Table 4 Example for describing the temporal roles that stakeholders play in policy D&I over time (Recommendation 4)

Example scenario

The Ministry of Health is proposing policy that would legalize overdose prevention centers to provide a sanctioned, safe space for individuals to consume personal drugs in a medically supervised setting. A coalition of harm reduction organizations lobby for the adoption of this policy by providing research that demonstrates that overdose prevention centers are associated with increased rates of initiation and engagement in substance use treatment, reduced rates of fatal and nonfatal overdose, and reduced rates of HIV and hepatitis C transmission. Once the law is passed, the coalition of harm reduction organizations and a local hospital help to implement by allocating trained staff for overdose prevention centers using their existing resources.

EPIS framework application steps

Determine which EPIS phases are relevant to this dissemination and implementation effort (see “Recommendation 3: Identify and define the nonlinear phases of policy D&I across contexts”).

  • This scenario focuses on the exploration, preparation, and implementation phases.

1. Conduct document review, ethnographic observation, network analysis, surveys, or interviews to identify which Ministry of Health stakeholders were acutely involved in each phase.

  • Identify Ministry of Health stakeholders who were part of the adoption decision during the exploration phase.

  • Identify stakeholders tasked with assessing the potential barriers and facilitators of an overdose prevention center during the preparation phase.

  • Identify which stakeholders were involved in implementation of the policy and creation of the overdose prevention center.

2. Use qualitative methods to describe factors that influence specific stakeholder behavior in each phase and whether those roles change over time.

  • Describe which factors led policymakers to explore, prepare, and implement policy legalizing overdose prevention centers.

  • Investigate how the coalition of harm reduction organizations originally served as an intermediary bridging factor, providing evidence to policymakers during the preparation phase.

  • The harm reduction organizations and the hospital became inner context frontline implementers during the implementation phase after the law was passed.