Table 2 Contextual variables for implementation across ecological levels
From: Revisiting concepts of evidence in implementation science
Ecological level | Examples |
|---|---|
Individual | Education level Race/ethnicity/age/gender Geography/rurality Basic human needsa Personal health history Readiness/motivation to undergo testing or therapy Literacy and numeracy Trust, mistrust, distrust Stigma Stress and distress Resilience Genotype and phenotype Motivation Values |
Interpersonal | Family health history Support from peers Social capital Social networks Social support from family, friends, coworkers, healthcare providers |
Organizational | Staff composition Staff expertise, experience, and skills Physical infrastructure Organizational and financial resources Organizational climate and culture Leadership Degree of participatory decision-making Density of organizational ties Centrality of agencies in a community Institutional racism Psychological safety Mission and priorities Guidelines and incentives Processes and procedures Training and retraining Norms Stability |
Socio-cultural and community | Social norms and values Cultural norms, values, traditions Health equity History Societal stigma Community capacity, priorities, assets Local resources and investments Structural racism Shared mental models Neighborhood characteristics Access to healthcare and health promoting resources |
Political and economic structures and systems | Societal values Political will Political ideology Lobbying and special interests Costs and benefits Professional guidelines Policies and regulations (both Big P and small p) |