Implementation strategies: recommendations for specifying and reporting

Implementation strategies: recommendations for specifying and reporting

2013 | Enola K Proctor, Byron J Powell and J Curtis McMillen
Implementation strategies are crucial in implementation science as they determine how healthcare practices are changed. However, these strategies are often inconsistently labeled, poorly described, and lack theoretical justification, operational definitions, or manuals. This makes it difficult to test their effectiveness and develop an evidence base for their efficiency, cost, and impact. The authors propose guidelines for naming, defining, and operationalizing implementation strategies across seven dimensions: actor, action, action targets, temporality, dose, implementation outcomes addressed, and theoretical justification. These guidelines aim to improve the reporting of implementation strategies in research studies and encourage further identification of elements relevant to implementation strategies for reporting guidelines. Implementation strategies vary in complexity and can be single-component or multifaceted. They include methods for provider training, intervention-specific tools, formal protocols, learning collaboratives, and economic strategies. The complexity of these strategies makes them challenging to describe, operationalize, and measure. To address this, the authors suggest that implementation strategies should be clearly named, defined, and operationalized to ensure they are comparable and evaluable. This includes specifying the actors involved, the actions taken, the targets of the actions, the timing, the frequency and intensity of the strategy, the implementation outcomes addressed, and the theoretical justification for the strategy. The authors also emphasize the importance of specifying the dose or intensity of implementation strategies, as this is critical for understanding their effectiveness. They recommend that implementation strategies be described in detail, including how they are to be enacted, to facilitate replication and comparison. The authors suggest that journals adopt reporting guidelines to ensure consistency in the description of implementation strategies, which will help in meta-analyses, replication, and the translation of findings into real-world healthcare improvements. They also highlight the need for national or international consensus processes to formalize and extend these guidelines.Implementation strategies are crucial in implementation science as they determine how healthcare practices are changed. However, these strategies are often inconsistently labeled, poorly described, and lack theoretical justification, operational definitions, or manuals. This makes it difficult to test their effectiveness and develop an evidence base for their efficiency, cost, and impact. The authors propose guidelines for naming, defining, and operationalizing implementation strategies across seven dimensions: actor, action, action targets, temporality, dose, implementation outcomes addressed, and theoretical justification. These guidelines aim to improve the reporting of implementation strategies in research studies and encourage further identification of elements relevant to implementation strategies for reporting guidelines. Implementation strategies vary in complexity and can be single-component or multifaceted. They include methods for provider training, intervention-specific tools, formal protocols, learning collaboratives, and economic strategies. The complexity of these strategies makes them challenging to describe, operationalize, and measure. To address this, the authors suggest that implementation strategies should be clearly named, defined, and operationalized to ensure they are comparable and evaluable. This includes specifying the actors involved, the actions taken, the targets of the actions, the timing, the frequency and intensity of the strategy, the implementation outcomes addressed, and the theoretical justification for the strategy. The authors also emphasize the importance of specifying the dose or intensity of implementation strategies, as this is critical for understanding their effectiveness. They recommend that implementation strategies be described in detail, including how they are to be enacted, to facilitate replication and comparison. The authors suggest that journals adopt reporting guidelines to ensure consistency in the description of implementation strategies, which will help in meta-analyses, replication, and the translation of findings into real-world healthcare improvements. They also highlight the need for national or international consensus processes to formalize and extend these guidelines.
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Understanding Implementation strategies%3A recommendations for specifying and reporting