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

Abstract

Background 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 Implementation Science Research Development (ImpRes) tool and supplementary guide to address this challenge and provide researchers with a systematic approach to designing implementation research. Methods A multi-method and multi-stage approach was employed. An international, multidisciplinary expert panel engaged in an iterative brainstorming and consensus-building process to generate core domains of the ImpRes tool, representing core implementation science principles and concepts that researchers should consider when designing implementation research. Simultaneously, an iterative process of reviewing the literature and expert input informed the development and content of the tool. Once consensus had been reached, specialist expert input was sought on involving and engaging patients/service users; and economic evaluation. ImpRes was then applied to 15 implementation and improvement science projects across the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London, a research organisation in London, UK. Researchers who applied the ImpRes tool completed an 11-item questionnaire evaluating its structure, content and usefulness. Results Consensus was reached on ten implementation science domains to be considered when designing implementation research. These include implementation theories, frameworks and models, determinants of implementation, implementation strategies, implementation outcomes and unintended consequences. Researchers who used the ImpRes tool found it useful for identifying project areas where implementation science is lacking (median 5/5, IQR 4–5) and for improving the quality of implementation research (median 4/5, IQR 4–5) and agreed that it contained the key components that should be considered when designing implementation research (median 4/5, IQR 4–4). Qualitative feedback from researchers who applied the ImpRes tool indicated that a supplementary guide was needed to facilitate use of the tool. Conclusions We have developed a feasible and acceptable tool, and supplementary guide, to facilitate consideration and incorporation of core principles and concepts of implementation science in applied health implementation research. Future research is needed to establish whether application of the tool and guide has an effect on the quality of implementation research.

Dissemination, implementation, and de-implementation: the trauma perspective

“…Quantitative data may include scores on scales validated to examine concepts such as organizational readiness to change and Organizational Change Manager scores 25. While CFIR is the most widely adopted, there are other tools such as the Implementation Science Research Development (ImpRes) offered to help design high-quality implementation research 26…”

Implementation outcome instruments for use in physical healthcare settings: a systematic review

“…Implementation research aims to close the research-topractice gap, support scale-up of evidence-based interventions and reduce research waste [1,2]. The field of implementation science has gained recognition over the last 10 years, with advances in effectiveness-implementation hybrid designs [3], frameworks that inform the determinants, processes and evaluation of implementation efforts [4][5][6][7], reporting guidance [8] and educational resources [9]. An essential component of these recent developments, and of the field as a whole, is the use of valid and reliable implementation outcome instruments.…”

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

“…[57] Fidelity assessment (process evaluation) [58] Mechanism of change (process evaluation) [59] Action Using the Theory Comparison and Selection Tool (T-CaST) and checklist [51], the AACTT framework is designed to be usable (includes relevant domains, has been developed so that key stakeholders can use it, we provide steps for its application and methods for promoting its application across a range of possible studies and an explanation for how the domains influence each other), testable/valid (can form the basis for testable hypotheses, includes face-valid explanations and has been used in empirical studies), applicable (focuses on a key implementation outcome, can be applied across a range of methods and across a range of analytical levels, populations and conditions and is generalisable across disciplines) and is likely to be acceptable (to key stakeholders, and is the historical evolution of a framework rooted in a particular discipline). Thus, in principle it fulfils all the criteria for use of a framework by implementation science researchers and practitioners, though its actual usability, testability, applicability and acceptability will ultimately be determined through application of the tool across a range of types of implementation research [52].…”