Draft:Role of Wiki Platforms in Dissemination and Implementation Science

Outline of Wiki article: this is what I am aiming to work on at 3/25 HGAPS meeting

A critique of peer review as a primary dissemination tool
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What is implementation science?
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Evaluation Frameworks
Notes on implementation frameworks:

Framework: Quality Implementation Framework

Source: Meyers, D. C., Durlak, J. A., & Wandersman, A. (2012). The quality Implementation framework: A synthesis of critical steps in the implementation process. American Journal of Community Psychology, 50(3-4), 462-480. doi:10.1007/s10464-012-9522-x


 * PDF: The_Quality_Implementation_Framework__A_Synthesis_of_Critical_Steps_in_the_Implementation_Process.pdf (d1j85byv4fcann.cloudfront.net)

Overview: This framework comprises 14 critical steps across four phases of implementation. It has been widely used in child and family services, behavioral health, and hospital settings. The four implementation phases and 14 critical steps are organized as follows:

Phase One: Initial considerations regarding the host setting


 * 1) Conducting a needs and resources assessment


 * Why are we doing this?
 * What problems or conditions will the innovation address (what is the need for the innovation?)
 * What part(s) of the organization and who in the organization will benefit from improvement efforts?


 * 1) Conducting a fit assessment


 * Does the innovation fit the setting?
 * How well does the innovation match the:
 * Identified needs of the organization/community?
 * Organization’s mission, priorities, values, and strategies for growth?
 * Cultural preferences of groups/consumers who participate in the activities/services provided by the organization?


 * 1) Conduction a capacity/readiness assessment?


 * Are we ready for this?
 * To what degree does the organization/community have the will and means (adequate resources, skills, and motivation) to implement the innovation?
 * Is the organization/community ready for change?


 * 1) Possibility for adaptation


 * Should the planned innovation be modified in any way to fit the host setting and target group?
 * What feedback can the host staff offer regarding how the proposed innovation needs to be changed to make it successful in a new setting and for its intended audience?
 * How will changes to the innovation be documented and monitored during implementation?


 * 1) Obtaining explicit buy-in from critical stakeholders and fostering a supportive community/organizational climate


 * Do we have genuine and explicit buy-ins for this innovation from:
 * Leadership with decision-making power?
 * Frontline staff who will deliver the innovation?
 * The local community?
 * Have we effectively dealt with important concerns, questions, or resistance to this innovation? What possible barriers to implementation need to be lessened or removed?
 * Can we identify and recruit an innovation champion(s)?
 * Are there one or more individuals who can inspire and lead others to implement this innovation and its associated practice(s)?
 * How can the organization/community assist in the effort to foster and maintain buy-in for change?


 * 1) Building general/organizational capacity


 * What infrastructure, skills, and motivation of the organization/community need enhancement in order to ensure the innovation will be implemented with quality?


 * 1) Staff recruitment/maintenance


 * Who will implement the innovation?
 * Who will support the practitioners who implement the innovation?
 * These individuals need expertise related to (a) the innovation, (b) its use,  (c) implementation science, and (d) process evaluation so they can support the implementation effort effectively


 * Might roles of some existing staff need realignment to ensure that adequate person-power is put towards implementation?


 * 1) Effective pre-innovation staff training


 * Can we provide sufficient training to teach the why, what, when, where, and how regarding the intended innovation?
 * How can we ensure that the training covers the theory, philosophy, values of the innovation, and the skill-based competencies needed for practitioners to achieve self-efficacy, proficiency, and correct application of the innovation?

Phase two: Creating a structure for implementation


 * 1) Creating implementation teams


 * Who will have organizational responsibility for implementation?
 * Can we develop a support team of qualified staff to work with front-line workers who are delivering the innovation?
 * Can we specify the roles, processes, and responsibilities of these team members?


 * 1) Developing an implementation plan


 * Can we create a clear plan that includes specific tasks and timelines to enhance accountability during implementation?
 * What challenges to effective implementation can we foresee that we can address proactively?

Phase three: Ongoing structure once implementation begins


 * 1) Technical assistance/coaching/supervision


 * Can we provide the necessary technical assistance to help the organization/community and practitioners deal with the inevitable practical problems that will develop once the innovation begins?


 * 1) Process evaluation


 * Do we have a plan to evaluate the relative strengths and limitations in the innovation’s implementation as it unfolds over time?
 * Data are needed on how well different aspects of the innovation are being conducted as well as the performance of different individuals implementing the innovation


 * 1) Supportive feedback mechanism
 * 2) Is there an effective process through which key findings from process data related to implementation are communicated, discussed, and acted upon?


 * How will process data on implementation be shared with all those involved in the innovation (e.g., stakeholders, administrators, implementation support staff, and front-line practitioners)?
 * This feedback should be offered in the spirit of providing opportunities for further personal learning and skill development and
 * organizational growth that leads to quality improvement in implementation

Phase four: Improving future applications


 * 1) Learning from experience


 * What lessons have been learned about implementing this innovation that we can share with others who have an interest in its use?

Some examples of use:


 * Frontiers | The Application of an Implementation Science Framework to Comprehensive School Physical Activity Programs: Be a Champion! | Public Health (frontiersin.org)


 * Practical Implementation Science: Developing and Piloting the Quality Implementation Tool - Meyers - 2012 - American Journal of Community Psychology - Wiley Online Library

Framework: EPIS (Exploration, Adoption/Preparation, Implementation, Sustainment) Model

Source: Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2010). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 4-23. doi:10.1007/s10488-010-0327-7


 * PDF: s10488-010-0327-7.pdf (springer.com)

Overview: This framework is a four-phase implementation model addressing implementation in public service sector contexts.

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^ original version

Some examples of use: COME BACK. Framework: PARiHS (Promoting Action on Research Implementation in Health Services

Source: Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the implementation of evidence based practice: A conceptual framework. Quality and Safety in Health Care, 7(3), 149-158. doi:10.1136/qshc.7.3.149


 * PDF: 149.full.pdf (bmj.com)

Overview: The PARIHS framework provides a way to implement research into practice, taking into consideration three key factors:


 * 1) Evidence (E): codified and uncodified sources of knowledge, including research evidence, practitioner experience, community preferences and experience, and local information. Some considerations:


 * Research-- evidence needs to be translated and adapted so that it makes sense in the local context.
 * Practitioner experience and expertise-- the ‘practical know-how’ of practitioners needs to be made explicit for practitioner expertise to be shared, critiqued, and developed.
 * Community/intended population-- groups and communities need to be included in decision making.
 * Local context and environment-- data on the local context such as evaluation data, local community stories, and knowledge of the organizational culture needs to be considered.


 * 1) Context (C): the context is the environment or setting in which the proposed change is to be implemented. Context is subdivided into three core elements:


 * An understanding of the prevailing culture
 * Leadership roles
 * The organization’s approach to measurement (evaluation)


 * 1) Facilitation (F): facilitation describes the type of support needed to help people change their attitudes, habits, skills, and ways of thinking and working.

This framework is expressed as:

SI (successful implementation) = f(E, C, F)

Each factor-- evidence, context, and facilitation-- consists of sub-elements that can be rated on a scale from low to high. High ratings on each factor are more likely to produce successful implementation results.