The Role of Formative Evaluation in Implementation Research and the QUERI Experience

Abstract

This article describes the importance and role of 4 stages of formative evaluation in our growing understanding of how to implement research findings into practice in order to improve the quality of clinical care. It reviews limitations of traditional approaches to implementation research and presents a rationale for new thinking and use of new methods. Developmental, implementation-focused, progress-focused, and interpretive evaluations are then defined and illustrated with examples from Veterans Health Administration Quality Enhancement Research Initiative projects. This article also provides methodologic details and highlights challenges encountered in actualizing formative evaluation within implementation research.

Factors influencing organizational adoption and implementation of clinical genetic services

“…Widespread implementation has not occurred, so we characterize this study as a "pre-implementation" study, i.e., a "developmental evaluation" of existing conditions relevant to adoption and delivery of genetic services, as a precursor to full-fledged implementation efforts. 9 …”

Improving physical activity program adoption using integrated research-practice partnerships: an effectiveness-implementation trial

“…In research-practice partnerships, stakeholders are involved in an iterative and interactive process for decision-making [19] whereas a typical efficacy-effectiveness-dissemination pipeline model [20,21] is more one directional. The pipeline approach first establishes internal validity under best practices (efficacy) and then positive outcomes in real-world demonstration (effectiveness) and the ability and willingness of people to implement the program with appropriate fidelity (implementation) [22].…”

“…Therefore, integrated research-practice partnerships may speed translation. However, there has been little research to determine if they result in practical interventions that are more likely to be adopted and implemented when compared to interventions developed through a pipeline model [20,21].…”

Implementation of a journal prototype for pregnant and parenting adolescents

“…Consistent with the implementation science literature, we aimed to capture in-depth information on participant and contextual factors in a complex setting that facilitated or hindered successful implementation. Practitioners and scholars can then draw on these factors to enhance future implementation efforts to tailor programs and interventions to be more congruent with and accommodative the needs of the clients being served (Jolley, 2014;Stetler et al, 2006).…”

“…Drawing on literature suggesting the importance of program evaluation ( e.g., de Meij et al 2013;Fixsen et al 2005), the main strength of this study is that we used multiple methods of data collection and analysis to conduct a robust formative evaluation of this initial phase of the program (Jolley, 2014). The results of this evaluation can assist not only the research team as we pursue future phases of the project, but also practitioners interested in testing similar programs (Stetler et al 2006). …”