Rugged landscapes: complexity and implementation science

Ornstein, Joseph T.; Hammond, Ross A.; Padek, Margaret; Mazzucca, Stephanie; Brownson, Ross C.

doi:10.1186/s13012-020-01028-5

Cited by 15 publications

(11 citation statements)

References 39 publications

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“…These models simulate how accumulating quantities (say, the number of individuals who are upto-date with colorectal cancer screening) change over time. As part of the broader field of systems science, system dynamics modeling has an explicit focus on and ability to simulate the elements of complexity present in implementation science work [52][53][54][55][56][57]. For example, time dynamics and delays during the implementation process are typical (e.g., change takes time, costs accrue quickly while health benefits accrue more slowly, data and system feedback is often delayed in its availability), and feedback loops can exist among relevant implementation considerations (i.e., when something in the system responds to earlier changes, either reinforcing or counteracting earlier changes-in both desired and undesired ways).…”

Section: C: Understand the Possible Consequences Of Each Alternativementioning

confidence: 99%

Using decision analysis to support implementation planning in research and practice

Smith

Knocke

Lich

2022

Implement Sci Commun

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Background The process of implementing evidence-based interventions, programs, and policies is difficult and complex. Planning for implementation is critical and likely plays a key role in the long-term impact and sustainability of interventions in practice. However, implementation planning is also difficult. Implementors must choose what to implement and how best to implement it, and each choice has costs and consequences to consider. As a step towards supporting structured and organized implementation planning, we advocate for increased use of decision analysis. Main text When applied to implementation planning, decision analysis guides users to explicitly define the problem of interest, outline different plans (e.g., interventions/actions, implementation strategies, timelines), and assess the potential outcomes under each alternative in their context. We ground our discussion of decision analysis in the PROACTIVE framework, which guides teams through key steps in decision analyses. This framework includes three phases: (1) definition of the decision problems and overall objectives with purposeful stakeholder engagement, (2) identification and comparison of different alternatives, and (3) synthesis of information on each alternative, incorporating uncertainty. We present three examples to illustrate the breadth of relevant decision analysis approaches to implementation planning. Conclusion To further the use of decision analysis for implementation planning, we suggest areas for future research and practice: embrace model thinking; build the business case for decision analysis; identify when, how, and for whom decision analysis is more or less useful; improve reporting and transparency of cost data; and increase collaborative opportunities and training.

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Section: C: Understand the Possible Consequences Of Each Alternativementioning

confidence: 99%

Using decision analysis to support implementation planning in research and practice

Smith

Knocke

Lich

2022

Implement Sci Commun

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“…Hybrid intervention-implementation studies are indeed valuable strains of scientific inquiry (Curran et al, 2012); however, implementation science stretches beyond co-studying the process of implementing ready-made interventions (Bertram et al, 2021;Nilsen & Birken, 2020). For instance, implementation science has implications for public health policies and decision making in complex systems (Nilsen & Cairney, 2020;Ornstein et al, 2020), how health and service systems are organized (Braithwaite et al, 2018;Evans et al, 2013), how services and interventions are designed (Lyon et al, 2020), how to promote equity in research and service systems (Baumann & Cabassa, 2020), and how to predict the value of public health initiatives (Eisman et al, 2020). The multi-faceted and complex nature of implementation as a scientific discipline warrants dedicated and earmarked research programs, institutions, and funding streams.…”

Section: The Need For Dedicated Implementation Researchmentioning

confidence: 99%

Launch of the Norwegian Network for Implementation Research (NIMP): Proceedings from the First Annual Conference

Engell

Varsi

Graverholt

et al. 2021

Glob Implement Res Appl

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Implementation research is growing in Norway, and the importance of implementation science for health and welfare improvements is gaining awareness across sectors. The Norwegian health and welfare systems have unique features that influence implementation research and practice, and context-specific implementation research is needed to solve Norwegian implementation issues. Implementation science has been fragmented, with limited connections between implementation researchers, disseminators, policymakers, and practitioners. Calls for a national network for implementation research echoed for several years, and in 2020 the Norwegian Network for Implementation Research (NIMP) was founded, and the first annual NIMP conference was held. With implementation science proliferating globally, similar efforts may be on the horizon in other countries. This paper describes the rationale and approach for developing NIMP, presents proceedings from the 2020 NIMP conference, and discusses the role of a national network in mobilizing implementation science communities and advancing an implementation science agenda nationally. NIMP was developed as an independent organization with six board members elected at a general assembly. NIMPs aims are to (1) raise awareness about implementation science in Norway, (2) promote sharing and exchange of knowledge from implementation research in Norway, and (3) facilitate implementation collaboration within Norway and internationally. One hundred forty-four implementation researchers, practitioners, policymakers, and students from across Norway attended the NIMP conference. There were 13 presentations of implementation research from different settings within health care, welfare services, and education. Themes included implementation strategies, barriers and facilitators, implementation theories and frameworks, and evaluation of implementation outcomes. The presentations showcased at the NIMP conference substantiated the need to connect and mobilize the implementation science community in Norway. Implementation issues are large and numerous, and more contemporary implementation research questions and designs may be required to solve them. NIMP needs to inform stakeholders in policy about the need for dedicated implementation research to improve our health and welfare systems. Critical implementation issues may require ambitious investments in implementation research. Our approach to developing a national implementation network may be of interest to aspiring networks in other countries.

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“…Organizational efforts supporting the implementation of research-supported interventions (RSIs) are required to bring about change effectively. Be it (health) care treatments, social support, or preventive programs—implementing RSIs often requires work at multiple levels of a system to successfully apply and sustain these complex interventions in practice [ 1 , 2 ]. Implementation usually involves various parties, such as organizations, health professionals, and care recipients, and collaboration between them [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Knowledge and attitudes of Implementation Support Practitioners—Findings from a systematic integrative review

Bührmann

Driessen²,

Metz

et al. 2022

PLoS ONE

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Background It requires thoughtful planning and work to successfully apply and sustain research-supported interventions like healthcare treatments, social support, or preventive programs in practice. Implementation support practitioners (ISPs) such as facilitators, technical assistance providers, knowledge brokers, coaches or consultants may be involved to actively support the implementation process. This article presents knowledge and attitudes ISPs bring to their work. Methods Building on a previously developed program logic, a systematic integrative review was conducted. Literature was sourced by searching nine electronic data bases, organizational websites, and by launching a call for publications among selected experts and social media. Article screening was performed independently by two researchers, and data from included studies were extracted by members of the research team and quality-assured by the lead researcher. The quality of included RCTs was assessed based on a framework by Hodder and colleagues. Thematic Analysis was used to capture information on knowledge and attitudes of ISPs across the included studies. Euler diagrams and heatmaps were used to present the results. Results Results are based on 79 included studies. ISPs reportedly displayed knowledge about the clinical practice they work with, implementation / improvement practice, the local context, supporting change processes, and facilitating evidence-based practice in general. In particular, knowledge about the intervention to be implemented and its target population, specific improvement / implementation methods and approaches, organizational structures and sensitivities, training, and characteristics of (good) research was described in the literature. Seven themes describing ISPs’ attitudes were identified: 1) professional, 2) motivated / motivating / encouraging / empowering, 3) empathetic / respectful / sensitive, 4) collaborative / inclusive, 5) authentic, 6) creative / flexible / innovative / adaptive, and 7) frank / direct / honest. Pertaining to a professional attitude, being responsive and focused were the most prevalent indicators across included publications. Conclusion The wide range and complexity of knowledge and attitudes found in the literature calls for a comprehensive and systematic approach to collaboratively develop a professional role for ISPs across disciplines. Embedding the ISP role in different health and social welfare settings will enhance implementation capacities considerably.

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Rugged landscapes: complexity and implementation science

Cited by 15 publications

References 39 publications

Using decision analysis to support implementation planning in research and practice

Using decision analysis to support implementation planning in research and practice

Launch of the Norwegian Network for Implementation Research (NIMP): Proceedings from the First Annual Conference

Knowledge and attitudes of Implementation Support Practitioners—Findings from a systematic integrative review

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