to which an organization is willing and able to implement a specific intervention [ 22 ]. The survey consists of 12 questions addressing the six components of The National Implementation Research Network’s Hexagon Tool (ie, need, fit, resources, evidence, readiness, and capacity) [ 23 ], as well as the three readiness components described by Scaccia et al [ 24 ] (ie, motivation, general capacities, and specific capacities) [ 24 ]. Based on answers to this survey, organizations were grouped into two categories: most ready (n=44), and least ready (n=40).…”

Section: Methodsmentioning

confidence: 99%

Tailored Versus Generic Knowledge Brokering to Integrate Mood Management Into Smoking Cessation Interventions in Primary Care Settings: Protocol for a Cluster Randomized Controlled Trial

Minian¹,

Noormohamed²,

Baliunas³

et al. 2018

JMIR Res Protoc

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BackgroundBoth tobacco smoking and depression are major public health problems associated with high morbidity and mortality. In addition, individuals with depression are almost twice as likely to smoke and less likely to achieve smoking cessation. In the Smoking Treatment for Ontario Patients program, an established smoking cessation program in Ontario, Canada, 38% of smokers in primary care settings have current or past depression with 6-month quit rates that are significantly lower than those without depression (33% versus 40%, P<.001). Integrating self-help mood management (eg, relaxation exercises and mood monitoring) with smoking cessation treatment increases long-term quit rates by 12%-20%. However, integration in real-world settings has not been reported. It is unclear which knowledge translation strategy would be more effective for motivating clinicians to provide resources on mood management to eligible patients.ObjectiveThe objectives of this study are to investigate the following comparisons among depressed smokers enrolled in a smoking cessation program: 1) the effectiveness of generalized, exclusively email-based prompts versus a personalized knowledge broker in implementing mood management interventions; 2) the effectiveness of the two knowledge translation strategies on smoking quit rates; and 3) the incremental costs of the two knowledge translation strategies on the implementation of mood management interventions.MethodsThe study design is a cluster randomized controlled trial of Family Health Teams participating in the Smoking Treatment for Ontario Patients program. Family Health Teams will be randomly allocated 1:1 to receive either generalized messages (related to depression and smoking) exclusively via email (group A) or be assigned a knowledge broker who provides personalized support through phone- and email-based check-ins (group B). The primary outcome, measured at the site level, is the proportion of eligible baseline visits that result in the provision of the mood management intervention to eligible patients.ResultsRecruitment for the primary outcome of this study will be completed in 2018/2019. Results will be reported in 2019/2020.ConclusionsThis study will address the knowledge gap in the implementation strategies (ie, email-based prompts versus a knowledge broker) of mood management interventions for smokers with depression in primary care settings.Trial RegistrationClinicalTrials.gov NCT03130998; https://clinicaltrials.gov/ct2/show/NCT03130998 (Archived on WebCite at www.webcitation.org/6ylyS6RTe)

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Implementation Science

Cited by 91 publications

References 62 publications

Tracking implementation strategies: a description of a practical approach and early findings

Tracking implementation strategies: a description of a practical approach and early findings

Key Informants Specify Core Elements of Peer Supports for Parents With Serious Mental Illness

Tailored Versus Generic Knowledge Brokering to Integrate Mood Management Into Smoking Cessation Interventions in Primary Care Settings: Protocol for a Cluster Randomized Controlled Trial

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