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Table 7 Illustration of Guide content: sample material for a sub-element

From: A Guide for applying a revised version of the PARIHS framework for implementation

Related Sub-elements Conceptual definitions Detailed observations regarding sub-elements Sample, optional questions to guide formative evaluation
Leadership support Leadership = Individuals in designated positions "...at any level of the organization including executive leaders, middle management, front-line supervisors, and team leaders, who have a direct or indirect influence on the implementation" [7]
Leadership Support = Behaviors, [verbalized] attitudes, and actions of leaders that reflect readiness or receptivity to a change [17]
• In general, relevant leaders' "supportive" actions can be characterized by various types of managerial behaviors or responsibilities, within a change/innovation situation such as EBP, as listed below. These are not directly taken from the original PARIHS framework but rather have been adapted based on the following: a task-oriented view of related PARIHS sub-elements, supplemental information from relevant papers [17][36, 37], relevant EBP behaviors of transformational leaders [17], and an effort to use language more familiar to targeted researchers.
Role clarity, e.g., ensuring transparency regarding both project-related and relevant change-related role responsibilities and accountabilities.
• To what extent do leaders show active and visible support for this change or this type of EBP and implementation?
Is the leader willing to engage with the study team for planning?
Is the leader willing to provide connections/entrees for the study team?
Does the leader have experience/comfort in this role?
Does the leader hold service directors accountable for collaboration and coordination in such change efforts/in this effort?
• To what extent are appropriate stakeholders or teams held accountable and incentivized or rewarded to carry out the implementation?
What about past experiences with this type of change?
• To what extent does the leader indicate the willingness to and in fact does the leader communicate the priority of this implementation?
  1. PARIHS = Promoting Action on Research Implementation in Health Services; EBP = evidence-based practice.