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"Implementation practice"
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Competences for implementation science: what trainees need to learn and where they learn it
by
Klug, Julia
,
Fixsen, Dean L.
,
Schultes, Marie-Therese
in
Competence
,
Continuing education
,
Core curriculum
2021
Education in implementation science, which involves the training of health professionals in how to implement evidence-based findings into health practice systematically, has become a highly relevant topic in health sciences education. The present study advances education in implementation science by compiling a competence profile for implementation practice and research and by exploring implementation experts’ sources of expertise. The competence profile is theoretically based on educational psychology, which implies the definition of improvable and teachable competences. In an online-survey, an international, multidisciplinary sample of 82 implementation experts named competences that they considered most helpful for conducting implementation practice and implementation research. For these competences, they also indicated whether they had acquired them in their professional education, additional training, or by self-study and on-the-job experience. Data were analyzed using a mixed-methods approach that combined qualitative content analyses with descriptive statistics. The participants deemed collaboration knowledge and skills most helpful for implementation practice. For implementation research, they named research methodology knowledge and skills as the most important ones. The participants had acquired most of the competences that they found helpful for implementation practice in self-study or by on-the-job experience. However, participants had learned most of their competences for implementation research in their professional education. The present results inform education and training activities in implementation science and serve as a starting point for a fluid set of interdisciplinary implementation science competences that will be updated continuously. Implications for curriculum development and the design of educational activities are discussed.
Journal Article
Advancing the selection of implementation science theories, models, and frameworks: a scoping review and the development of the SELECT-IT meta-framework
2025
Background
Theories, models, and frameworks (TMFs) are central to implementation practice and research. Selecting one or more TMF(s) for a project remains challenging due to numerous options and limited guidance. This study aimed to (1) identify and categorize the reported purposes and attributes of TMFs, as well as the practical considerations of TMF users, and (2) synthesize these findings into a meta-framework that supports implementation practitioners and researchers in selecting TMFs.
Methods
A scoping review was conducted using Joanna Briggs Institute guidelines. Medline, Embase, and CINAHL were searched to identify articles on the selection of TMFs. Articles were selected and data extracted using Covidence. Inductive thematic analysis was used to refine and categorize purposes, attributes and practical considerations. The meta-framework was developed by mapping these categories onto a sequential process, pilot-testing through case studies, and iteratively refining it based on team feedback.
Results
Of 9,276 records, 43 articles (2005–2024) were included. Most articles reported TMF purposes (41 articles), followed by attributes (30) and practical considerations (13). Seven distinct purposes were identified: (1) enhancing conceptual clarity, (2) anticipating change and guiding inquiry, (3) guiding the implementation process, (4) guiding identification of determinants, (5) guiding design and adaptation of strategies, (6) guiding evaluation and causal explanation, and (7) guiding interpretation and dissemination. Additionally, 24 TMF attributes were grouped into five domains: clarity and structure, scientific strength and evidence, applicability and usability, equity and sociocultural responsiveness, and system and partner integration. Ten practical considerations were grouped into three domains: team expertise and readiness, resource availability, and project fit. These findings informed the development of the
S
ystematic
E
valuation and Se
lect
ion of
I
mplementation Science
T
heories, Models and Frameworks (SELECT-IT) meta-framework, comprising four steps: (1) determine the purpose(s) of using TMF(s); (2) identify potential TMFs; (3) evaluate short-listed TMFs against attributes; and (4) assess practical considerations of using TMF(s) within the project context. A worked example and two user-friendly worksheets illustrate its utility.
Conclusions
This study advances understanding of the selection of implementation science TMFs by distinguishing inherent TMF attributes from practical considerations. The SELECT-IT meta-framework offers a structured, context-sensitive approach for selecting appropriate TMFs. Future research should evaluate its validity and utility across diverse contexts.
Journal Article
Understanding Evidence-Based Practice (EBP) Implementation in HCOs Through the Lens of Organizational Theory
Despite the increasing use of theory in the field of implementation science over the past decade, the literature has largely focused on using deterministic frameworks to retrospectively understand \"what\" factors are essential for the effective implementation of evidence-based practices (EBPs). On the other hand, gaps remain in using organizational theory to prospectively understand \"how\" successful EBP implementation occurs in healthcare organizations (HCOs). This article discusses the theoretical and empirical contributions of two selected recent exploratory research works, which provide a starting point for addressing the identified gaps in the literature, with the purpose of deriving implications for theory, practice, and future research in implementation science. The selected works used the theory of \"effective knowledge sharing network structures in professional complex systems (PCS),\" developed through an integration of organizational theories, to design prospective interventions for enabling EBP implementation in HCOs. In doing so, these studies have helped explain \"how\" inter-professional knowledge exchange and collective learning occurred, to enable successful EBP implementation in HCOs. Correspondingly, the selected works have served a dual purpose in: 1) identifying evidence-based management (EBM) practice strategies for successful EBP implementation; while 2) further developing the theoretical literature on \"effective knowledge sharing networks in PCS.\" Importantly, by addressing the identified gaps in the literature, the selected works serve to either complement or supplement existing theoretical approaches in implementation science. To this effect, they provide unique insights for theory, practice, and research in implementation science, including insights into a potential \"dual-role\" for the future implementation researcher--one of advancing implementation science, while working to strengthen implementation practice. Based on these contributions, it could be argued that the selected works provide a starting point for a new research stream that has the potential to occupy a distinct position in the taxonomy of theoretical approaches used in implementation science. Keywords: evidence-based practice (EBP) implementation, inter-professional knowledge exchange, organizational learning (OL), knowledge sharing networks, professional complex systems (PCS) theory, practice improvement
Journal Article
Leveraging academic initiatives to advance implementation practice: a scoping review of capacity building interventions
by
Alicia C. Bunger
,
Sharon J. Tucker
,
Lisa A. Juckett
in
Academic institutions
,
Behavioral health care
,
Capacity Building
2022
Background
Academic institutions building capacity for implementation scholarship are also well positioned to build capacity in real world health and human service settings. How practitioners and policy makers are included and trained in implementation capacity-building initiatives, and their impact on building implementation practice capacity is unclear. This scoping review identified and examined features of interventions that build implementation practice capacity across researchers and practitioners or practitioners-in-training.
Methods
Five bibliographic databases were searched. Eligible studies (a) described an implementation capacity building intervention with a connection to an academic institution, (b) targeted researchers and practitioners (including practitioners-in-training, students, or educators), and (c) reported intervention or participant outcomes. Articles that only described capacity building interventions without reporting outcomes were excluded. Consistent with Arksey and O’Malley’s framework, key study characteristics were extracted (target participants, core components, and outcomes) and analyzed using open coding and numerical analysis.
Results
Of 1349 studies identified, 64 met eligibility for full-text review, and 14 were included in the final analysis. Half of the studies described implementation capacity building interventions that targeted health or behavioral health researchers, practitioners, and practitioners-in-training together, and half targeted practitioners or practitioners-in-training only. The most common components included structured didactic activities offered in person or online, mentorship and expert consultation to support implementation, and practical application activities (e.g., field placements, case studies). Knowledge sharing activities and technical assistance were less common. All studies reported favorable outcomes related to knowledge attainment, increased ability to implement evidence, productivity, and satisfaction.
Conclusions
Building implementation capacity among practitioners is critical for integrating insights from implementation science into the field and preventing the “secondary” implementation research-to-practice gap. This scoping review identified several promising implementation practice capacity building interventions that tend to build practitioner capacity via expert led activities which may be relevant for academic institutions seeking to build implementation practice capacity. To avoid widening the implementation research-to-practice gap, implementation capacity building interventions are needed that target policy makers, expand beyond multiple practice settings, and leverage university/community partnerships or on-site academic medical centers. Future studies will also be needed to test the impact on service quality and public health outcomes.
Journal Article
How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework
by
Cassidy, Christine E.
,
Straiton, Nicola
,
Fontaine, Guillaume
in
Actors
,
Actresses
,
Adaptation
2025
Background
Clear specification and reporting of implementation strategies and their targeted healthcare professional behaviors are essential for replication, adaptation, and cumulative learning in implementation science. However, critical gaps remain in the consistent use of reporting frameworks. This study aimed to: (1) assess the completeness of implementation strategy reporting using the Template for Intervention Description and Replication (TIDieR) checklist; (2) examine trends in implementation strategy reporting over time; and (3) assess the completeness of the reporting of healthcare professional behaviors targeted for change using the Action, Actor, Context, Target, Time (AACTT) framework.
Methods
We conducted a secondary analysis of 204 trials included in a systematic review of implementation strategies aimed at changing healthcare professional behavior. Implementation strategies were assessed using the 12-item TIDieR checklist; target behaviors were characterized using the five AACTT domains. Two independent reviewers extracted and coded the data. Descriptive statistics were used to summarize reporting patterns. Data were synthesized narratively and presented in tables, with trends illustrated via a scatterplot.
Results
Assessment of implementation strategy reporting using TIDieR showed that procedural details (98%), materials used (95%), and modes of delivery (88%) were frequently reported. Critical elements such as strategy tailoring (28%), fidelity assessment (19% planned; 17% actual), and modifications (10%) were often missing. A modest improvement in reporting was observed after the publication of TIDieR, with median scores increasing from 15.0 (IQR: 13.0–16.0) pre-2014 to 16.0 (IQR: 15.0–18.0) post-2014. Assessment of target healthcare professional behavior reporting using AACTT indicated that actions (e.g., “assess illness”) and actors (e.g., nurses) were generally well reported at a high level. However, key contextual and temporal details were largely absent. While physical context was documented in all studies, the emotional and social contexts of behaviors were rarely reported. Crucial information on the duration, frequency, and period of behaviors was rarely reported.
Conclusions
Implementation strategies and target behaviors are not consistently or sufficiently reported in trials. Increased adoption of structured reporting tools such as TIDieR and AACTT is essential to enhance transparency. Incorporating these frameworks during protocol development could strengthen intervention evaluation and reporting, advancing implementation science and fostering cumulative knowledge.
Trial registration
PROSPERO CRD42019130446.
Journal Article
Practice Implementation Within a Multidivisional Firm: The Role of Institutional Pressures and Value Consistency
2020
This paper proposes a model to predict when the subunits of a multidivisional firm implement a practice adopted by the firm more or less extensively, focusing on the intraorganizational environment. Drawing on institutional arguments, I propose that a subunit’s extent of practice implementation is a combined result of coercive pressures from its headquarters, imitation of its peer units, and its own perception of the practice’s legitimacy. More specifically, I argue that a subunit will implement new practices related to corporate social responsibility (CSR) more fully (1) when the corporate mandate from the headquarters is more pressing, (2) when its peer subunits have implemented similar actions, and (3) when the practice is perceived as consistent with the subunit’s own values. Regression results further suggest that peers and headquarters influence a subunit’s extent of implementation of a practice only when the subunit perceives it as highly consistent with its own values—a finding that points to the importance of values for practice legitimacy and the need to rethink practice implementation within complex organizations.
Journal Article
Implementing New Practices: An Empirical Study of Organizational Learning in Hospital Intensive Care Units
by
Tucker, Anita L
,
Nembhard, Ingrid M
,
Edmondson, Amy C
in
Applied sciences
,
Best practice
,
best-practice transfer
2007
This paper contributes to research on organizational learning by investigating specific learning activities undertaken by improvement project teams in hospital intensive care units and proposing an integrative model to explain implementation success. Organizational learning is important in this context because medical knowledge changes constantly and hospital care units must learn new practices if they are to provide high-quality care. To develop a model of factors affecting improvement project teams driving essential organizational learning in health care, we draw from three streams of related researchbest-practice transfer (BPT), team learning (TL), and process change (PC). To test the models hypotheses, we collected data from 23 neonatal intensive care units seeking to implement new or improved practices. We first analyzed the frequency of specific learning activities reported by improvement project participants and discovered two distinct factors: learn-what (activities that identify current best practices) and learn-how (activities that operationalize practices in a given setting). Next, ordinary least squares (OLS) regression analyses supported three of our four hypotheses. Specifically, a high level of supporting evidence for a units portfolio of improvement projects was associated with implementation success. Learn-how was positively associated with implementation success, but learn-what was not. Psychological safety was associated with learn-how, which was found to mediate between psychological safety and implementation success.
Journal Article
Reported use of implementation science theories, models, and frameworks in 151 implementation trials: secondary analysis of a systematic review targeting nursing practice
by
Collins, Simonne E
,
Folch, Nathalie
,
Chicoine, Gabrielle
in
Analysis
,
Dissemination & Implementation
,
Evidence-based nursing
2025
Background: Theories, models, and frameworks (TMFs) are central to the development and evaluation of implementation strategies supporting evidence-based practice (EBP). However, evidence on how and to what extent TMFs are used in implementation trials remains limited. Purpose: This study aimed to examine the nature and extent of TMF use in implementation trials, identify which TMFs are most frequently employed, and explore temporal trends in their use. Methods: A secondary analysis was conducted on 151 randomized trials of implementation strategies targeting EBP in nursing. Trials and their protocols were coded in NVivo 14 using a framework adapted from Painter's continuum of theory use (2005) and Michie and Prestwich's theory coding scheme (2010). The framework categorized theory use as \"informed by\" \"applied\" \"tested\" or \"built\" theory. Descriptive statistics were calculated in R, and temporal trends in TMF use across categories were analyzed. Results: Among the 151 trials, 54 (36%) reported using a TMF. Of these, most applied TMFs to guide implementation strategy design (28%), followed by justifying the study's purpose, aims, or objectives (15%). Testing theory was infrequent (9%), and no trials reported refining or building theory. Classic theories, such as the theory of planned behavior and social cognitive theory, were the most frequently cited. No clear temporal trend was found in TMF use across the categories. Conclusions: TMFs remain underutilized in implementation trials, with their application primarily limited to justifying study rationale or informing implementation strategy development. Greater emphasis on the testing and refinement of TMFs is recommended to advance implementation science. Registration information: Review registration: PROSPERO CRD42019130446. This study analyzed 151 randomized implementation trials (research studies) aimed at promoting high-quality health care delivered by nurses to see to what degree theories, models, and frameworks are used and how. We assessed whether trials used theories, models, and frameworks and, if so, how they were applied. Our findings reveal that only one-third of the trials explicitly used a theory, model, or framework. When one was used, it was most commonly applied to inform the development of implementation strategies or to justify the study's purpose and objectives. Far fewer studies tested how theories, models, and frameworks function, and none reported building or enhancing existing theories, models, and frameworks. Since implementation science aims to use theoretical approaches to improve the adoption of evidence-based practices, we expected a more comprehensive spectrum of applications. Future research could explore these differences and assess the use of theory across disciplines. We recommend enhanced capacity building in the use of theoretical approaches for trialists, and the use of reporting checklists to promote clearer and more consistent reporting of the use of theories, models, and frameworks in implementation trials, ultimately supporting more rigorous and theory-driven research. Keywords: implementation practice; implementation research; healthcare professionals; knowledge translation; theories
Journal Article
Use of implementation science methods to design Wellness Hub, a responsive program to address long-term care and retirement homes’ challenges during the COVID-19 pandemic
by
Fahim, Christine
,
Hassan, Ayaat T.
,
Strifler, Lisa
in
Canada
,
COVID-19 vaccines
,
Data collection
2026
Background
Long-term care and retirement homes (LTCH/RH) faced systemic challenges that were exacerbated by the COVID-19 pandemic. Homes faced three major challenges over the course of the pandemic: implementing infection prevention and control (IPAC) practices, facilitating COVID-19 vaccine uptake and confidence, and addressing staff well-being and burnout. This manuscript describes the use of implementation science methods to design an evidence-based, theoretically-rooted program titled the
Wellness Hub
to support LTCH and RH to navigate real-time COVID-19 challenges.
Methods
Challenges facing homes were categorized to theoretical constructs using the Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR). Implementation mapping was used to identify strategies to mitigate barriers and leverage facilitators at the individual level using the SELECT tool (rooted in Michie’s Behaviour Change Wheel) and at the organizational level using the CFIR-Expert Recommendations for Implementing Change (ERIC) matching tool. A multidisciplinary project team and steering committee reviewed the results and contextualized identified strategies to design the
Wellness Hub Program
components.
Results
Twelve TDF domains and 18 CFIR constructs were identified as barriers and/or facilitators to implementation of IPAC protocols, COVID-19 vaccine uptake, and staff well-being programs. Via the SELECT tool, we identified 14 implementation strategies to target individual-level change. An additional four strategies for organizational and systems-level implementation change were identified via the CFIR-ERIC mapping tool. The resulting
Wellness Hub Program
included: town halls, implementation coaches, promotion for LTCH/RH wellness days, creation of infographics and educational resources (including an open-access resource repository), a weekly newsletter summarizing LTCH/RH directives, a vaccine champions program and e-learning course, modelled change, an IPAC-self-assessment tool, seed funding, vaccine incentives, access to off-site COVID-19 testing, monthly community of practice meetings and use of opinion leaders.
Conclusion
Use of implementation science methods facilitated the design of a responsive support program to address LTCH and RH’s real-time, evolving COVID-19 challenges.
Study registration
https://osf.io/hkfae
.
Journal Article
The Impact of Strategy Implementation Practices on Entrepreneurial Orientation Through Emotional Intelligence/ an Applied Study at the University of Information and Communication Technology – Baghdad
by
Rahman, Mujahid Mutlaq Abdul
,
Alkaabi, Hameed Salim
,
Aajeel, Belqis Nagy
in
Emotional Intelligence
,
Entrepreneurial Orientation
,
Strategic Implementation Practices
2023
Purpose: The current paper aims to reach to verify the existence of the impact of strategic implementation practices and emotional intelligence in the entrepreneurial orientation of the University of Information and Communication Technology in Baghdad. Theoretical Framework: The main purpose of the theoretical framework is to identify all dimensions and variables of strategy implementation practices, entrepreneurship, and emotional intelligence, and thus form a deep scientific vision of the study and its variables. Design/Methodology/Approach: The main tool was to distribute a questionnaire to a sample of (50) of the advanced, intermediate and lower leadership cadres in order to conduct statistical analysis according to the (SPSS v25) program on it. Findings: The results of the statistical analysis of the data that there is an impact relationship between the implementation of the strategy by its exclusion (stakeholder participation, resource mobilization, knowledge development, and culture management), in the entrepreneurial orientation, which confirms that the leadership of the organization in question depends clearly on its capabilities in the correct implementation of the strategies formulated by it. Research, Practical & Social Implications: Three basic variables used in the paper fore dimension used to implementation practices, fore dimensions used for emotional intelligence and one dimension for entrepreneurial orientation. Originality/Value: The contribution of the paper lies in the possibility of implementing Strategies that serve organizations in formulating their entrepreneurial orientation, whose reflection contributes to the success of the research community directly or through different concepts such as emotional intelligence.
Journal Article