Step 4: Select Research Methods
The Many Methods of Implementation Science
A broad and inclusive definition of the field defines implementation science as a systematic, scientific approach to ask and answer questions about how we get “what works” to people who need it, with greater speed, fidelity, efficiency, quality and relevant coverage.
This broad landscape of inquiry allows for the application of at least fourteen research methods from a wide range of disciplines. Research methods in scientific research refer to the specific techniques and procedures used to collect, analyze, and interpret data.
In implementation science, these methods are used 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. Choosing the right method ensures that the study accurately measures what it intends to (validity) and produces consistent results over time (reliability). A mismatch between the research question and method can lead to invalid or unreliable findings, undermining the study’s credibility.
While the selection of research methods below is not exhaustive, together they provide a set of tools that are used to assess and improve implementation and scale-up of health and human-centered interventions.
Open Access articles will be marked with ✪
Please note some journals will require subscriptions to access a linked article.
Organizational Assessment
Evaluation of an organization’s readiness and capacity to implement evidence-based practices. This process helps identify strengths, weaknesses, and areas needing improvement to ensure successful implementation.
❯ What factors influence the readiness of an organization to implement a new intervention?
❯ How do contextual factors within the organization affect the implementation process?
❯ What is the role of organizational leadership in supporting or hindering implementation efforts?
❯ How do inter-organizational relationships and networks influence the implementation process?
✪ The role of organizational research in implementing evidence-based practice: QUERI Series (Implementation Science, 2008)
✪ Organizational- and system-level characteristics that influence implementation of shared decision-making and strategies to address them — a scoping review (Implementation Science, 2018)
✪ The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study (Implementation Science, 2012)
✪ A complementary marriage of perspectives: understanding organizational social context using mixed methods (Implementation Science, 2014)
✪ Towards evidence-based palliative care in nursing homes in Sweden: a qualitative study informed by the organizational readiness to change theory (Implementation Science, 2018)
✪ Assessing organizational implementation context in the education sector: confirmatory factor analysis of measures of implementation leadership, climate, and citizenship (Implementation Science, 2018)
Stakeholder & Policy Analysis
The intentional integration of stakeholder (individuals or groups who have an interest in a particular policy or program) perspectives and feedback in the analysis of policy advisability, execution and impact.
❯ How do different stakeholders influence the implementation of evidence-based interventions?
❯ What are the policy barriers and facilitators to implementing new interventions?
❯ How can stakeholder engagement be optimized to enhance the implementation process?
A Framework for Enhancing the Value of Research for Dissemination and Implementation (American Journal of Public Health, 2014)
✪ Addressing Health Equity Through Action on the Social Determinants of Health: A Global Review of Policy Outcome Evaluation Methods (International Journal of Health Policy and Management, 2018)
✪ How to engage stakeholders in research: design principles to support improvement (Health Research Policy and Systems, 2018)
✪ Engaging policy-makers, health system managers, and policy analysts in the knowledge synthesis process: a scoping review (Implementation Science, 2018)
✪ The micropolitics of implementation; a qualitative study exploring the impact of power, authority, and influence when implementing change in healthcare teams (BMC Health Services Research, 2020)
✪ Evidence-informed policy formulation and implementation: A comparative case study of two national policies for improving health and social care in Sweden (Implementation Science, 2015)
✪ HIV policy implementation in two health and demographic surveillance sites in Uganda: Findings from a national policy review, health facility surveys and key informant interviews (Implementation Science, 2017)
Implementation science in global health settings: Collaborating with governmental & community partners in Uganda (Psychiatry Research, 2019)
Economic Evaluation
Comparing the costs and benefits of different courses of action. Specifically, understanding the costs associated with evidence-based practices (such as interventions, policies, programs, and tools) and the efforts required to deliver and sustain them.
❯ What are the costs and benefits of the implementation strategy compared to the status quo?
❯ How do the costs of implementation vary across different settings and populations?
❯ What is the cost-effectiveness of different implementation strategies?
❯ What are the long-term financial impacts of sustaining an intervention?
Methodological reviews of economic evaluations in health care: what do they target? (The European Journal of Health Economics, 2014)
✪ Economic evaluation of implementation strategies in health care (Implementation Science, 2014)
Economic evaluation in implementation science: Making the business case for implementation strategies (Psychiatry Research, 2019)
✪ Use of health economic evaluation in the implementation and improvement science fields—a systematic literature review (Implementation Science, 2019)
Including Economic Evaluations in Implementation Science (Journal of General Internal Medicine , 2020)
✪ Cost data in implementation science: categories and approaches to costing (Implementation Science, 2022)
💻 Pragmatic Research & Costing in D&I Grants (Dr. Russell E. Glasgow, University of Colorado)
✪ Economic Evaluation of Active Implementation versus Guideline Dissemination for Evidence-Based Care of Acute Low-Back Pain in a General Practice Setting (PLOS One, 2013)
✪ Economic evaluation of Community Level Interventions for Pre-eclampsia (CLIP) in South Asian and African countries: a study protocol (Implementation Science, 2015)
✪ A Cost-Effectiveness Tool to Guide the Prioritization of Interventions for Rheumatic Fever and Rheumatic Heart Disease Control in African Nations (PLOS Neglected Tropical Diseases, 2016)
✪ Economic Evaluations of Stepped Models of Care for Depression and Anxiety and Associated Implementation Strategies: A Review of Empiric Studies (International Journal of Integrated Care, 2019)
Social Marketing
The application of marketing principles to influence behaviors that benefit individuals and communities for the greater social good. This approach is used to design, implement, and evaluate programs aimed at promoting the adoption of evidence-based practices and interventions. Includes audience segmentation, targeted messaging, and the use of various communication channels to reach and engage specific groups.
Qualitative Health Systems Research
Research that uses methods of observation and interviewing to evaluate health systems through the lens of those who experience them, and to explain factors that shape outcomes, dimensions of care, as well as the social and political determinants of health. For an excellent overview of qualitative methods in implementation research, see Qualitative methods in implementation research: An introduction (Psychiatry Research, 2019).
❯ How do healthcare providers and staff perceive and experience the implementation of new interventions?
❯ What are the contextual factors that influence the success or failure of implementation efforts?
❯ How do patients and community members perceive and engage with the implemented interventions?
❯ What are the underlying mechanisms and processes that drive implementation outcomes?
✪ Qualitative Data Analysis for Health Services Research: Developing Taxonomy, Themes, and Theory (Health Services Research, 2007)
✪ Qualitative Methods in Implementation Science (The National Cancer Institute, 2018)
Anchoring contextual analysis in health policy and systems research: A narrative review of contextual factors influencing health committees in low and middle income countries (Social Science & Medicine, 2015)
✪ Identification of gaps for implementation science in the HIV prevention, care and treatment cascade: A qualitative study in 19 districts in Uganda (BMC Research Notes, 2016)
✪ Health policy and systems research and analysis in Nigeria: Examining health policymakers’ and researchers’ capacity assets, needs and perspectives in south-east Nigeria (Health Research Policy and Systems, 2016)
✪ Synergies, strengths and challenges: findings on community capability from a systematic health systems research literature review (BMC Health Services Research, 2016)
✪ Unraveling PBF effects beyond impact evaluation: results from a qualitative study in Cameroon (BMJ Global Health, 2017)
Dissemination Research
The targeted distribution of information and intervention materials to a specific public health or clinical practice audience.
❯ What are the most effective strategies for disseminating evidence-based interventions to target audiences?
❯ How do contextual factors influence the success of dissemination efforts?
❯ What are the barriers and facilitators to the adoption of disseminated interventions?
❯ How can dissemination strategies be adapted to different populations and settings?
✪ Disseminating research findings: what should researchers do? A systematic scoping review of conceptual frameworks (Implementation Science, 2010)
The Science, and Art, of Program Dissemination: Strategies, Successes, and Challenges (New Directions for Child and Adolescent Development, 2015)
✪ Strategies for disseminating recommendations or guidelines to patients: a systematic review (Implementation Science, 2016)
WEBINAR: Designing for Dissemination: How might we increase the reach and impact of our discoveries? (Recording of ACCORDS Grand Rounds, presented by Ross Brownson, June 2018)
✪ Developing a national dissemination plan for collaborative care for depression: QUERI Series (Implementation Science, 2008)
✪ Does dissemination extend beyond publication: a survey of a cross section of public funded research in the UK (Implementation Science, 2010)
✪ Dissemination of evidence-based cancer control interventions among Catholic faith-based organizations: results from the CRUZA randomized trial (Implementation Science, 2016)
Prioritizing Implementation Barriers
This process enables teams to determine which implementation barriers are most important to address to support evidence-based intervention implementation. To learn more, visit ImpSciMethods.org.
❯ Which barriers have the greatest impact on the implementation process?
❯ How do different barriers interact and compound to affect implementation outcomes?
❯ What strategies are most effective in overcoming prioritized barriers?
❯ How do contextual factors influence the prioritization and impact of barriers?
Rapid Evidence Synthesis
Used to summarize and synthesize research literature and can be applied to synthesizing evidence on known determinants for implementing evidence-based interventions. To learn more, visit ImpSciMethods.org.
❯ What are the most effective strategies for implementing evidence-based interventions in specific settings?
❯ What factors influence the success or failure of implementation efforts?
❯ How can strategies be adapted to fit different cultural and contextual settings?
✪ Study protocol: Novel Methods for Implementing Measurement-Based Care with youth in Low-Resource Environments (NIMBLE) (Implementation Science Communications, 2023)
✪ Implementation of a Rapid Evidence Assessment Infrastructure during the Coronavirus Disease 2019 (COVID-19) Pandemic to Develop Policies, Clinical Pathways, Stimulate Academic Research, and Create Educational Opportunities (The Journal of Pediatrics, 2020)
Operations Research
The use of qualitative or quantitative models to facilitate decision-making in complex implementation, particularly relating to structure, prospective evaluation, and reconfiguration.
❯ 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?
✪ Operational research as implementation science: definitions, challenges and research priorities (Implementation Science, 2016)
Experiences in implementation and publication of operations research interventions: gaps and a way forward (Journal of the International AIDS Society, 2016)
Advancing the strategic use of HIV operations research to strengthen local policies and programmes: The Research to Prevention Project (Journal of the International AIDS Society, 2015)
✪ Shifting management of a community volunteer system for improved child health outcomes: Results from an operations research study in Burundi (BMC Health Services Research, 2015)
✪ Efficiency of the implementation of cardiovascular risk management in primary care practices: an observational study (Implementation Science, 2016)
Impact Evaluation
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.
❯ What differences in outcomes are see between two strategies?
❯ What was the impact of the implementation strategy on beneficiaries?
❯ How do outcomes among beneficiaries compare to outcomes among individuals who did not receive the strategy?
✪ Impact Evaluation in Practice – Second Edition (World Bank, 2016)
✪ Conducting implementation research in impact studies of education interventions: A guide for researchers (Institute of Education Sciences: US Department of Education, 2023)
✪ Integrating impact evaluation and implementation research to accelerate evidence-informed action (International Initiative for Impact Evaluation, 2018)
✪ Quantitative and Qualitative Methods in Impact Evaluation and Measuring Results (UK Department for International Development, 2009)
✪ Impact of pharmacy worker training and deployment on access to essential medicines and health outcomes in Malawi: protocol for a cluster quasi-experimental evaluation (Implementation Science, 2014)
Interventions to Drive Uptake of Voluntary Medical Male Circumcision—A Collection of Impact Evaluation Evidence (Journal of Acquired Immune Deficiency Syndromes, 2016)
The European Union’s Ambient and Assisted Living Joint Programme: An evaluation of its impact on population health and well-being (Health Informatics Journal, 2016)
✪ Evaluation of the Impact of a Mass Media Campaign on Periodontal Knowledge among Iranian Adults: A Three-Month Follow-Up (PLOS One, 2017)
Counting what really counts? Assessing the political impact of science (The Journal of Technology Transfer, 2017)
Rapid Ethnographic Assessment
Used to efficiently gather ethnographic data about determinants by seeking to understand the people, tasks, and environments involved from stakeholder perspectives. To learn more, visit ImpSciMethods.org.
❯ What are the contextual factors influencing implementation?
❯ How do stakeholders perceive and experience the implementation process?
❯ What are the barriers and facilitators to successful implementation?
❯ How do power dynamics and relationships impact the implementation process?
✪ Designing an implementation strategy to increase health-related social needs screening: Applying the PRISM framework in a resource-limited clinical setting (Translational Behavioral Medicine, 2023)
✪ A Rapid Ethnographic Assessment of the Impact of the COVID-19 Pandemic on Mental Health Services Delivery in an Acute Care Medical Emergency Department and Trauma Center (Administration and Policy in Mental Health and Mental Health Services Research , 2021)
Causal Pathway Diagrams
A graphical tool that enables visualization of how implementation strategies bring about implementation outcomes and the conditions under which they work. To learn more, visit ImpSciMethods.org.
❯ What are the specific mechanisms through which an implementation strategy leads to desired outcomes?
❯ How do different components of an implementation strategy interact to produce outcomes?
❯ What are the proximal and distal outcomes of an implementation strategy?
❯ What are the moderators and preconditions that affect the implementation process?
Surveillance & Data Systems
Routine surveillance data from control and experimental groups can be used illustrate the performance or impact of new policies and programs in an environment, capture real-time feedback, guide resource allocation, and systematically capture implementation processes.
❯ How do implementation outcomes vary over time and across different settings?
❯ What are the real-time barriers and facilitators to implementation?
❯ How effective are the strategies in achieving their intended outcomes?
❯ What are the long-term sustainability and scalability of the interventions?
✪ Public Health Surveillance Systems: Recent Advances in Their Use and Evaluation (Annual Review of Public Health, 2016)
✪ Data-driven quality improvement in low-and middle-income country health systems: Lessons from seven years of implementation experience across Mozambique, Rwanda, and Zambia (BMC Health Services Research, 2017)
✪ Using routine health information systems for well-designed health evaluations in low- and middle-income countries (Health Policy and Planning, 2016)
Implementation Science and the Pregnancy Risk Assessment Monitoring System (Journal of Women’s Health, 2014)
✪ Surveillance Systems to Track and Evaluate Obesity Prevention Efforts (Annual Review of Public Health, 2017)
✪ Harnessing the Power of Data to Guide Local Action and End Tuberculosis (The Journal of Infectious Diseases, 2017)
✪ HIV Clustering in Mississippi: Spatial Epidemiological Study to Inform Implementation Science in the Deep South (JMIR Public Health and Surveillance, 2018)
Find Examples
Browse our Library of UW community co-authored publications to see examples of research a variety of research methods.
PAUSE AND REFLECT
❯ How inclusive is the research design? Are diverse stakeholders involved in the design and planning stages? How are the voices of historically marginalized communities being incorporated?
❯ What are the potential biases in the research methods? Are there inherent biases in the chosen methods that could affect the results? How can these biases be identified and mitigated?
❯ How will data be collected and analyzed? Are the data collection methods culturally sensitive and appropriate for all target populations? How will the data analysis account for differences across diverse groups?
❯ What are the ethical considerations? Are there ethical concerns related to the research methods that could disproportionately affect certain groups? How will informed consent and confidentiality be ensured for all participants?
❯ What are the potential unintended consequences? Could the research methods inadvertently reinforce existing inequities or create new ones? How will these risks be monitored and addressed?
❯ How can one effectively segment the target audience to tailor implementation strategies?
❯ What are the most effective communication strategies to promote the adoption of evidence-based practices?
❯ What are the barriers and facilitators to behavior change within the target population?
✪ Social Marketing in Public Health (Annual Review of Public Health, 2005)
✪ A Framework for Disseminating Evidence-Based Health Promotion Practices (Preventing Chronic Disease, 2012)
✪ The effectiveness of social marketing in global health: A systematic review (Health Policy and Planning, 2017)
✪ Social marketing interventions for the prevention and control of neglected tropical diseases: A systematic review (PLoS Neglected Tropical Diseases, 2020)
✪ Health marketing and behavioral change: A review of the literature (Journal of Medicine and Life, 2018)
✪ Role of social marketing in promoting primary care to succeed in current era (Journal of Family Medicine and Primary Care, 2019)
Direct‐to‐Consumer Marketing: A Complementary Approach to Traditional Dissemination and Implementation Efforts for Mental Health and Substance Abuse Interventions (Clinical Psychology Science and Practice, 2015)
Selling Innovations Like Soap: The Interactive Systems Framework and Social Marketing (American Journal of Community Psychology, 2017)
Using system dynamics modeling to evaluate a community-based social marketing framework (Journal of Social Marketing, 2019)
✪ Effectiveness of social marketing in improving knowledge, attitudes and practice of consumption of vitamin A-fortified oil in Tanzania (Public Health Nutrition, 2019)