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

Abstract

The advancement of implementation science is dependent on identifying assessment strategies that can address implementation and clinical outcome variables in ways that are valid, relevant to stakeholders, and scalable. This paper presents a measurement agenda for implementation science that integrates the previously disparate assessment traditions of idiographic and nomothetic approaches. Although idiographic and nomothetic approaches are both used in implementation science, a review of the literature on this topic suggests that their selection can be indiscriminate, driven by convenience, and not explicitly tied to research study design. As a result, they are not typically combined deliberately or effectively. Thoughtful integration may simultaneously enhance both the rigor and relevance of assessments across multiple levels within health service systems. Background on nomothetic and idiographic assessment is provided as well as their potential to support research in implementation science. Drawing from an existing framework, seven structures (of various sequencing and weighting options) and five functions (Convergence, Complementarity, Expansion, Development, Sampling) for integrating conceptually distinct research methods are articulated as they apply to the deliberate, design-driven integration of nomothetic and idiographic assessment approaches. Specific examples and practical guidance are provided to inform research consistent with this framework. Selection and integration of idiographic and nomothetic assessments for implementation science research designs can be improved. The current paper argues for the deliberate application of a clear framework to improve the rigor and relevance of contemporary assessment strategies. KeywordsImplementation science, Assessment, Measurement, Nomothetic, Idiographic, Research design Intentional research design in implementation science: implications for the use of nomothetic and idiographic assessment Research design and measurement in implementation science Implementation science is focused on improving health services through the evaluation of methods that promote the use of research findings (e.g., evidencebased practices) in routine service delivery settings [1]. Studies in this area are situated at the end of the National Institutes of Health translational research pipeline (i.e., at T3 or T4); which describes how innovations move from basic scientific discovery, to intervention, and to large scale, sustained delivery in routine community practice [2]. 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].

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