Authors:
Cara C. Lewis, Hannah E. Frank, Gracelyn Cruden, Bo Kim, Aubyn C. Stahmer, Aaron R. Lyon, Bianca Albers, Gregory A. Aarons, Rinad S. Beidas, Brian S. Mittman, Bryan J. Weiner, Nate J. Williams, Byron J. Powell & MNoE Group
University of Washington affiliated authors are displayed in bold.
✪ Open Access
Published: September 2024
Read the full text in the open access journal Implementation Science Communications
Abstract:
Background
Implementation science scholars have made significant progress identifying factors that enable or obstruct the implementation of evidence-based interventions, and testing strategies that may modify those factors. However, little research sheds light on how or why strategies work, in what contexts, and for whom. Studying implementation mechanisms—the processes responsible for change—is crucial for advancing the field of implementation science and enhancing its value in facilitating equitable policy and practice change. The Agency for Healthcare Research and Quality funded a conference series to achieve two aims: (1) develop a research agenda on implementation mechanisms, and (2) actively disseminate the research agenda to research, policy, and practice audiences. This article presents the resulting research agenda, including priorities and actions to encourage its execution.
Method
Building on prior concept mapping work, in a semi-structured, 3-day, in-person working meeting, 23 US-based researchers used a modified nominal group process to generate priorities and actions for addressing challenges to studying implementation mechanisms. During each of the three 120-min sessions, small groups responded to the prompt: “What actions need to be taken to move this research forward?” The groups brainstormed actions, which were then shared with the full group and discussed with the support of facilitators trained in structured group processes. Facilitators grouped critical and novel ideas into themes. Attendees voted on six themes they prioritized to discuss in a fourth, 120-min session, during which small groups operationalized prioritized actions. Subsequently, all ideas were collated, combined, and revised for clarity by a subset of the authorship team.
Results
From this multistep process, 150 actions emerged across 10 priority areas, which together constitute the research agenda. Actions included discrete activities, projects, or products, and ways to shift how research is conducted to strengthen the study of implementation mechanisms.
Conclusions
This research agenda elevates actions to guide the selection, design, and evaluation of implementation mechanisms. By delineating recommended actions to address the challenges of studying implementation mechanisms, this research agenda facilitates expanding the field of implementation science, beyond studying what works to how and why strategies work, in what contexts, for whom, and with which interventions.
Contributions to the literature
- This research agenda operationalizes a set of activities to strengthen the implementation science field’s focus on why and how strategies work.
- The research agenda addresses the following activities: accumulating knowledge, innovating methods and overcoming design challenges, improving measurement, providing guidance for specifying causal mechanisms, increasing focus on theorizing, engaging the policy and practice community, engaging funders, building capacity, enhancing equity, and effectively disseminating methods.
- Studying implementation mechanisms can promote pragmatic strategy development, equitable processes and outcomes, and policy relevance by clarifying pathways for overcoming contextually specific barriers and achieving outcomes of interest.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**