Aligning implementation and user-centered design strategies to enhance the impact of health services: results from a concept mapping study

Abstract

Background: Innovative approaches are needed to maximize fit between the characteristics of evidence-based practices (EBPs), implementation strategies that support EBP use, and contexts in which EBPs are implemented. Standard approaches to implementation offer few ways to address such issues of fit. We characterized the potential for collaboration with experts from a relevant complementary approach, user-centered design (UCD), to increase successful implementation. Method: Using purposive and snowball sampling, we recruited 56 experts in implementation (n = 34) or UCD (n = 22). Participants had 5+ years of professional experience (M = 10.31), worked across many settings (e.g., healthcare, education, human services), and were mostly female (59%) and white (73%). Each participant completed a webbased concept mapping structured conceptualization task. They sorted strategies from established compilations for implementation (36 strategies) and UCD (30 strategies) into distinct clusters, then rated the importance and feasibility of each strategy. Results: We used multidimensional scaling techniques to examine patterns in the sorting of strategies. Based on conceptual clarity and fit with established implementation frameworks, we selected a final set of 10 clusters (i.e., groups of strategies), with five implementation-only clusters, two UCD-only clusters, and three trans-discipline clusters. The highest-priority activities (i.e., above-average importance and feasibility) were the trans-discipline clusters plus facilitate change and monitor change. Implementation and UCD experts sorted strategies into similar clusters, but each gave higher importance and feasibility ratings to strategies/clusters from their own discipline. Conclusions: In this concept mapping study, experts in implementation and UCD had perspectives that both converged (e.g., trans-discipline clusters, which were all rated as high-priority) and diverged (e.g., in importance/ feasibility ratings). The results provide a shared understanding of the alignment between implementation science and UCD, which can increase the impact and sustainability of EBP implementation efforts. Implications for improved collaboration among implementation and UCD experts are discussed.

Design and impact evaluation of a digital reproductive health program in Rwanda using a cluster randomized design: study protocol

“…Attending a study school at baseline Between 12 and 19 years of age Consent (for participants ages [18][19] or assent (for participants under 18) provided to participate Parental consent provided (for participants under 18) Willingness to provide valid contact information for study follow-up purposes.…”

“…CyberRwanda is a digital intervention for urban and peri-urban youth aged [12][13][14][15][16][17][18][19]. Designed in partnership with youth and their communities, it combines ageappropriate storytelling content about FP/RH and economic empowerment, with discreet, streamlined access to contraception and other essential products from trained pharmacists through a mobile ordering platform.…”

Facilitators and “deal breakers”: a mixed methods study investigating implementation of the Goal setting and action planning (G-AP) framework in community rehabilitation teams

“…The unfolding interaction between an intervention and the setting in which it is delivered is integral to the implementation process [39][40][41]. Services inevitably need to adapt, to varying degrees, to create a workable fit between the two [39,42].…”

“…Commitment and engagement from those in a position to effect change is essential to successful implementation [40][41][42]. So too is the role of 'champions' who can motivate and tailor implementation efforts in local settings [40,43].…”

“…Commitment and engagement from those in a position to effect change is essential to successful implementation [40][41][42]. So too is the role of 'champions' who can motivate and tailor implementation efforts in local settings [40,43]. Our findings suggested that in Team C, competing priorities experienced by those in leadership positions and staff changes (resulting in loss of a G-AP champion) may explain to some extent why the necessary changes to organisational structures and clinical processes required to support successful G-AP implementation were not forthcoming.…”