Economic evaluation in implementation science: Making the business case for implementation strategies

Eisman, Andria B.; Kilbourne, Amy M.; Dopp, Alex R.; Saldana, Lisa; Eisenberg, Daniel

doi:10.1016/j.psychres.2019.06.008

Cited by 116 publications

(133 citation statements)

References 29 publications

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“…The assessment of cost was increased to move beyond cost of implementation and implementation strategies, cost effectiveness, and budget impact analysis to a more comprehensive assessment across RE-AIM dimensions. This aligns with the importance of a wide range of cost considerations used by policy makers and organizational leaders ( 16 ). The area of cost assessment and analysis in dissemination and implementation science is emerging ( 16 , 19 ) and the expanded cost metrics provide a methodology for assessing costs related to reach, adoption, implementation, and organizational maintenance—with a focus on both the strategies used to enhance each outcome and the operational costs associated with each dimension.…”

Section: Discussionsupporting

confidence: 62%

“…The training costs are distinct from the ongoing operational costs for intervention implementation. In addition to these two costs, specific budget impact assessments ( 16 ) are included to provide practical information for implementation sites.…”

Section: Resultsmentioning

confidence: 99%

“…Gaps identified across the RE-AIM framework and the IOF were also considered and addressed through a proposed expansion of the operational definitions of RE-AIM indicators. Specifically, while cost and adaptation have both been discussed and examined in the context of both frameworks—methods to operationalize both have been limited ( 4 , 7 , 16 – 19 ). Framework operational definitions based on the cross tabular comparisons are shown in Table 2 .…”

Section: Methodsmentioning

confidence: 99%

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Comparing, Contrasting, and Integrating Dissemination and Implementation Outcomes Included in the RE-AIM and Implementation Outcomes Frameworks

Reilly

Kennedy

Porter

et al. 2020

Front. Public Health

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As the field of dissemination and implementation science matures, there are a myriad of outcomes, identified in numerous frameworks, that can be considered across individual, organizational, and population levels. This can lead to difficulty in summarizing literature, comparing across studies, and advancing translational science. This manuscript sought to (1) compare, contrast, and integrate the outcomes included in the RE-AIM and Implementation Outcomes Frameworks (IOF) and (2) expand RE-AIM indicators to include relevant IOF dissemination and implementation outcomes. Cross tabular comparisons were made between the constitutive definitions of each construct, across frameworks, to reconcile apparent discrepancies between approaches and to distinguish between implementation outcomes and implementation antecedents. A great deal of consistency was identified across approaches, including adoption (the intention, initial decision, or action to employ an evidence-based intervention), fidelity/implementation (the degree to which an intervention was delivered as intended), organizational maintenance/sustainability (extent to which a newly implemented treatment is maintained or institutionalized), and cost. The IOF construct of penetration was defined as a higher-order construct that may encompass the reach, adoption, and organizational maintenance outcomes within RE-AIM. Within the IOF approach acceptability, appropriateness, and feasibility did not match constitutive definitions of dissemination or implementation but rather reflected theoretical antecedents of implementation outcomes. Integration of the IOF approach across RE-AIM indicators was successfully achieved by expanding the operational definitions of RE-AIM to include antecedents to reach, adoption, implementation, and organizational maintenance. Additional combined metrics were also introduced including penetration, individual level utility, service provider utility, organizational utility, and systemic utility. The expanded RE-AIM indicators move beyond the current approaches described within both the RE-AIM framework and IOF and provides additional planning and evaluation targets that can contribute to the scientific field and increase the translation of evidence into practice.

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Section: Discussionsupporting

confidence: 62%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Comparing, Contrasting, and Integrating Dissemination and Implementation Outcomes Included in the RE-AIM and Implementation Outcomes Frameworks

Reilly

Kennedy

Porter

et al. 2020

Front. Public Health

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“…Testing the cost-effectiveness of an IS that has been shown to have superior effectiveness, relative to an active-control IS, is termed IR testing an upper right quadrant (URQ) hypothesis. It is considered a priority testable hypothesis for IR as knowing the effectiveness of an intervention/strategy is not su cient for many potential users, especially decision makers who need to know whether the bene ts from the intervention/strategy are commensurate with its costs (i.e., whether it delivers value), [35][36][37][38] Further, noting that economic evaluation of implementation strategies "has been neglected," Foy et al encouraged IR with an economic evaluation component. 22 Building upon Garner et al (2012), 31 which found pay-for-performance to be an effective IS for improving the implementation and effectiveness of A-CRA in a superiority trial, Garner et al (2018) 39 provide an example of IR testing an URQ hypothesis.…”

Section: Three Priority Aims For Implementation Researchmentioning

confidence: 99%

Priority domains, aims, and testable hypotheses for implementation research: Protocol for a scoping review and evidence map

Garner

Kirk

2020

Preprint

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Background: The challenge of implementing evidence-based innovations within practice settings is a significant public health issue the field of implementation research (IR) is focused on addressing. Significant amounts of funding, time, and effort have been invested in IR to date, yet there remains significant room for advancement, especially regarding IR’s development of scientific theories as defined by the National Academy of Sciences (i.e., a comprehensive explanation of the relationship between variables that is supported by a vast body of evidence). Research priority setting (i.e., promoting consensus about areas where research effort will have wide benefits to society) is a key approach to helping accelerate research advancements. Thus, building upon existing IR, general principles of data reduction, and a general framework for moderated mediation, this article identifies four priority domains, three priority aims, and four testable hypotheses for IR, which we organize in the priority aims and testable hypotheses (PATH) diagram..Methods: The objective of this scoping review is to map the extent to which IR has examined the identified PATH priorities to date. Because Implementation Science is the leading journal for publishing IR and receives over 800 submissions annually, our sample will include IR (specifically, original research articles and short reports) published in Implementation Science between its inception in 2006 and December 2019. The protocol for the current scoping review and evidence map has been developed in accordance with the approach developed by Arksey & O’Malley and advanced by Levac, Colquhoun, and O’Brien. Because scoping reviews seek to provide an overview of the identified evidence base rather than synthesize findings from across studies, we plan to use our data-charting form to provide a descriptive overview of implementation research to-date and summarize the research via one or more summary tables. We will use the PATH diagram to organize a map of the evidence to date.Discussion: This scoping review and evidence map is intended to help accelerate IR focused on suggested priority aims and testable hypotheses, which in turn will accelerate IR’s development of National Academy of Sciences-defined scientific theories and, subsequently, improvements in public health.Systematic review registration: Open Science Framework: https://osf.io/3vhuj/

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“…Recent work now provides a primer on the different types and methods of economic evaluations used in implementation science. 12,13 The study by Ritchie et al 5 used methods to document the various activities performed by facilitators and their time spent on these activities on a regular basis. The study's approach can provide a template to guide similar efforts to measure implementation costs in other practices or systems.…”

mentioning

confidence: 99%

Including Economic Evaluations in Implementation Science

Yoon

2020

J GEN INTERN MED

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Economic evaluation in implementation science: Making the business case for implementation strategies

Cited by 116 publications

References 29 publications

Comparing, Contrasting, and Integrating Dissemination and Implementation Outcomes Included in the RE-AIM and Implementation Outcomes Frameworks

Comparing, Contrasting, and Integrating Dissemination and Implementation Outcomes Included in the RE-AIM and Implementation Outcomes Frameworks

Priority domains, aims, and testable hypotheses for implementation research: Protocol for a scoping review and evidence map

Including Economic Evaluations in Implementation Science

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