Context Matters, So How Do We Get Better at Working With Context in Implementation Research and Practice? Comment on "Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-country Analysis"

Abstract

In the field of implementation research, it is widely recognised that ‘context matters’. Attempts to implement innovations, research and new knowledge into practice invariably meet contextual challenges at multiple levels during the process of implementation. The paper by Squires and colleagues provides a detailed insight into the many different features and attributes of context. Yet, as this commentary argues, there are significant challenges ahead if we are to apply our growing understanding about context to improve the practice of implementation in everyday health care. This will require attention to the practicalities of working with context to achieve successful implementation.

Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Response to Recent Commentaries

“…The ICON framework outlines what attributes of context to consider when planning or implementing ways of meaningfully integrating these concepts in their research or during implementation. We agree with Cairney 2 and Harvey 4 who stated that access to resources plays an important role in implementation. We also believe that context could differ in non-English speaking countries as proposed by Eldh 13 and Rycroft-Malone, 3 and differ in countries considered as part of the Global South as proposed by Gagnon 5 and van Pelt and Beidas.…”

“…Our approach aligns with Harvey’s 4 and Pfadenhauer’s 6 recommendations that researchers should use multiple methodologies to address conceptual problems. We agree with Pfadenhauer 6 , van Pelt and Beidas 10 who commented that our qualitative interview study with health system stakeholders provides important insights about the context concept.…”

“…We agree with Van Pelt and Beidas’ 10 assertion that a list of context attributes and their definitions can act as a shared vocabulary between researchers and knowledge users, which can further encourage collaboration amongst these groups. Harvey 4 reported that based on the findings of the system stakeholder qualitative paper, 1 culture and resources should be the main foci as they were consistently mentioned by system stakeholders. Her comment 4 provides insight on how we might integrate the research evidence we compiled in developing ICON to inform decisions related to practice and policy.…”

“…Harvey 4 reported that based on the findings of the system stakeholder qualitative paper, 1 culture and resources should be the main foci as they were consistently mentioned by system stakeholders. Her comment 4 provides insight on how we might integrate the research evidence we compiled in developing ICON to inform decisions related to practice and policy.…”

“…The interrelationships between these elements mean that changes in one element can influence change in many other elements of the system. 7 Harvey 4 emphasizes the importance of developing tools that can help individuals prioritize the context attributes that should be assessed and evaluated. We agree with these commentaries.…”