Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science.
Background: Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the...
| Published in: | Implementation Science Vol. 4; pp. 50 - 51 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | research Journal Article |
| Published: |
BioMed Central
2009
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104907109&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104907109 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17485908 38MN jtl: Implementation Science issn: 17485908 maglogo: N pubinfo: dt: 2009 vid: 4 pid: 24147 pub: BioMed Central artinfo: ui: 104907109 NLM19664226 2010392128 10.1186/1748-5908-4-50 NLM19664226 PMC2736161 104907109 ppf: 50 ppct: 1 formats: tig: atl: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. aug: au: Damschroder LJ Aron DC Keith RE Kirsh SR Alexander JA Lowery JC Damschroder, Laura J Aron, David C Keith, Rosalind E Kirsh, Susan R Alexander, Jeffery A Lowery, Julie C affil: HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System (11H), 2215 Fuller Rd, Ann Arbor, MI 48105, USA sug: subj: Applied Research Methods Patient Care Methods Health Services Human ab: Background: Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts.Methods: We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts.Results: The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct.Conclusion: The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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