Research Methods in Implementation Science

A broad and inclusive definition defines implementation science as a systematic, scientific approach to ask and answer questions about how we get “what works” to people who need it, for as long as they need it, with greater speed, fidelity, efficiency, quality and relevant coverage. This definition allows for the application of at least ten research methods from a broad range of disciplines in order to understand and improve the determinants, processes, and outcomes of implementation and, ultimately, scale-up and sustainability to achieve population-level health benefits.

While this selection of research methods is not exhaustive, together they provide a set of tools that are used to assess and improve implementation and scale-up of health interventions. These methods allow exploration of the continuum consisting of three categories of outcomes: proximal implementation outcomes, such as acceptability, appropriateness, adoption, costs, feasibility, fidelity, penetration, and sustainability; intermediate service delivery outcomes such as efficiency, equity, timeliness, and patient-centeredness; and distal health outcomes.

10 key research methods of implementation science

Systems Analysis and Improvement

Definition: Defined by the developers as the 'mentored, iterative application of a systems analysis tool and related improvement approach to provide facility-level staff and managers with a holistic view of their system’s performance, identify which steps in the [care] cascade are the highest priority for improvement and which bottlenecks are modifiable, and test contextually appropriate solutions.'1
 

Methodology:
Examples of use:

Surveillance & Data Systems

Definition: Routine surveillance data from control and experimental groups can be used illustrate the performance or impact of new policies and programs in an environment.
 

Methodology:
Examples of use:

Social Marketing

Definition: The application of marketing principals to policy selection, as well as to implementation or intervention planning and operational delivery, done in a reflexive and critical manner.
 

Methodology:
Examples of use:

Impact Evaluation

Definition: An evaluation of how the intervention or implementation affects relevant outcomes, intended or otherwise, and typically includes evidence of how outcomes would or would not differ in the absence of the intervention or implementation.
 
Key Questions:

  • What would have happened had the intervention not taken place?
  • What was the impact of the intervention on beneficiaries?
  • How does the outcome among beneficiaries compare to the outcome among individuals who were not involved in the program?

 

Examples of Use:

Operations Research

Definition: The use of qualitative or quantitative models to facilitate decision-making in complex implementation, particularly relating to structure, prospective evaluation, and reconfiguration.
 
Key Questions:

  • What are the implementation problems exhibited by a particular project?
  • What are the innovative solutions to deal with implementation problems?
  • What policies or service delivery models can improve effectiveness or efficiency?
  • What is the optimal allocation of resources for the program?

 

Methodology:
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Qualitative Health Systems Research