Skip to main content

Table 2 Implementation outcomes and determinants assessed in measurement tools (N = 86), then split by large-scale and unique tools

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

Domain   Included measures (N = 86) % Large-scale tools (n = 23) % Unique tools (n = 63) % Definition Source
Implementation outcomes Acceptability 18 20.9 0 0.0 18 28.6 Perceptions by staff in organizations mandated to implement the policy, or perceptions of other stakeholders, that the policy mandate is agreeable, palatable, or satisfactory Proctor et al. [19]
Adoption 32 37.2 10 43.5 22 34.9 Intention and initial actions of mandated organizations to revise their organizational policies to address policy mandates (not policy development or passage of bills into law) Proctor et al. [19]
Appropriateness 9 10.5 0 0.0 9 14.3 Perceived fit, relevance, or compatibility of the [policy] for a given practice setting, provider, or consumer; and/or perceived fit of the [policy] to address a particular issue or problem; context fit Proctor et al. [19]
Feasibility 8 9.3 1 4.3 7 11.1 Extent to which a new [policy] can be successfully used or carried out within a given agency or setting; level of administration required to implement a policy, often called policy automaticity Proctor et al. [19]
Fidelity/compliance 70 81.4 21 91.3 49 77.8 Degree to which a [policy] was implemented as it was prescribed Proctor et al. [19]
Penetration 15 17.4 8 34.8 7 11.1 Integration of a [policy] within a service setting and its subsystems Proctor et al. [19]
Sustainability 3 3.5 1 4.3 2 3.2 Extent [new policy] is maintained or institutionalized within a service setting’s ongoing, stable operations Proctor et al. [19]
Cost of implementation 5 5.8 0 0.0 5 7.9 Cost impact of an implementation effort Proctor et al. [19]
Policy/innovation characteristics Adaptability 3 3.5 0 0.0 3 4.8 Degree to which [a policy] can be adapted, tailored, refined, or reinvented to meet local needs Damschroder et al. [24]
Complexity 3 3.5 0 0.0 3 4.8 Perceived difficulty of implementation, reflected by duration, scope, radicalness, disruptiveness, centrality, and intricacy and number of steps required to implement Damschroder et al. [24]
Organizational characteristics/inner setting Champions 6 7.0 0 0.0 6 9.5 Field or practice leaders, people who can facilitate and support practice change among professionals Damschroder et al. [24]
Organizational culture and climate 9 10.5 1 4.3 8 12.7 Culture: “Norms, values, and basic assumptions of a given organization”; or climate: “Absorptive capacity for change”, extent policy compliance will be rewarded, supported, and expected within their organization Damschroder et al. [24]; Bullock [47]
Policy implementation climate (IC) 4 4.7 0 0.0 4 6.3 Organizational climate specific to the policy mandate Damschroder et al. [24]
IC: goals and feedback 6 7.0 3 13.0 3 4.8 Degree [the policy mandate] goals are clearly communicated, acted upon, and fed back to staff and alignment of that feedback with goals Damschroder et al. [24]
IC: relative priority 21 24.4 2 8.7 19 30.2 Individuals’ shared perception of importance of the [policy] implementation within the organization, competing priorities Damschroder et al. [24]
Opinion leaders 7 8.1 0 0.0 7 11.1 Individuals in an organization who have formal or informal influence on attitudes and beliefs of their colleagues with respect to implementing the policy Damschroder et al. [24]
Readiness to implement (RI) 5 5.8 0 0.0 5 7.9   Damschroder et al. [24]
RI: communication of policy 41 47.7 18 78.3 23 36.5 Communication plans and channels created for how the regulatory agency or implementing organization/s will disseminate policy mandate content information to implementers. Actions taken to disseminate policy requirements and guidelines to implementers. Damschroder et al. [24]
RI: policy awareness/knowledge 27 31.4 2 8.7 25 39.7 Implementing staff/provider awareness the policy mandate exists, or knowledge of policy content Damschroder et al. [24]
RI: leadership for implementation 42 48.8 22 95.7 20 31.7 Commitment, involvement, and accountability of leaders and managers with the implementation Damschroder et al. [24]
RI: non-training resources 43 50.0 15 65.2 28 44.4 Level of resources dedicated for implementation and ongoing operations including money…physical space, and time, other than training resources Damschroder et al. [24]
RI: training 35 40.7 16 69.6 19 30.2 Training of staff/providers in implementing organizations on how to implement the policy-mandated practices Damschroder et al. [24]
Structure of organization 2 2.3 0 0.0 2 3.2 The social architecture, age, maturity, and size of an organization Damschroder et al. [24]
Implementation process Enforcement 10 11.6 1 4.3 9 14.3 Strategies used to hold individuals accountable for implementation fidelity/compliance From screening/coding
Evaluation 35 40.7 18 78.3 17 27.0 Quantitative and qualitative feedback about the progress and quality of implementation accompanied with regular personal and team debriefing about progress and experience. Damschroder et al. [24]
General barriers and facilitators 20 23.3 2 8.7 18 28.6 Factors which facilitate/enable or hinder implementation From screening/coding
Collaboration 11 12.8 7 30.4 4 6.3 Active involvement of other stakeholders in the organization to implement the policy From screening/coding
Innovation participants 19 22.1 10 43.5 9 14.3 Engaging individuals who will directly benefit/receive the policy action Damschroder et al. [24]
Actor relationships/networks Actor relationships/networks 45 52.3 22 95.7 23 36.5 Presence and characteristics of relationships between parallel organizations that must collaborate for policy implementation to be effective Bullock [47]
Visibility of policy role and policy actors 23 26.7 8 34.8 15 23.8 Perceived presence and importance of different actors pertinent to implementation of the policy Bullock [47]
Actor context Political will for policy implementation 12 14.0 3 13.0 9 14.3 Societal desire and commitment to generate resources to carry out policies Bullock [47]
Target population characteristics 1 1.2 0 0.0 1 1.6 Demographics, norms, and neighborhood environments of the population groups that are affecting policy implementation Bullock [47]
Other domain (not in manual) CFIR process-planning 2 2.3 0 0.0 2 3.2 The degree to which a scheme or method of behavior and tasks for implementing [a policy] are developed in advance, and the quality of those schemes or methods Damschroder et al. [24]
CFIR innovation characteristics-relative advantage 1 1.2 0 0.0 1 1.6 Stakeholders’ perception of the advantage of implementing the intervention versus an alternative solution Damschroder et al. [24]
CFIR inner setting-tension for change 1 1.2 0 0.0 1 1.6 The degree to which stakeholders perceive the current situation as intolerable or needing change Damschroder et al. [24]