Step 6: Choose Measures
Measurement in Implementation Science
Measurement in implementation science is currently characterized by both significant progress and notable challenges.
As a relatively new field, implementation science has seen the development of numerous measures aimed at evaluating various aspects of implementation processes and outcomes. However, many of these measures have not undergone rigorous psychometric evaluation, raising concerns about their validity and reliability. This lack of standardized, validated measures makes it difficult to compare results across studies and hinders the accumulation of generalizable knowledge.
One of the primary issues in the field is the development of measures that are often specific to particular studies or contexts and are rarely used more than once. This practice limits the ability to build a cohesive body of evidence and makes it challenging to draw broader conclusions about implementation strategies and their effectiveness. Additionally, there is a lack of minimal reporting standards for these measures, which further complicates efforts to assess their quality and applicability.
Current debates in the field revolve around several key issues. One major debate concerns the balance between developing context-specific measures and creating more generalizable tools that can be applied across different settings and populations. While context-specific measures can provide detailed insights into particular interventions, they often lack the broader applicability needed for generalizable research findings. Another ongoing discussion focuses on the need for measures that not only have strong psychometric properties but are also pragmatic and feasible for use in real-world settings. This includes considerations of the burden on respondents and the practicality of implementing these measures in various contexts.
Furthermore, there is a growing emphasis on the importance of stakeholder involvement in the development of implementation measures. Engaging practitioners, policymakers, and other stakeholders in the measurement development process can help ensure that the tools are relevant, useful, and feasible for those who will be using them. This collaborative approach is seen as essential for advancing the field and improving the quality and utility of implementation science research.
Overall, while the field of implementation science has made significant strides in developing measures, ongoing efforts are needed to address these challenges and debates to enhance the rigor and impact of research in this area.
Systems Antecedents for Dissemination and Implementation: A Review and Analysis of Measures (Health Education and Behavior, 2011)
Toward the Effective and Efficient Measurement of Implementation Fidelity (Administration and Policy in Mental Health and Mental Health Services Research, 2011)
✪ Advancing the application, quality and harmonization of implementation science measures (Implementation Science, 2012)
✪ Measuring factors affecting implementation of health innovations: A systematic review of structural, organizational, provider, patient, and innovation level measures (Implementation Science, 2013)
Measures for Predictors of Innovation Adoption (Administration and Policy in Mental Health and Mental Health Services Research, 2015)
✪ Psychometric properties of implementation measures for public health and community settings and mapping of constructs against the Consolidated Framework for Implementation Research: a systematic review (Implementation Science, 2016)
✪ Developing measures to assess constructs from the Inner Setting domain of the Consolidated Framework for Implementation Research (Implementation Science, 2018)
✪ Implementation outcome instruments for use in physical healthcare settings: a systematic review (Implementation Science, 2020)
The Dissemination & Implementation Models Webtool: ASSESS
The ASSESS section of the D&I Models Webtool helps implementation researchers, practitioners, and students identify, select, and use measurement instruments that are aligned with dissemination and implementation (D&I) theories, models, and frameworks (TMFs). The resource brings together a diverse collection of assessment instruments, including both quantitative measures and qualitative assessment approaches, and provides guidance on how to choose instruments that best fit a project's goals, setting, population, and stage of implementation. Users can explore available instruments, learn best practices for measurement selection, and connect assessment tools to key D&I constructs and frameworks.
Researchers can search for instruments using keywords or specific criteria, identify measures linked to D&I constructs of interest, and review instrument characteristics and metadata to inform selection decisions. Whether developing a new implementation study, evaluating an intervention, or selecting outcomes for a quality improvement initiative, the ASSESS section offers practical guidance and searchable resources that support rigorous, theory-informed measurement in implementation science.
The Instrument Review Project: Measures of Implementation Science in Behavioral Health
The field of implementation science has made substantial progress in identifying, evaluating, and improving measures used to study implementation processes and outcomes. One landmark contribution was the Society for Implementation Research Collaboration (SIRC) Instrument Review Project, led by Cara C. Lewis and funded by the National Institute of Mental Health (NIMH). The project systematically reviewed hundreds of implementation science instruments used in behavioral health, creating one of the field’s most comprehensive assessments of measure quality and availability. It also introduced the Psychometric and Pragmatic Evidence Rating Scale (PAPERS), which provides a standardized approach for evaluating both the scientific rigor and real-world usability of implementation measures.
The project’s impact extends well beyond its funding. Its repositories, evaluation methods, and published systematic reviews continue to guide researchers in selecting high-quality measures and identifying gaps where new instrument development is needed. The SIRC Instrument Review Project helped establish measurement standards for implementation science and accelerated efforts to improve the validity, reliability, and practicality of measures used across health, behavioral health, and community settings. Readers interested in the broader significance of this work may wish to explore international advisory board member Michel Wensing’s reflection in Implementation Research and Practice.
✪ Instrumentation issues in implementation science (Implementation Science, 2014)
✪ The Society for Implementation Research Collaboration Instrument Review Project: A methodology to promote rigorous evaluation (Implementation Science, 2015)
✪ Advancing implementation science through measure development and evaluation: A study protocol (Implementation Science, 2015)
✪ Outcomes for implementation science: an enhanced systematic review of instruments using evidence-based rating criteria (Implementation Science, 2015)
✪ Measurement resources for dissemination and implementation research in health (Implementation Science, 2016)
✪ Toward criteria for pragmatic measurement in implementation research and practice: A stakeholder-driven approach using concept mapping (Implementation Science, 2017)
✪ Psychometric assessment of three newly developed implementation outcome measures (Implementation Science, 2017)
✪ Operationalizing the ‘pragmatic’ measures construct using a stakeholder feedback and a multi-method approach (BMC Health Services Research, 2018)
✪ An updated protocol for a systematic review of implementation-related measures (Systematic Reviews, 2018)
Stakeholder perspectives and use of implementation science measurement tools (Conference Presentation, 2018)
Measures and Outcomes in Implementation Science (Advancing the Science of Implementation Across the Cancer Continuum, 2018)
Pragmatic measures for implementation research: development of the Psychometric and Pragmatic Evidence Rating Scale (PAPERS) (Translational Behavioral Medicine, 2019)
✪ Enhancing the Impact of Implementation Strategies in Healthcare: A Research Agenda (Frontiers in Public Health, 2019)
✪ Psychometric and Pragmatic Properties of Social Risk Screening Tools: A Systematic Review (American Journal of Preventive Medicine, 2019)
✪ Quantitative measures of health policy implementation determinants and outcomes: a systematic review (Implementation Science, 2020)
✪ Measuring implementation outcomes: An updated systematic review of measures’ psychometric properties (Implementation Research and Practice, 2020)
✪ Measures of organizational culture, organizational climate, and implementation climate in behavioral health: A systematic review (Implementation Research and Practice, 2021)
✪ Measuring characteristics of individuals: An updated systematic review of instruments’ psychometric properties (Implementation Research and Practice, 2021)
EQUITY CHECK: Pause and reflect
Do the selected measures:
❯ assess equitable reach, adoption, fidelity, implementation quality, sustainability, and outcomes?
❯ allow results to be examined across populations and settings?
❯ measure factors that contribute to inequities, including access barriers, discrimination, resource constraints, or policy influences?
❯ assess unintended consequences and potential harms?
❯ reflect outcomes valued by patients, communities, and implementation partners?
❯ include indicators of trust, engagement, empowerment, or shared decision-making when relevant?
The IS Research Pathway
Open Access articles are marked with ✪
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Videos from our friends
NCI TIDIRC Module 3: Implementation Science Measures, Dr. Bryan J. Weiner, PhD (University of Washington)
Implementation Science Measures: Dr. Alyssa Lozano, PhD (University of Miami)
Advancing Measurement in Implementation Science: D&I Models in Health ASSESS Webtool
Pragmatic Measurement of Implementation Outcomes, Dr. Cara C. Lewis, PhD
Design and Measurement Considerations for Implementation Science Projects, Dr. William Calo, PhD
Design and Measurement Considerations for Implementation Science Projects, Dr. Seren Yoong, PhD (Swinburne University)
Find Examples

Browse our Library of UW community co-authored publications to see examples of research on implementation measures and measurement.