Articles

“The role as a champion is to not only monitor but to speak out and to educate”: the contradictory roles of hand hygiene champions

Implementation science experts define champions as “supporting, marketing, and driving through an implementation, overcoming indifference or resistance that the intervention may provoke in an organization.” Ma...

Authors: Cassie Cunningham Goedken, Daniel J. Livorsi, Michael Sauder, Mark W. Vander Weg, Emily E. Chasco, Nai-Chung Chang, Eli Perencevich and Heather Schacht Reisinger

Sustainment, Sustainability, and Spread Study (SSaSSy): protocol for a study of factors that contribute to the sustainment, sustainability, and spread of practice changes introduced through an evidence-based quality-improvement intervention in Canadian nursing homes

Implementation scientists and practitioners, alike, recognize the importance of sustaining practice change, however post-implementation studies of interventions are rare. This is a protocol for the Sustainment...

Authors: Whitney B. Berta, Adrian Wagg, Lisa Cranley, Malcolm B. Doupe, Liane Ginsburg, Matthias Hoben, Lauren MacEachern, Stephanie Chamberlain, Fiona Clement, Adam Easterbrook, Janice M. Keefe, Jennifer Knopp-Sihota, Tim Rappon, Colin Reid, Yuting Song and Carole A. Estabrooks

Identifying relevant concepts and factors for the sustainability of evidence-based practices within acute care contexts: a systematic review and theory analysis of selected sustainability frameworks

There is growing recognition among healthcare professionals that the sustainability of evidence-based practices (EBPs) within different settings is variable and suboptimal. Understanding why a particular EBP m...

Authors: Letitia Nadalin Penno, Barbara Davies, Ian D. Graham, Chantal Backman, Ibo MacDonald, Julie Bain, Alekhya Mascarenhas Johnson, Julia Moore and Janet Squires

Evaluating the implementation of the PACE Steps to Success Programme in long-term care facilities in seven countries according to the RE-AIM framework

The PACE ‘Steps to Success’ programme is a complex educational and development intervention for staff to improve palliative care in long-term care facilities (LTCFs). In a cluster randomized controlled trial, ...

Authors: Mariska Oosterveld-Vlug, Bregje Onwuteaka-Philipsen, Maud ten Koppel, Hein van Hout, Tinne Smets, Lara Pivodic, Marc Tanghe, Nele Van Den Noortgate, Jo Hockley, Sheila Payne, Danni Collingridge Moore, Violetta Kijowska, Katarzyna Szczerbińska, Marika Kylänen, Suvi Leppäaho, Claudia Mercuri…

The effectiveness of guideline implementation strategies in the dental setting: a systematic review

Guideline implementation has been an ongoing challenge in the dental practice setting. Despite this, there are no reviews summarising the existing evidence regarding effective guideline implementation strategi...

Authors: Amy R. Villarosa, Della Maneze, Lucie M. Ramjan, Ravi Srinivas, Michelle Camilleri and Ajesh George

Adapting evidence-informed complex population health interventions for new contexts: a systematic review of guidance

Adapting interventions that have worked elsewhere can save resources associated with developing new interventions for each specific context. While a developing body of evidence shows benefits of adapted interv...

Authors: A. Movsisyan, L. Arnold, R. Evans, B. Hallingberg, G. Moore, A. O’Cathain, L. M. Pfadenhauer, J. Segrott and E. Rehfuess

Process evaluation of a complex intervention to optimize quality of prescribing in nursing homes (COME-ON study)

The COME-ON study was a cluster-controlled trial of a complex intervention that consisted of a blended training program, local interdisciplinary meetings, and interdisciplinary case conferences in Belgian nurs...

Authors: Pauline Anrys, Goedele Strauven, Sandrine Roussel, Marie Vande Ginste, Jan De Lepeleire, Veerle Foulon and Anne Spinewine

Harnessing the power of theorising in implementation science

Theories occupy different positions in the scientific circle of enquiry as they vary in scope, abstraction, and complexity. Mid-range theories play a crucial bridging role between raw empirical observations an...

Authors: Roman Kislov, Catherine Pope, Graham P. Martin and Paul M. Wilson

Action, actor, context, target, time (AACTT): a framework for specifying behaviour

Designing implementation interventions to change the behaviour of healthcare providers and other professionals in the health system requires detailed specification of the behaviour(s) targeted for change to en...

Authors: Justin Presseau, Nicola McCleary, Fabiana Lorencatto, Andrea M. Patey, Jeremy M. Grimshaw and Jill J. Francis

The impact of basic vs. enhanced Go NAPSACC on child care centers’ healthy eating and physical activity practices: protocol for a type 3 hybrid effectiveness-implementation cluster-randomized trial

To prevent childhood obesity and promote healthy development, health authorities recommend that child care programs use the evidence-based practices that foster healthy eating and physical habits in children. ...

Authors: Amber E. Vaughn, Christina R. Studts, Byron J. Powell, Alice S. Ammerman, Justin G. Trogdon, Geoffrey M. Curran, Derek Hales, Erik Willis and Dianne S. Ward

Does increased implementation support improve community clinics’ guideline-concordant care? Results of a mixed methods, pragmatic comparative effectiveness trial

Disseminating care guidelines into clinical practice remains challenging, partly due to inadequate evidence on how best to help clinics incorporate new guidelines into routine care. This is particularly true i...

Authors: Rachel Gold, Arwen Bunce, Stuart Cowburn, James V. Davis, Joan C. Nelson, Christine A. Nelson, Elisabeth Hicks, Deborah J. Cohen, Michael A. Horberg, Gerardo Melgar, James W. Dearing, Janet Seabrook, Ned Mossman and Joanna Bulkley

Targeting adaptability to improve Medication Therapy Management (MTM) implementation in community pharmacy

(1) To develop an adaptation framework for MTM delivery for pharmacists (the MTM Adaptability Framework), (2) to examine the impact of an educational intervention informed by the MTM Adaptability Framework on ...

Authors: Kenneth C. Hohmeier, James S. Wheeler, Kea Turner, Jarrod S. Vick, Merrill L. Marchetti, Jeremy Crain and Andrea Brookhart

Can a multicomponent multidisciplinary implementation package change physicians’ and nurses’ perceptions and practices regarding thrombolysis for acute ischemic stroke? An exploratory analysis of a cluster-randomized trial

The Thrombolysis ImPlementation in Stroke (TIPS) trial tested the effect of a multicomponent, multidisciplinary, collaborative intervention designed to increase the rates of intravenous thrombolysis via a clus...

Authors: Md Golam Hasnain, Christopher R. Levi, Annika Ryan, Isobel J. Hubbard, Alix Hall, Christopher Oldmeadow, Alice Grady, Amanda Jayakody, John R. Attia and Christine L. Paul

Building capacity: a cross-sectional evaluation of the US Training Institute for Dissemination and Implementation Research in Health

In 2011, the National Institute of Health (NIH) initiated the Training in Dissemination and Implementation Research in Health (TIDIRH) program. Over its first 5 years, TIDIRH provided an in-person, week-long t...

Authors: Cynthia A. Vinson, Mindy Clyne, Nina Cardoza and Karen M. Emmons

The role of the outer setting in implementation: associations between state demographic, fiscal, and policy factors and use of evidence-based treatments in mental healthcare

Despite consistent recognition of their influence, empirical study of how outer setting factors (e.g., policies, financing, stakeholder relationships) influence public systems’ investment in and adoption of ev...

Authors: Eric J. Bruns, Elizabeth M. Parker, Spencer Hensley, Michael D. Pullmann, Philip H. Benjamin, Aaron R. Lyon and Kimberly E. Hoagwood

Investigation of factors influencing the implementation of two shared decision-making interventions in contraceptive care: a qualitative interview study among clinical and administrative staff

There is limited evidence on how to implement shared decision-making (SDM) interventions in routine practice. We conducted a qualitative study, embedded within a 2 × 2 factorial cluster randomized controlled t...

Authors: Sarah Munro, Ruth Manski, Kyla Z. Donnelly, Daniela Agusti, Gabrielle Stevens, Michelle Banach, Maureen B. Boardman, Pearl Brady, Chrissy Colón Bradt, Tina Foster, Deborah J. Johnson, Judy Norsigian, Melissa Nothnagle, Heather L. Shepherd, Lisa Stern, Lyndal Trevena…

Implementation of a behavioral medicine approach in physiotherapy: a process evaluation of facilitation methods

In a quasi-experimental study, facilitation was used to support implementation of the behavioral medicine approach in physiotherapy. The facilitation consisted of an individually tailored multifaceted interven...

Authors: Johanna Fritz, Lars Wallin, Anne Söderlund, Lena Almqvist and Maria Sandborgh

Elucidating the influence of supervisors’ roles on implementation climate

Supervisors play an essential role in implementation by diffusing and synthesizing information, selling implementation, and translating top management’s project plans to frontline workers. Theory and emerging ...

Authors: Alicia C. Bunger, Sarah A. Birken, Jill A. Hoffman, Hannah MacDowell, Mimi Choy-Brown and Erica Magier

Assessing the Integrated Community-Based Health Systems Strengthening initiative in northern Togo: a pragmatic effectiveness-implementation study protocol

Over the past decade, prevalence of maternal and child morbidity and mortality in Togo, particularly in the northern regions, has remained high despite global progress. The causes of under-five child mortality...

Authors: Molly E. Lauria, Kevin P. Fiori, Heidi E. Jones, Sesso Gbeleou, Komlan Kenkou, Sibabe Agoro, Abdourahmane Diparidé Agbèrè, Kelly D. Lue and Lisa R. Hirschhorn

Capturing implementation knowledge: applying focused ethnography to study how implementers generate and manage knowledge in the scale-up of obesity prevention programs

Bespoke electronic information management systems are being used for large-scale implementation delivery of population health programs. They record sites reached, coordinate activity, and track target achievem...

Authors: Kathleen P. Conte, Abeera Shahid, Sisse Grøn, Victoria Loblay, Amanda Green, Christine Innes-Hughes, Andrew Milat, Lina Persson, Mandy Williams, Sarah Thackway, Jo Mitchell and Penelope Hawe

Facilitating action planning within audit and feedback interventions: a mixed-methods process evaluation of an action implementation toolbox in intensive care

Audit and feedback (A&F) is more effective if it facilitates action planning, but little is known about how best to do this. We developed an electronic A&F intervention with an action implementation toolbox to...

Authors: Wouter T. Gude, Marie-José Roos-Blom, Sabine N. van der Veer, Dave A. Dongelmans, Evert de Jonge, Niels Peek and Nicolette F. de Keizer

Correction to: A repeated cross-sectional study of clinicians’ use of psychotherapy techniques during 5 years of a system-wide effort to implement evidence-based practices in Philadelphia

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Authors: Rinad S. Beidas, Nathaniel J. Williams, Emily M. Becker-Haimes, Gregory A. Aarons, Frances K. Barg, Arthur C. Evans, Kamilah Jackson, David Jones, Trevor Hadley, Kimberly Hoagwood, Steven C. Marcus, Geoffrey Neimark, Ronnie M. Rubin, Sonja K. Schoenwald, Danielle R. Adams, Lucia M. Walsh…

Implementation of the uterine fibroids Option Grid patient decision aids across five organizational settings: a randomized stepped-wedge study protocol

Uterine fibroids are non-cancerous overgrowths of the smooth muscle in the uterus. As they grow, some cause problems such as heavy menstrual bleeding, pelvic pain, discomfort during sexual intercourse, and rar...

Authors: Peter Scalia, Marie-Anne Durand, Rachel C. Forcino, Danielle Schubbe, Paul J. Barr, Nancy O’Brien, A. James O’Malley, Tina Foster, Mary C. Politi, Shannon Laughlin-Tommaso, Erika Banks, Tessa Madden, Raymond M. Anchan, Johanna W. M. Aarts, Priscilla Velentgas, Joyce Balls-Berry…

Inclusion of a care bundle for fever, hyperglycaemia and swallow management in a National Audit for acute stroke: evidence of upscale and spread

In the Quality in Acute Stroke Care (QASC) trial undertaken in stroke units (SUs) located in New South Wales (NSW), Australia (2005–2010), facilitated implementation of a nurse-led care bundle to manage fever,...

Authors: Tara Purvis, Sandy Middleton, Louise E. Craig, Monique F. Kilkenny, Simeon Dale, Kelvin Hill, Catherine D’Este and Dominique A. Cadilhac

Implementing cardiovascular disease prevention guidelines to translate evidence-based medicine and shared decision making into general practice: theory-based intervention development, qualitative piloting and quantitative feasibility

The use of cardiovascular disease (CVD) prevention guidelines based on absolute risk assessment is poor around the world, including Australia. Behavioural barriers amongst GPs and patients include capability (...

Authors: Carissa Bonner, Michael Anthony Fajardo, Jenny Doust, Kirsten McCaffery and Lyndal Trevena

The effect of a clinical decision support system on prompting an intervention for risky alcohol use in a primary care smoking cessation program: a cluster randomized trial

Clinical decision support systems (CDSSs) may promote practitioner adherence to evidence-based guidelines. This study examined if the addition of a CDSS influenced practitioner delivery of a brief intervention...

Authors: Nadia Minian, Dolly Baliunas, Aliya Noormohamed, Laurie Zawertailo, Norman Giesbrecht, Christian S. Hendershot, Bernard Le Foll, Jürgen Rehm, Andriy V. Samokhvalov and Peter L. Selby

Understanding the influences on successful quality improvement in emergency general surgery: learning from the RCS Chole-QuIC project

Acute gallstone disease is the highest volume Emergency General Surgical presentation in the UK. Recent data indicate wide variations in the quality of care provided across the country, with national guidance ...

Authors: Timothy J. Stephens, Jonathan R. Bamber, Ian J. Beckingham, Ellie Duncan, Nial F. Quiney, John F. Abercrombie and Graham Martin

Spread tools: a systematic review of components, uptake, and effectiveness of quality improvement toolkits

The objective was to conduct a systematic review of toolkit evaluations intended to spread interventions to improve healthcare quality. We aimed to determine the components, uptake, and effectiveness of public...

Authors: Susanne Hempel, Claire O’Hanlon, Yee Wei Lim, Margie Danz, Jody Larkin and Lisa Rubenstein

Implementation interventions for musculoskeletal programs of care in the active military and barriers, facilitators, and outcomes of implementation: a scoping review

Musculoskeletal disorders are common in the active military and are associated with significant lost duty days and disability. Implementing programs of care to manage musculoskeletal disorders can be challengi...

Authors: Carol Cancelliere, Deborah Sutton, Pierre Côté, Simon D. French, Anne Taylor-Vaisey and Silvano A. Mior

Using a RE-AIM framework to identify promising practices in National Diabetes Prevention Program implementation

The National Diabetes Prevention Program (National DPP) is rapidly expanding in an effort to help those at high risk of type 2 diabetes prevent or delay the disease. In 2012, the Centers for Disease Control an...

Authors: Kunthea Nhim, Stephanie M. Gruss, Deborah S. Porterfield, Sara Jacobs, Wendi Elkins, Elizabeth T. Luman, Susan Van Aacken, Patricia Schumacher and Ann Albright

Designing high-quality implementation research: development, application, feasibility and preliminary evaluation of the implementation science research development (ImpRes) tool and guide

Designing implementation research can be a complex and daunting task, especially for applied health researchers who have not received specialist training in implementation science. We developed the Implementat...

Authors: Louise Hull, Lucy Goulding, Zarnie Khadjesari, Rachel Davis, Andy Healey, Ioannis Bakolis and Nick Sevdalis

Status and potential of bacterial genomics for public health practice: a scoping review

Next-generation sequencing (NGS) is increasingly being translated into routine public health practice, affecting the surveillance and control of many pathogens. The purpose of this scoping review is to identif...

Authors: Nina Van Goethem, Tine Descamps, Brecht Devleesschauwer, Nancy H. C. Roosens, Nele A. M. Boon, Herman Van Oyen and Annie Robert

Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services

Advanced physiotherapist-led services have been embedded in specialist orthopaedic and neurosurgical outpatient departments across Queensland, Australia, to ameliorate capacity constraints. Simulation modellin...

Authors: Nicole Moretto, Tracy A. Comans, Angela T. Chang, Shaun P. O’Leary, Sonya Osborne, Hannah E. Carter, David Smith, Tania Cavanagh, Dean Blond and Maree Raymer

Implementation Science and Implementation Science Communications: our aims, scope, and reporting expectations

In the 13 years since the inception of Implementation Science, we have witnessed a continued rise in the number of submissions, reflecting the growing global interest in methods to enhance the uptake of research ...

Authors: Anne E. Sales, Paul M. Wilson, Michel Wensing, Gregory A. Aarons, Rebecca Armstrong, Signe Flottorp, Alison M. Hutchinson, Justin Presseau, Anne Rogers, Nick Sevdalis, Janet Squires, Sharon Straus and Bryan J. Weiner

Implementation effectiveness of health interventions for indigenous communities: a systematic review

Translating research into practice is an important issue for implementing health interventions effectively for Indigenous communities. He Pikinga Waiora (HPW) is a recent implementation framework that provides...

Authors: Truely Harding and John Oetzel

Impact of removal and restriction of me-too medicines in a hospital drug formulary on in- and outpatient drug prescriptions: interrupted time series design with comparison group

The study covered in- and out-of-hospital care in a region in north-western Spain. The intervention evaluated took the form of a change in the hospital drugs formulary. Before the intervention, the formulary c...

Authors: Raquel Vázquez-Mourelle, Eduardo Carracedo-Martínez and Adolfo Figueiras

In-depth comparison of two quality improvement collaboratives from different healthcare areas based on registry data—possible factors contributing to sustained improvement in outcomes beyond the project time

Quality improvement collaboratives (QICs) are widely used to improve healthcare, but there are few studies of long-term sustained improved outcomes, and inconsistent evidence about what factors contribute to s...

Authors: Beatrix Algurén, Annika Nordin, Boel Andersson-Gäre and Anette Peterson

What is full capacity protocol, and how is it implemented successfully?

Full capacity protocol (FCP) is an internationally recognized intervention designed to address emergency department (ED) crowding. Despite FCP international recognition and positive effects on hospital perform...

Authors: Amir Alishahi Tabriz, Sarah A. Birken, Christopher M. Shea, Bruce J. Fried and Peter Viccellio

Use of health economic evaluation in the implementation and improvement science fields—a systematic literature review

Economic evaluation can inform whether strategies designed to improve the quality of health care delivery and the uptake of evidence-based practices represent a cost-effective use of limited resources. We repo...

Authors: Sarah Louise Elin Roberts, Andy Healey and Nick Sevdalis

Proceedings from the 2nd Annual UK Implementation Science Research Conference, 'Advancing the science of scaling up: Improving efficiency and effectiveness of implementation strategies in healthcare': meeting abstracts

Authors:

Guideline-based quality indicators—a systematic comparison of German and international clinical practice guidelines

Evidence-based clinical practice guidelines (CPGs) are relevant sources for generating quality indicators (QIs). The objective of this study was to compare guideline-based QIs of German and international CPGs ...

Authors: Monika Becker, Jessica Breuing, Monika Nothacker, Stefanie Deckert, Marie Brombach, Jochen Schmitt, Edmund Neugebauer and Dawid Pieper

To do or not to do—balancing governance and professional autonomy to abandon low-value practices: a study protocol

Many interventions used in health care lack evidence of effectiveness and may be unnecessary or even cause harm, and should therefore be de-implemented. Lists of such ineffective, low-value practices are commo...

Authors: Henna Hasson, Per Nilsen, Hanna Augustsson, Sara Ingvarsson, Sara Korlén and Ulrica von Thiele Schwarz

Disseminating and implementing a lifestyle-based healthy weight program for mothers in a national organization: a study protocol for a cluster randomized trial

Excessive weight gain among young adult women age 18–45 years is an alarming and overlooked trend that must be addressed to reverse the epidemics of obesity and chronic disease. During this vulnerable period, ...

Authors: Rachel G. Tabak, Cynthia D. Schwarz, Allison Kemner, Kenneth B. Schechtman, Karen Steger-May, Veronda Byrth and Debra Haire-Joshu

A repeated cross-sectional study of clinicians’ use of psychotherapy techniques during 5 years of a system-wide effort to implement evidence-based practices in Philadelphia

Little work investigates the effect of behavioral health system efforts to increase use of evidence-based practices or how organizational characteristics moderate the effect of these efforts. The objective of ...

Authors: Rinad S. Beidas, Nathaniel J. Williams, Emily M. Becker-Haimes, Gregory A. Aarons, Frances K. Barg, Arthur C. Evans, Kamilah Jackson, David Jones, Trevor Hadley, Kimberly Hoagwood, Steven C. Marcus, Geoffrey Neimark, Ronnie M. Rubin, Sonja K. Schoenwald, Danielle R. Adams, Lucia M. Walsh…

Training in Implementation Practice Leadership (TRIPLE): evaluation of a novel practice change strategy in behavioral health organizations

Effective leadership for organizational change is critical to the implementation of evidence-based practices (EBPs). As organizational leaders in behavioral health organizations often are promoted from within ...

Authors: Enola Proctor, Alex T. Ramsey, Matthew T. Brown, Sara Malone, Cole Hooley and Virginia McKay

Scaling Up Safer Birth Bundle Through Quality Improvement in Nepal (SUSTAIN)—a stepped wedge cluster randomized controlled trial in public hospitals

Each year, 2.2 million intrapartum-related deaths (intrapartum stillbirths and first day neonatal deaths) occur worldwide with 99% of them taking place in low- and middle-income countries. Despite the accelera...

Authors: Rejina Gurung, Anjani Kumar Jha, Susheel Pyakurel, Abhishek Gurung, Helena Litorp, Johan Wrammert, Bijay Kumar Jha, Prajwal Paudel, Syed Moshfiqur Rahman, Honey Malla, Srijana Sharma, Manish Gautam, Jorgen Erland Linde, Md Moinuddin, Uwe Ewald, Mats Målqvist…

Investigating midwives’ barriers and facilitators to multiple health promotion practice behaviours: a qualitative study using the theoretical domains framework

In addition to their more traditional clinical role, midwives are expected to perform various health promotion practice behaviours (HePPBes) such as informing pregnant women about the benefits of physical acti...

Authors: Julie M. McLellan, Ronan E. O’Carroll, Helen Cheyne and Stephan U. Dombrowski

The clinician crowdsourcing challenge: using participatory design to seed implementation strategies

In healthcare settings, system and organization leaders often control the selection and design of implementation strategies even though frontline workers may have the most intimate understanding of the care de...

Authors: Rebecca E. Stewart, Nathaniel Williams, Y. Vivian Byeon, Alison Buttenheim, Sriram Sridharan, Kelly Zentgraf, David T. Jones, Katelin Hoskins, Molly Candon and Rinad S. Beidas

Improving HIV service delivery for people who inject drugs in Kazakhstan: study protocol for the Bridge stepped-wedge trial

People who inject drugs (PWID) in Kazakhstan face many barriers to HIV testing as well as to accessing HIV care, to retention in HIV care, and to initiating and adhering to anti-retroviral treatment (ART). Nee...

Authors: Tara McCrimmon, Louisa Gilbert, Timothy Hunt, Assel Terlikbayeva, Elwin Wu, Meruyert Darisheva, Sholpan Primbetova, Azamat Kuskulov, Alissa Davis, Anindita Dasgupta, Bruce R. Schackman, Lisa R. Metsch, Daniel J. Feaster, Baurzhan Baiserkin and Nabila El-Bassel

Correction to: Addressing challenges in scaling up TB and HIV treatment integration in rural primary healthcare clinics in South Africa (SUTHI): a cluster randomized controlled trial protocol

Following publication of the original article [1], the authors reported an error in the wording of the study hypothesis. The error occurs in the Aims and Objectives sub-section of the Methods section and is hi...

Authors: Kogieleum Naidoo, Santhanalakshmi Gengiah, Nonhlanhla Yende-Zuma, Nesri Padayatchi, Pierre Barker, Andrew Nunn, Priashni Subrayen and Salim S. Abdool Karim