Articles

Hypertension care cascade at a large urban HIV clinic in Uganda: a mixed methods study using the Capability, Opportunity, Motivation for Behavior change (COM-B) model

Persons living with HIV (PLHIV) receiving antiretroviral therapy (ART) have a high prevalence of hypertension (HTN) and increased risk of mortality from cardiovascular diseases. HTN and HIV care integration is...

Authors: Martin Muddu, Isaac Ssinabulya, Simon P. Kigozi, Rebecca Ssennyonjo, Florence Ayebare, Rodgers Katwesigye, Mary Mbuliro, Isaac Kimera, Chris T. Longenecker, Moses R. Kamya, Jeremy I. Schwartz, Anne R. Katahoire and Fred C. Semitala

German translation and pre-testing of Consolidated Framework for Implementation Research (CFIR) and Expert Recommendations for Implementing Change (ERIC)

Implementation frameworks may support local implementation strategies with a sound theoretical foundation. The Consolidated Framework for Implementation Research (CFIR) facilitates identification of contextual ba...

Authors: Verena Regauer, Eva Seckler, Craig Campbell, Amanda Phillips, Thomas Rotter, Petra Bauer and Martin Müller

Initial validation of a self-report questionnaire based on the Theoretical Domains Framework: determinants of clinician adoption of a novel colorectal cancer screening strategy

Colorectal cancer (CRC) screening for average risk adults age 45 and older continues to be underutilized in the USA. One factor consistently associated with CRC screening completion is clinician recommendation...

Authors: Xuan Zhu, Minji K. Lee, Emily Weiser, Joan M. Griffin, Paul J. Limburg and Lila J. Finney Rutten

An implementation intervention to increase the routine provision of antenatal care addressing gestational weight gain: study protocol for a stepped-wedge cluster trial

Weight gain during pregnancy that is outside of recommended levels is associated with a range of adverse outcomes for the mother and child, including gestational diabetes, pre-eclampsia, preterm birth, and obe...

Authors: Melanie Kingsland, Jenna Hollis, Eva Farragher, Luke Wolfenden, Karen Campbell, Craig Pennell, Penny Reeves, Belinda Tully, Justine Daly, John Attia, Christopher Oldmeadow, Mandy Hunter, Henry Murray, Francesco Paolucci, Maralyn Foureur, Chris Rissel…

Development of a theory-based video-game intervention to increase advance care planning conversations by healthcare providers

Hospitalization offers an opportunity for healthcare providers to initiate advance care planning (ACP) conversations, yet such conversations occur infrequently. Barriers to these conversations include attitude...

Authors: Deepika Mohan, Meredith A. MacMartin, Julia S. C. Chelen, Carolyn B. Maezes and Amber E. Barnato

Rapid-cycle systems modeling to support evidence-informed decision-making during system-wide implementation

To “model and simulate change” is an accepted strategy to support implementation at scale. Much like a power analysis can inform decisions about study design, simulation models offer an analytic strategy to synth...

Authors: R. Christopher Sheldrick, Gracelyn Cruden, Ana J. Schaefer and Thomas I. Mackie

Fidelity of kangaroo mother care services in the public health facilities in Bangladesh: a cross-sectional mixed-method study

Kangaroo mother care (KMC) is a proven low-cost intervention to prevent neonatal mortality of pre-term and low birth weight babies and is very relevant to Bangladesh. KMC provides thermal regulation and thus d...

Authors: Saima Mehjabeen, Mowtushi Matin, Rajat Das Gupta, Ipsita Sutradhar, Yameen Mazumder, Minjoon Kim, Shamina Sharmin, Jahurul Islam and Malabika Sarker

Integrating social determinants of health screening and referral during routine emergency department care: evaluation of reach and implementation challenges

Despite the importance of social determinants in health outcomes, little is known about the best practices for screening and referral during clinical encounters. This study aimed to implement universal social ...

Authors: Andrea S. Wallace, Brenda L. Luther, Shawna M. Sisler, Bob Wong and Jia-Wen Guo

Centralized colorectal cancer screening outreach and patient navigation for vulnerable populations in North Carolina: study protocol for the SCORE randomized controlled trial

Although colorectal cancer (CRC) screening is effective in reducing CRC mortality, screening rates in vulnerable populations served by community health centers (CHCs) remain below national targets. CHCs in Nor...

Authors: Teri L. Malo, Sara Y. Correa, Alexis A. Moore, Renée M. Ferrari, Jennifer Leeman, Alison T. Brenner, Stephanie B. Wheeler, Xianming Tan and Daniel S. Reuland

Closing the know-do gap for child health: UNICEF’s experiences from embedding implementation research in child health and nutrition programming

UNICEF operates in 190 countries and territories, where it advocates for the protection of children’s rights and helps meet children’s basic needs to reach their full potential. Embedded implementation researc...

Authors: Debra Jackson, A. S. M. Shahabuddin, Alyssa B. Sharkey, Karin Källander, Maria Muñiz, Remy Mwamba, Elevanie Nyankesha, Robert W. Scherpbier, Andreas Hasman, Yarlini Balarajan, Kerry Albright, Priscilla Idele and Stefan Swartling Peterson

Sustainment of proactive physical therapy for individuals with early-stage Parkinson’s disease: a quality improvement study over 4 years

Implementation science frameworks aided the development of a new, evidence-based clinical physical therapy program. The purpose of this report is to describe the process of sustaining a clinical program in pra...

Authors: Jillian MacDonald, Laura Doyle, Jennifer L. Moore and Miriam R. Rafferty

A mixed-methods study of multi-level factors influencing mammography overuse among an older ethnically diverse screening population: implications for de-implementation

There is growing concern that routine mammography screening is overused among older women. Successful and equitable de-implementation of mammography will require a multi-level understanding of the factors cont...

Authors: Jessica D. Austin, Parisa Tehranifar, Carmen B. Rodriguez, Laura Brotzman, Mariangela Agovino, Danya Ziazadeh, Nathalie Moise and Rachel C. Shelton

Preparing a financial incentive program to improve retention in HIV care and viral suppression for scale: using an implementation science framework to evaluate an mHealth system in Tanzania

Viral suppression is key to ending the HIV epidemic, yet only 58% of people living with HIV (PLHIV) in sub-Saharan Africa are suppressed. Cash transfers are an effective strategy to improve retention in care, ...

Authors: Laura Packel, Carolyn Fahey, Atuganile Kalinjila, Agatha Mnyippembe, Prosper Njau and Sandra I. McCoy

De-implementation and substitution of clinical care processes: stakeholder perspectives on the transition to primary human papillomavirus (HPV) testing for cervical cancer screening

New cervical cancer screening guidelines recommend primary human papillomavirus (HPV) testing for women age 30–65 years. Healthcare organizations are preparing to de-implement the previous recommended strategi...

Authors: Erin E. Hahn, Corrine Munoz-Plaza, Danielle E. Altman, Chunyi Hsu, Nancy T. Cannizzaro, Quyen Ngo-Metzger, Patricia Wride, Michael K. Gould, Brian S. Mittman, Melissa Hodeib, Krishnansu S. Tewari, Lena H. Ajamian, Ramez N. Eskander, Devansu Tewari and Chun R. Chao

The effect of caregiver key opinion leaders on increasing caregiver demand for evidence-based practices to treat youth anxiety: protocol for a randomized control trial

Research has identified cognitive behavioral therapy with exposures (CBT) as an effective treatment for youth anxiety. Despite implementation efforts, few anxious youth receive CBT. Direct-to-consumer marketin...

Authors: Margaret E. Crane, Marc S. Atkins, Sara J. Becker, Jonathan Purtle, Thomas M. Olino and Philip C. Kendall

Facilitators and barriers to clinical practice guideline-consistent supportive care at pediatric oncology institutions: a Children’s Oncology Group study

Clinical practice guideline (CPG)-consistent care improves patient outcomes, but CPG implementation is poor. Little is known about CPG implementation in pediatric oncology. This study aimed to understand suppo...

Authors: Aaron J. Sugalski, Tammy Lo, Melissa Beauchemin, Allison C. Grimes, Paula D. Robinson, Alexandra M. Walsh, Nancy Santesso, Ha Dang, Brian T. Fisher, Andrea Rothfus Wrightson, Lolie C. Yu, Lillian Sung and L. Lee Dupuis

Implementation of a central-line bundle: a qualitative study of three clinical units

Evidence for the central line-associated bloodstream infection (CLABSI) bundle effectiveness remains mixed, possibly reflecting implementation challenges and persistent ambiguities in how CLABSIs are counted a...

Authors: Joanne Goldman, Leahora Rotteau, Kaveh G. Shojania, G. Ross Baker, Paula Rowland, Marlys K. Christianson, Timothy J. Vogus, Connie Cameron and Maitreya Coffey

Development of an intervention to support the implementation of evidence-based strategies for optimising antibiotic prescribing in general practice

Trials show that antimicrobial stewardship (AMS) strategies, including communication skills training, point-of-care C-reactive protein testing (POC-CRPT) and delayed prescriptions, help optimise antibiotic pre...

Authors: Aleksandra J. Borek, Anne Campbell, Elle Dent, Michael Moore, Christopher C. Butler, Alison Holmes, A. Sarah Walker, Monsey McLeod and Sarah Tonkin-Crine

Daily weekday audit and feedback to clinicians for an inpatient intervention in obstetrics: is there sustained impact over the weekend? A secondary analysis of a prospective cohort study

Audit and feedback as an implementation strategy leads to small, but potentially important improvements in practice. Yet, audit and feedback is time and personnel intensive. Many interventions designed for inp...

Authors: Rebecca F. Hamm, Lisa D. Levine, Meghan Lane-Fall and Rinad Beidas

Understanding barriers and facilitators to implementation of psychosocial care within orthopedic trauma centers: a qualitative study with multidisciplinary stakeholders from geographically diverse settings

Psychosocial factors are pivotal in recovery after acute orthopedic traumatic injuries. Addressing psychosocial factors is an important opportunity for preventing persistent pain and disability. We aim to iden...

Authors: Ana-Maria Vranceanu, Jafar Bakhshaie, Mira Reichman, James Doorley, Ryan A. Mace, Cale Jacobs, Mitchel Harris, Kristin R. Archer, David Ring and A. Rani Elwy

Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services

Seven housing and health services organizations were guided through a process of translating Chapter Six of the Canadian Guidelines for Recovery-Oriented Practice into a recovery-oriented innovation and plan f...

Authors: Myra Piat, Megan Wainwright, Danielle Cherkas, Sébastien Leblanc, Eleni Sofouli, Marie-Pier Rivest, Hélène Albert, Regina Casey, Joseph J. O’Rourke and Lise Labonté

Comparing inductive and deductive analysis techniques to understand health service implementation problems: a case study of childhood vaccination barriers

Effective implementation requires a comprehensive understanding of individual, organisational and system determinants. This study aimed to compare inductive and deductive analysis techniques to understand a co...

Authors: Carissa Bonner, Jane Tuckerman, Jessica Kaufman, Daniel Costa, David N. Durrheim, Lyndal Trevena, Susan Thomas and Margie Danchin

Aligning implementation science with improvement practice: a call to action

In several recent articles, authors have called for aligning the fields of implementation and improvement science. In this paper, we call for implementation science to also align with improvement practice. Multip...

Authors: Jennifer Leeman, Catherine Rohweder, Matthew Lee, Alison Brenner, Andrea Dwyer, Linda K. Ko, Meghan C. O’Leary, Grace Ryan, Thuy Vu and Shoba Ramanadhan

Reflective writing: a tool to support continuous learning and improved effectiveness in implementation facilitators

Implementation facilitators support the adoption of evidence-based practices and other improvement efforts in complex healthcare settings. Facilitators are trained to develop essential facilitation skills and ...

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

Stakeholder perspectives to inform adaptation of a hypertension treatment program in primary healthcare centers in the Federal Capital Territory, Nigeria: a qualitative study

Implementing an evidence-based hypertension program in primary healthcare centers (PHCs) in the Federal Capital Territory, Nigeria is an opportunity to improve hypertension diagnosis, treatment, and control an...

Authors: Rosemary C. B. Okoli, Gabriel Shedul, Lisa R. Hirschhorn, Ikechukwu A. Orji, Tunde M. Ojo, Nonye Egenti, Kasarachi Omitiran, Blessing Akor, Abigail S. Baldridge, Mark D. Huffman, Dike Ojji and Namratha R. Kandula

Study protocol: A stepped-wedge, cluster-randomized trial of the effectiveness of a deliberative loop in identifying implementation strategies for the adoption of a dental sealant guideline in dental clinics

The American Dental Association (ADA) recommends dental providers apply dental sealants to the occlusal surfaces of permanent molars for the prevention or treatment of non-cavitated dental caries. Despite the ...

Authors: Deborah E. Polk, Erick G. Guerrero, Inga Gruß, Nilesh H. Shah, Nadia M. Yosuf, Tim Dawson, Charles D. Kaplan, Daniel J. Pihlstrom and Jeffrey L. Fellows

Implementation of a community-based low-calorie dietary intervention for the induction of type-2 diabetes and pre-diabetes remission: a feasibility study utilising a type 2 hybrid design

The aims of this feasibility study were to (1) examine the implementation of a community-based health advocate (CHA) training programme to develop the clinical skills needed to support a diabetes remission pro...

Authors: Kim R. Quimby, Natasha Sobers, Colette George, Natalie Greaves, Francine Browman-Jones and T. Alafia Samuels

Implementation contextual factors related to community-based active travel to school interventions: a mixed methods interview study

Active travel to school contributes to multiple physical and psychosocial benefits for youth, yet population rates of active travel to school are alarmingly low in the USA and many other countries. Though walk...

Authors: MacKenzie Koester, Carolina M. Bejarano, Ann M. Davis, Ross C. Brownson, Jon Kerner, James F. Sallis, Chelsea Steel and Jordan A. Carlson

The CircumVent Project: a CPAP/O₂ helmet solution for non-invasive ventilation using an implementation research framework

Acute respiratory failure, a major cause of death in COVID-19, is managed with high-flow oxygen therapy via invasive mechanical ventilation. In resource-limited settings like Nigeria, the shortage of ventilato...

Authors: Aimalohi A. Ahonkhai, Adesola Z. Musa, André A. Fenton, Muktar H. Aliyu, Igho Ofotokun, Alex Hornstein, Baba M. Musa, Nnamdi Nwosu, Ifeoma Ulasi, Samuel Ajayi, Catherine Falade, Adedamola Dada, Aliyu Abdu, Mogaji Sunday, Adenike Odewabi, Muyiwa K. Rotimi…

Tracing the potential of networks to improve community cancer care: an in-depth single case study

Despite overall declines in cancer mortality in the USA over the past three decades, many patients in community settings fail to receive evidence-based cancer care. Networks that link academic medical centers ...

Authors: Jennifer L. Ridgeway, Lisa A. Boardman, Joan M. Griffin and Timothy J. Beebe

De-implementing and sustaining an intervention to eliminate nursing home resident bed and chair alarms: interviews on leadership and staff perspectives

Improving nursing home quality of care relies partly on reducing or stopping ineffective or harmful practices, a process known as de-implementation. We know little about de-implementation in this setting. Rela...

Authors: Christine W. Hartmann, Christopher Gillespie, George G. Sayre and A. Lynn Snow

Types of implementation of the dementia-specific case conference concept WELCOME-IdA in nursing homes: a qualitative process evaluation of the FallDem effectiveness trial

Dementia is regularly associated with behavioral and psychological symptoms of dementia (BPSD, also referred to as challenging behavior). Structured dementia-specific case conferences (DSCCs) enable nursing st...

Authors: Sonja Teupen, Daniela Holle and Martina Roes

Implementing at-birth, point-of-care HIV testing in Kenya: a qualitative study using the Consolidated Framework for Implementation Research

At-birth and point-of-care (POC) testing can expedite early infant diagnosis of HIV and improve infant outcomes. Guided by the Consolidated Framework for Implementation Research (CFIR), this study describes th...

Authors: Catherine Wexler, Yvonne Kamau, Elizabeth Muchoki, Shadrack Babu, Nicodemus Maosa, May Maloba, Melinda Brown, Kathy Goggin, Natabhona Mabachi, Brad Gautney and Sarah Finocchario-Kessler

Understanding the value of adhering to or adapting evidence-based interventions: a study protocol of a discrete choice experiment

Whereas the value of an evidence-based intervention (EBI) is often determined by its effect on clinical outcomes, the value of implementing and using EBIs in practice is broader, reflecting qualities such as a...

Authors: Ulrica von Thiele Schwarz, Aaron R. Lyon, Kristoffer Pettersson, Fabrizia Giannotta, Pernilla Liedgren and Henna Hasson

Identified barriers and facilitators to stroke risk screening in children with sickle cell anemia: results from the DISPLACE consortium

Children with sickle cell anemia are at risk for stroke. Ischemic stroke risk can be identified among children ages 2–16 years with sickle cell anemia using transcranial Doppler ultrasound. Despite strong reco...

Authors: Shannon M. Phillips, Alyssa M. Schlenz, Martina Mueller, Cathy L. Melvin, Robert J. Adams and Julie Kanter

Implementation strategy fidelity evaluation for a multidisciplinary Chest Injury Protocol (ChIP)

Blunt chest wall injuries can lead to complications, especially without early intervention. A blunt Chest Injury Protocol (ChIP) was developed to help improve the consistency of evidence-based care following admi...

Authors: Sarah Kourouche, Kate Curtis, Belinda Munroe, Michael Watts, Sharyn Balzer and Thomas Buckley

Champions for improved adherence to guidelines in long-term care homes: a systematic review

The champion model is increasingly being adopted to improve uptake of guideline-based care in long-term care (LTC). Studies suggest that an on-site champion may improve the quality of care residents’ health ou...

Authors: Amanda M. Hall, Gerd M. Flodgren, Helen L. Richmond, Sheila Welsh, Jacqueline Y. Thompson, Bradley M. Furlong and Andrea Sherriff

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