Articles

Building capacity for implementation—the KT Challenge

The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, f...

Authors: Agnes T. Black, Marla Steinberg, Amanda E. Chisholm, Kristi Coldwell, Alison M. Hoens, Jiak Chin Koh, Allana LeBlanc, Martha Mackay, Amy Salmon and M. Elizabeth Snow

Accuracy of emergency physicians’ self-estimates of CT scan utilization and its potential effect on an audit and feedback intervention: a randomized trial

Audit and feedback (A&F) has been used as a strategy to modify clinician behavior with moderate success. Although A&F is theorized to work by improving the accuracy of clinicians’ estimates of their own behavi...

Authors: Celine Larkin, Alexandra M. Sanseverino, James Joseph, Lauren Eisenhauer and Martin A. Reznek

Multi-tiered external facilitation: the role of feedback loops and tailored interventions in supporting change in a stepped-wedge implementation trial

Facilitation is a complex, relational implementation strategy that guides change processes. Facilitators engage in multiple activities and tailor efforts to local contexts. How this work is coordinated and sha...

Authors: Lauren S. Penney, Teresa M. Damush, Nicholas A. Rattray, Edward J. Miech, Sean A. Baird, Barbara J. Homoya, Laura J. Myers and Dawn M. Bravata

Optimizing hospital-to-home transitions for older persons in rural communities: a participatory, multimethod study protocol

Transitional care involves time-limited interventions focusing on the continuity of care from hospital to home, to optimize patient functioning and management. Providing interventions, as part of transitional ...

Authors: Mary T. Fox, Souraya Sidani, Jeffrey I. Butler, Mark W. Skinner, Marilyn Macdonald, Evelyne Durocher, Kathleen F. Hunter, Adrian Wagg, Lori E. Weeks, Ann MacLeod and Sherry Dahlke

Structural readiness to implement community-wide mass drug administration programs for soil-transmitted helminth elimination: results from a three-country hybrid study

Current soil-transmitted helminth (STH) control programs target pre-school and school-age children with mass drug administration (MDA) of deworming medications, reducing morbidity without interrupting ongoing ...

Authors: Arianna Rubin Means, Elizabeth Orlan, Marie-Claire Gwayi-Chore, Angelin Titus, Saravanakumar Puthupalayam Kaliappan, Comlanvi Innocent Togbevi, Félicien Chabi, Katherine E. Halliday, Providence Nindi, Euripide Avokpaho, Khumbo Kalua, Moudachirou Ibikounlé, Sitara S. R. Ajjampur, Bryan J. Weiner, Judd L. Walson and Kumudha Aruldas

Understanding the need for a whole-of-society approach in school nutrition policy implementation: a qualitative analysis

Only three of twenty Caribbean Community (CARCICOM) countries have mandatory school nutrition policies despite one third of the region’s children being overweight or obese. In Barbados, there are nutrition gui...

Authors: Natasha P. Sobers, Lisa Bishop, Shu Wen Ng, Suzanne Soares-Wynter, Natalie S. Greaves and Madhuvanti M. Murphy

The Cognitive Walkthrough for Implementation Strategies (CWIS): a pragmatic method for assessing implementation strategy usability

Implementation strategies have flourished in an effort to increase integration of research evidence into clinical practice. Most strategies are complex, socially mediated processes. Many are complicated, expen...

Authors: Aaron R. Lyon, Jessica Coifman, Heather Cook, Erin McRee, Freda F. Liu, Kristy Ludwig, Shannon Dorsey, Kelly Koerner, Sean A. Munson and Elizabeth McCauley

The Clinical Sustainability Assessment Tool: measuring organizational capacity to promote sustainability in healthcare

Few validated assessment tools are available to increase understanding and measure factors associated with sustainment of clinical practices, an increasingly recognized need among clinicians. We describe the d...

Authors: Sara Malone, Kim Prewitt, Rachel Hackett, John C. Lin, Virginia McKay, Callie Walsh-Bailey and Douglas A. Luke

Adaptation and implementation of the WHO Safe Childbirth Checklist around the world

The World Health Organization (WHO) published the WHO Safe Childbirth Checklist in 2015, which included the key evidence-based practices to prevent the major causes of maternal and neonatal morbidity and morta...

Authors: Rose L. Molina, Anne-Caroline Benski, Lauren Bobanski, Danielle E. Tuller and Katherine E. A. Semrau

Correction to: Implementation determinants and mechanisms for the prevention and treatment of adolescent HIV in sub-Saharan Africa: concept mapping of the NIH Fogarty International Center Adolescent HIV Implementation Science Alliance (AHISA) initiative

Authors: Gregory A. Aarons, Kendal Reeder, Nadia A. Sam-Agudu, Susan Vorkoper and Rachel Sturke

Implementation for Sustained Impact in Teleophthalmology (I-SITE): applying the NIATx Model for tailored implementation of diabetic retinopathy screening in primary care

Teleophthalmology provides evidence-based, telehealth diabetic retinopathy screening that is underused even when readily available in primary care clinics. There is an urgent need to increase teleophthalmology...

Authors: Alejandra Torres Diaz, Loren J. Lock, Todd D. Molfenter, Jane E. Mahoney, Deanne Boss, Timothy D. Bjelland and Yao Liu

Costs of implementing community-based intervention for HIV testing in sub-Saharan Africa: a systematic review

Community-based interventions (CBIs) are interventions aimed at improving the well-being of people in a community. CBIs for HIV testing seek to increase the availability of testing services to populations that...

Authors: Florida Uzoaru, Ucheoma Nwaozuru, Jason J. Ong, Felix Obi, Chisom Obiezu-Umeh, Joseph D. Tucker, Thembekile Shato, Stacey L. Mason, Victoria Carter, Sunita Manu, Rhonda BeLue, Oliver Ezechi and Juliet Iwelunmor

Adapting coordinated specialty care in the post-COVID-19 era: study protocol for an integrative mixed-methods study

Coordinated Specialty Care (CSC) programs provide evidence-based services for young people with a recent onset of a psychotic disorder. OnTrackNY is a nationally recognized model of CSC treatment in New York s...

Authors: Sapana R. Patel, Iruma Bello, Leopoldo J. Cabassa, Ilana R. Nossel, Melanie M. Wall, Elaina Montague, Reanne Rahim, Chacku M. Mathai and Lisa B. Dixon

Acceptance and completion of rifapentine-based TB preventive therapy (3HP) among people living with HIV (PLHIV) in Kampala, Uganda—patient and health worker perspectives

A 12-dose, once-weekly regimen of isoniazid and rifapentine (3HP) is effective in preventing tuberculosis (TB) among people living with HIV (PLHIV). We sought to identify potential barriers to and facilitators...

Authors: Fred C. Semitala, Allan Musinguzi, Jackie Ssemata, Fred Welishe, Juliet Nabunje, Jillian L. Kadota, Christopher A. Berger, Achilles Katamba, Noah Kiwanuka, Moses R. Kamya, David Dowdy, Adithya Cattamanchi and Anne R. Katahoire

Pragmatic approaches to analyzing qualitative data for implementation science: an introduction

Qualitative methods are critical for implementation science as they generate opportunities to examine complexity and include a diversity of perspectives. However, it can be a challenge to identify the approach...

Authors: Shoba Ramanadhan, Anna C. Revette, Rebekka M. Lee and Emma L. Aveling

Evaluation of carbapenem-resistant Enterobacteriaceae (CRE) guideline implementation in the Veterans Affairs Medical Centers using the consolidated framework for implementation research

Infections caused by carbapenem-resistant Enterobacteriaceae (CRE) and carbapenemase-producing (CP) CRE are difficult to treat, resulting in high mortality in healthcare settings every year. The Veterans Healt...

Authors: Cassie Cunningham Goedken, Marylou Guihan, Charnetta R. Brown, Swetha Ramanathan, Amanda Vivo, Katie J. Suda, Margaret A. Fitzpatrick, Linda Poggensee, Eli N. Perencevich, Michael Rubin, Heather Schacht Reisinger, Martin Evans and Charlesnika T. Evans

Combining Realist approaches and Normalization Process Theory to understand implementation: a systematic review

Realist approaches and Normalization Process Theory (NPT) have both gained significant traction in implementation research over the past 10 years. The aim of this study was therefore to explore how the approac...

Authors: Sonia Michelle Dalkin, Rebecca J. L. Hardwick, Catherine A. Haighton and Tracy L. Finch

A systematic review of school health policy measurement tools: implementation determinants and outcomes

Governments in some countries or states/provinces mandate school-based policies intended to improve the health and well-being of primary and secondary students and in some cases the health of school staff. Exa...

Authors: Gabriella M. McLoughlin, Peg Allen, Callie Walsh-Bailey and Ross C. Brownson

Virtual external implementation facilitation: successful methods for remotely engaging groups in quality improvement

Relatively little guidance exists on how to use virtual implementation facilitation to successfully implement evidence-based practices and innovations into clinical programs. Yet virtual methods are increasing...

Authors: Christine W. Hartmann, Ryann L. Engle, Camilla B. Pimentel, Whitney L. Mills, Valerie A. Clark, Virginia C. Keleher, Princess Nash, Corilyn Ott, Therasia Roland, Sharon Sloup, Barbara Frank, Cathie Brady and A. Lynn Snow

Sustaining implementation facilitation: a model for facilitator resilience

Implementation facilitators enable healthcare staff to effectively implement change, yet little is known about their affective (e.g., emotional, mental, physical) experiences of facilitation. We propose an exp...

Authors: Tanya T. Olmos-Ochoa, David A. Ganz, Jenny M. Barnard, Lauren Penney, Erin P. Finley, Alison B. Hamilton and Neetu Chawla

The development and evaluation of an HIV implementation science network in New England: lessons learned

Describe and evaluate an implementation science network focused on HIV prevention and treatment in New England.

Authors: Jacob J. van den Berg, Elaine O’Keefe, Daniel Davidson, David A. Fiellin, Trace Kershaw, Russell C. Barbour, Susan Cu-Uvin and Paul D. Cleary

Implementation strategies in the context of medication reconciliation: a qualitative study

Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have be...

Authors: Deonni P. Stolldorf, Sheila H. Ridner, Timothy J. Vogus, Christianne L. Roumie, Jeffrey L. Schnipper, Mary S. Dietrich, David G. Schlundt and Sunil Kripalani

Using qualitative and participatory methods to refine implementation strategies: universal family psychosocial screening in pediatric cancer

Children with cancer and their families are at risk for short- and long-term psychosocial difficulties. Screening for psychosocial risk remains inconsistent, leading to inequitable access to psychosocial servi...

Authors: Janet A. Deatrick, Anne E. Kazak, Rebecca E. Madden, Glynnis A. McDonnell, Katherine Okonak, Michele A. Scialla and Lamia P. Barakat

A more practical guide to incorporating health equity domains in implementation determinant frameworks

Due to striking disparities in the implementation of healthcare innovations, it is imperative that researchers and practitioners can meaningfully use implementation determinant frameworks to understand why dis...

Authors: Eva N. Woodward, Rajinder Sonia Singh, Phiwinhlanhla Ndebele-Ngwenya, Andrea Melgar Castillo, Kelsey S. Dickson and JoAnn E. Kirchner

Barriers and facilitators affecting implementation of the Canadian clinical practice guidelines for the diagnosis of acute aortic syndrome

Acute aortic syndrome (AAS) is an uncommon, life-threatening emergency that is frequently misdiagnosed. The 2020 Canadian clinical practice guidelines for the diagnosis of AAS incorporate all available evidenc...

Authors: Caitlin Dmitriew and Robert Ohle

Feasibility of a pharmacy-led intervention to de-implement non-guideline-concordant proton pump inhibitor use

Proton pump inhibitors (PPIs) are among the most prescribed medications and are often used unnecessarily. PPIs are used for the treatment of heartburn and acid-related disorders. Emerging evidence indicates th...

Authors: Jackson S. Musuuza, Emily Fong, Paul Lata, Katie Willenborg, Mary Jo Knobloch, Margaret J. Hoernke, Andrew R. Spiel, Jessica S. Tischendorf, Katie J. Suda and Nasia Safdar

Interactive and Participatory Audit and Feedback (IPAF): theory-based development and multi-site implementation outcomes with specialty clinic staff

Theory-based implementation strategies, such as audit and feedback (A&F), can improve the adoption of evidence-based practices. However, few strategies have been developed and tested to meet the needs of speci...

Authors: Edmond Ramly, Diane R. Lauver, Andrea Gilmore-Bykovskyi and Christie M. Bartels

Identifying actionable strategies: using Consolidated Framework for Implementation Research (CFIR)-informed interviews to evaluate the implementation of a multilevel intervention to improve colorectal cancer screening

Many evidence-based interventions (EBIs) found to be effective in research studies often fail to translate into meaningful patient outcomes in practice. The purpose of this study was to identify facilitators a...

Authors: Helen Lam, Michael Quinn, Toni Cipriano-Steffens, Manasi Jayaprakash, Emily Koebnick, Fornessa Randal, David Liebovitz, Blasé Polite and Karen Kim

Achieving ‘coherence’ in routine practice: a qualitative case-based study to describe speech and language therapy interventions with implementation in mind

Implementation depends on healthcare professionals being able to make sense of a new intervention in relation to their routine practice. Normalisation Process Theory refers to this as coherence work. However, ...

Authors: Avril Nicoll, Margaret Maxwell and Brian Williams

Facilitators and barriers to the utilization of the ACT SMART Implementation Toolkit in community-based organizations: a qualitative study

Evidence-based practices (EBPs) have been shown to improve behavioral and mental health outcomes for children diagnosed with autism spectrum disorder (ASD). Research suggests that the use of these practices in...

Authors: Aksheya Sridhar, Amy Drahota and Kiersten Walsworth

Evaluation of multi-level barriers and facilitators in a large diabetic retinopathy screening program in federally qualified health centers: a qualitative study

Recommended annual diabetic retinopathy (DR) screening for people with diabetes has low rates in the USA, especially in underserved populations. Telemedicine DR screening (TDRS) in primary care clinics could e...

Authors: Ana Bastos de Carvalho, S. Lee Ware, Tamara Belcher, Franceska Mehmeti, Eric B. Higgins, Rob Sprang, Cody Williams, Jamie L. Studts and Christina R. Studts

Implementation determinants and mechanisms for the prevention and treatment of adolescent HIV in sub-Saharan Africa: concept mapping of the NIH Fogarty International Center Adolescent HIV Implementation Science Alliance (AHISA) initiative

Adolescent HIV prevention and treatment is a high priority for youth healthcare in sub-Saharan Africa.

Authors: Gregory A. Aarons, Kendal Reeder, Nadia A. Sam-Agudu, Susan Vorkoper and Rachel Sturke

A mixed methods evaluation of the large-scale implementation of a school- and community-based parenting program to reduce violence against children in Tanzania: a study protocol

Despite the rapid dissemination of parenting programs aiming to reduce and prevent violence against children (VAC) worldwide, there is limited knowledge about and evidence of the implementation of these progra...

Authors: Mackenzie Martin, Jamie Lachman, Joyce Wamoyi, Yulia Shenderovich, Mwita Wambura, Samwel Mgunga, Esther Ndyetabura, Amal Ally, Asheri Barankena, Amon Exavery and Nyasha Manjengenja

Development of a multilevel intervention to increase colorectal cancer screening in Appalachia

Colorectal cancer (CRC) screening rates are lower in Appalachian regions of the United States than in non-Appalachian regions. Given the availability of various screening modalities, there is critical need for...

Authors: Aaron J. Kruse-Diehr, Jill M. Oliveri, Robin C. Vanderpool, Mira L. Katz, Paul L. Reiter, Darrell M. Gray II, Michael L. Pennell, Gregory S. Young, Bin Huang, Darla Fickle, Mark Cromo, Melinda Rogers, David Gross, Ashley Gibson, Jeanne Jellison, Michael D. Sarap…

How do healthcare professionals make decisions concerning low-value care practices? Study protocol of a factorial survey experiment on de-implementation

A large number of practices used in health care lack evidence of effectiveness and may be unnecessary or even cause harm. As such, they should be de-implemented. While there are multiple actors involved in de-...

Authors: Marta Roczniewska, Ulrica von Thiele Schwarz, Hanna Augustsson, Per Nilsen, Sara Ingvarsson and Henna Hasson

Organizational supports for knowledge translation in paediatric health centres and research institutes: insights from a Canadian environmental scan

Organizational supports are thought to help address wide-ranging barriers to evidence-informed health care (EIHC) and knowledge translation (KT). However, little is known about the nature of the resources and ...

Authors: Stephanie Miranda Nadine Glegg, Andrea Ryce, Kimberly J. Miller, Laura Nimmon, Anita Kothari and Liisa Holsti

Exploring the heterogeneity of factors that may influence implementation of PrEP in family planning clinics: a latent profile analysis

Title X-funded family planning clinics have been identified as optimal sites for delivery of pre-exposure prophylaxis (PrEP) for HIV prevention. However, PrEP has not been widely integrated into family plannin...

Authors: Kaitlin N. Piper, Regine Haardörfer, Cam Escoffery, Anandi N. Sheth and Jessica Sales

Implementation support for contingency management: preferences of opioid treatment program leaders and staff

Contingency management (CM), a behavioral intervention that provides incentives for achieving treatment goals, is an evidence-based adjunct to medication to treat opioid use disorder. Unfortunately, many front...

Authors: Kelli Scott, Shelly Jarman, Samantha Moul, Cara M. Murphy, Kimberly Yap, Bryan R. Garner and Sara J. Becker

Implementing eScreening for suicide prevention in VA post-9/11 transition programs using a stepped-wedge, mixed-method, hybrid type-II implementation trial: a study protocol

Post-9/11 veterans who enroll in VA health care frequently present with suicidal ideation and/or recent suicidal behavior. Most of these veterans are not screened on their day of enrollment and their risk goes...

Authors: James O. E. Pittman, Laurie Lindamer, Niloofar Afari, Colin Depp, Miguel Villodas, Alison Hamilton, Bo Kim, Maria K. Mor, Erin Almklov, John Gault and Borsika Rabin

Harmonizing evidence-based practice, implementation context, and implementation strategies with user-centered design: a case example in young adult cancer care

Attempting to implement evidence-based practices in contexts for which they are not well suited may compromise their fidelity and effectiveness or burden users (e.g., patients, providers, healthcare organizati...

Authors: Emily R. Haines, Alex Dopp, Aaron R. Lyon, Holly O. Witteman, Miriam Bender, Gratianne Vaisson, Danielle Hitch and Sarah Birken

Optimizing Implementation in Cancer Control (OPTICC): protocol for an implementation science center

Evidence-based interventions (EBIs) could reduce cervical cancer deaths by 90%, colorectal cancer deaths by 70%, and lung cancer deaths by 95% if widely and effectively implemented in the USA. Yet, EBI impleme...

Authors: Cara C. Lewis, Peggy A. Hannon, Predrag Klasnja, Laura-Mae Baldwin, Rene Hawkes, Janell Blackmer and Ashley Johnson

Increasing risk-concordant cardiovascular care in diverse health systems: a mixed methods pragmatic stepped wedge cluster randomized implementation trial of shared decision making (SDM4IP)

The primary prevention of cardiovascular (CV) events is often less intense in persons at higher CV risk and vice versa. Clinical practice guidelines recommend that clinicians and patients use shared decision m...

Authors: Jennifer L. Ridgeway, Megan E. Branda, Derek Gravholt, Juan P. Brito, Ian G. Hargraves, Sandra A. Hartasanchez, Aaron L. Leppin, Yvonne L. Gomez, Devin M. Mann, Vivek Nautiyal, Randal J. Thomas, Emma M. Behnken, Victor D. Torres Roldan, Nilay D. Shah, Charanjit S. Khurana and Victor M. Montori

Implementing immediate postpartum contraception: a comparative case study at 11 hospitals

Immediate postpartum long-acting reversible contraception (LARC) is an evidence-based practice, but hospitals face significant barriers to its adoption. Our objective was to examine how organizational context ...

Authors: Michelle H. Moniz, Kirsten Bonawitz, Marisa K. Wetmore, Vanessa K. Dalton, Laura J. Damschroder, Jane H. Forman, Alex F. Peahl and Michele Heisler

Mixed-methods economic evaluation of the implementation of tobacco treatment programs in National Cancer Institute-designated cancer centers

The Cancer Center Cessation Initiative (C3I) was launched in 2017 as a part of the NCI Cancer Moonshot program to assist NCI-designated cancer centers in developing tobacco treatment programs for oncology pati...

Authors: Ramzi G. Salloum, Heather D’Angelo, Ryan P. Theis, Betsy Rolland, Sarah Hohl, Danielle Pauk, Jennifer H. LeLaurin, Yasmin Asvat, Li-Shiun Chen, Andrew T. Day, Adam O. Goldstein, Brian Hitsman, Deborah Hudson, Andrea C. King, Cho Y. Lam, Katie Lenhoff…

Are Danish vocational schools ready to implement “smoke-free school hours”? A qualitative study informed by the theory of organizational readiness for change

The smoking prevalence is high among students enrolled in vocational education and training, which is considered a lower level of education. The school tobacco policy regarding smoke-free school hours stipulat...

Authors: Anneke Vang Hjort, Michael Schreuders, Kathrine Højlund Rasmussen and Charlotte Demant Klinker

From novice to expert: methods for transferring implementation facilitation skills to improve healthcare delivery

There is substantial evidence that facilitation can address the challenges of implementing evidence-based innovations. However, facilitators need a wide variety of complex skills; lack of these can have a nega...

Authors: Mona J. Ritchie, Louise E. Parker and JoAnn E. Kirchner

Adapting and adopting highly specialized pediatric eating disorder treatment to virtual care: a protocol for an implementation study in the COVID-19 context

The COVID-19 pandemic has negatively impacted individuals with eating disorders; resulting in increased symptoms, as well as feelings of isolation and anxiety. To conform with social distancing requirements, o...

Authors: Jennifer Couturier, Danielle Pellegrini, Catherine Miller, Paul Agar, Cheryl Webb, Kristen Anderson, Melanie Barwick, Gina Dimitropoulos, Sheri Findlay, Melissa Kimber, Gail McVey and James Lock

Adaptation of a quality improvement approach to implement eScreening in VHA healthcare settings: innovative use of the Lean Six Sigma Rapid Process Improvement Workshop

The Veterans Health Administration (VHA) developed a comprehensive mobile screening technology (eScreening) that provides customized and automated self-report health screening via mobile tablet for veterans se...

Authors: James O. E. Pittman, Borsika Rabin, Erin Almklov, Niloofar Afari, Elizabeth Floto, Eusebio Rodriguez and Laurie Lindamer

An integrated knowledge translation approach to address avoidable rehospitalisations and unplanned admissions for older people in South Australia: implementation and evaluation program plan

Repeated admission to hospital can be stressful for older people and their families and puts additional pressure on the health care system. While there is some evidence about strategies to better integrate car...

Authors: Gillian Harvey, Clarabelle T. Pham, Maria C. Inacio, Kate Laver, Elizabeth A. Lynch, Robert N. Jorissen, Jonathan Karnon, Alice Bourke, John Forward, John Maddison, Craig Whitehead, Jesmin Rupa, Carmel McNamara and Maria Crotty

Trialists perspectives on sustaining, spreading, and scaling-up of quality improvement interventions

Quality improvement (QI) evaluations rarely consider how a successful intervention can be sustained long term, nor how to spread or scale to other locations. A survey of authors of randomized trials of diabete...

Authors: Celia Laur, Ann Marie Corrado, Jeremy M. Grimshaw and Noah Ivers