Navigating the complexities of digital health technology implementation: a scoping review of barriers and facilitators - Implementation Science Communications Background The implementation of digital health technologies (DHTs) is a strategic priority for many health systems, yet integrating them into routine clinical use remains challenging. While numerous ...

Navigating the complexities of digital health technology implementation: a scoping review of barriers and facilitators #ImpSciComms #impsci

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Rethinking barriers and facilitators in implementation science: conceptual, methodological, and practical challenges, and ways forward - Implementation Science Communications Implementation science has long relied on the concepts of barriers and facilitators (B&F) to explain why evidence-based practices succeed or fail. Determinant frameworks such as the Consolidated Frame...

Rethinking barriers and facilitators in implementation science: conceptual, methodological, and practical challenges, and ways forward #ImpSciComms #impsci

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Defining and measuring implementation climate: a scoping review and concept analysis - Implementation Science Communications Background Implementation climate is a key organizational determinant of whether evidence-based interventions (EBIs) are adopted, delivered with fidelity, and sustained in healthcare. Despite its impo...

Defining and measuring implementation climate: a scoping review and concept analysis #ImpSciComms #impsci

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Implementation Science Communications Implementation Science Communications, an official companion journal to Implementation Science, is a forum to publish research to foster the uptake of ...

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“We’re building the plane while we’re flying it”: perspectives on local cigar policy implementation from qualitative interviews with key personnel - Implementation Science Communications Background Nearly 300 US municipalities have enacted policies regulating cigar pack size and price to reduce youth access to and use of inexpensive cigars. This study characterizes the policy implemen...

“We’re building the plane while we’re flying it”: perspectives on local cigar policy implementation from qualitative interviews with key personnel #impsci #ImpSciComms

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Visualizing contextual determinants in and across heterogeneous settings: a qualitative study on structured school health promotion implementation - Implementation Science Communications Background Schools have the potential to promote equitable health from early life onwards yet require sufficient organizational capacity to achieve sustained action. Structured improvement approaches,...

Visualizing contextual determinants in and across heterogeneous settings: a qualitative study on structured school health promotion implementation #impsci #ImpSciComms

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Enhancing adoption of patient safety culture assessments in Brazil: a strategy informed by CFIR and ERIC - Implementation Science Communications Background Regular assessments of Patient Safety Culture (PSC) are recommended by the World Health Organization to strengthen healthcare systems. In Brazil, despite national campaigns, hospital adhere...

Enhancing adoption of patient safety culture assessments in Brazil: a strategy informed by CFIR and ERIC #impsci #ImpSciComms

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What makes patient navigation work? Identifying functions and forms and conducting causal loop diagramming to specify components of a successful colorectal cancer patient navigation program - Implemen... Background We implemented a centralized colorectal cancer (CRC) screening program with navigation to follow-up colonoscopy for community health center (CHC) patients with positive stool-based test scr...

What makes patient navigation work? Identifying functions and forms and conducting causal loop diagramming to specify components of a successful colorectal cancer patient navigation program #impsci #ImpSciComms

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Optimizing qualitative methods in implementation research: a resource for editors, reviewers, authors, and researchers to dispel ten common misperceptions about qualitative research methods - Implemen... Background Qualitative methods are central to implementation research. Qualitative research provides rich contextual insight into lived experiences of health and illness, healthcare systems and care d...

Optimizing qualitative methods in implementation research: a resource for editors, reviewers, authors, and researchers to dispel ten common misperceptions about qualitative research methods #impsci #ImpSciComms

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Considerations for evaluating pragmatic design elements in digital health intervention trials: the case of Keep It Up! 3.0 - Implementation Science Communications Background Digital health interventions are increasingly promoted in healthcare and prevention practices due to their potential for reaching key populations in a cost-efficient manner. Yet there has been limited research on how to effectively implement them with pragmatic approaches that can facilitate scale-up. Keep It Up! (KIU!) 3.0 was a hybrid type 3 implementation–effectiveness trial comparing two delivery strategies (i.e. trial arms) of an HIV prevention intervention for cisgender, young men who have sex with men. We aimed to determine the level of pragmatism of our two-armed trial before and after changes to the county-randomized design. Methods We applied different versions of the PRagmatic Explanatory Continuum Indicator Summary (PRECIS) tool to the two trial arms: delivery of KIU! by community-based organizations (CBO) versus centralized, direct-to-consumer (DTC) delivery. We scored PRECIS-2 for the original study design and the modified design in which the DTC strategy expanded nationally. We applied PRECIS-2-PS to the modified study design. Nine coders in three groups independently scored the tools. Scores were iteratively discussed to arrive at one consensus score per domain, tool, design stage, and arm. We plotted results using the PRECIS-2 and PRECIS-2-PS wheels and averaged domains scores to describe overall score along the Pragmatic–Explanatory Continuum. Results Using PRECIS-2, the trial was on the pragmatic side of the spectrum for both arms and design stages, with average ratings ranging from 3.89–4.33. Both arms were highly pragmatic in the original and modified design in the Setting and Primary Analysis domains and least pragmatic in the Follow-up domain. In the modified trial design, the CBO and DTC arms again scored rather pragmatic using the PRECIS-2-PS tool, but CBO arm scored higher in the eligibility, recruitment, and organization domains compared to PRECIS-2 (5 vs. 4, respectively). Conclusions Application of both the PRECIS-2 and PRECIS-2-PS tools validated the pragmatic design of KIU! 3.0 as originally designed and after modifications during trial implementation. Our findings highlight instances where one tool may be more suitable than the other to assess the pragmatic–explanatory continuum for emerging digital health interventions delivered in diverse settings and with different implementation strategies.

Considerations for evaluating pragmatic design elements in digital health intervention trials: the case of Keep It Up! 3.0 #impsci #ImpSciComms

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Scaling-up an mHealth system to deliver financial incentives to improve adherence to antiretroviral therapy in Tanzania - Implementation Science Communications Background Financial incentives are increasingly used to achieve UNAIDS' 95–95-95 goals for ending HIV by 2030. While evidence supports their effectiveness, scaling these interventions remains challenging. This study examines the implementation successes and challenges of a financial incentive intervention in Tanzania, delivered via an mHealth application that provides automated mobile money disbursements, biometric identification, and SMS reminders. Methods Conducted alongside a Hybrid Type 1 Effectiveness-Implementation trial, the study evaluated financial incentives given to adults starting ART at 32 clinics. We used the Structured Assessment of Feasibility, Compatibility Beliefs in Technology (CBIT) scales, and the Program Sustainability Assessment Tool. Perspectives from 657 participants living with HIV and 90 clinic staff were collected using Proctor’s implementation science framework. Results Clinic staff rated the mHealth system highly on CBIT subscales for perceived usefulness, ease of use, and compatibility, each scoring over 6 out of 7. Integration and applicability of the financial incentive within the mHealth system were well received, with 93.0% of staff agreeing it improved job performance. Among participants, 86.4% found SMS reminders helpful for attending appointments, and 76.7% felt the cash delivery met their expectations. Challenges included unreliable fingerprint identification and undelivered SMS reminders. Conclusions Despite issues with fingerprint identification and SMS delivery, the financial incentive intervention via mHealth was found to be acceptable, feasible, and potentially sustainable in resource-limited settings, with support from host governments. Future research should enhance the intervention's effectiveness and optimize biometric identification methods. Trial registration ClinicalTrials.gov NCT04201353. Registered 17 December 2019, https://clinicaltrials.gov/study/NCT04201353

Scaling-up an mHealth system to deliver financial incentives to improve adherence to antiretroviral therapy in Tanzania #impsci #ImpSciComms

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Implementation research in forensic mental health: a scoping review - Implementation Science Communications Background Forensic mental health (FMH) serves as a critical juncture between the mental health and criminal justice systems. Factors on multiple levels – including sociopolitical, organizational, and individual— pose challenges to conducting implementation research in these settings. This hinders the uptake of evidence-based interventions and improvements to patient outcomes. This study examined implementation research conducted in FMH settings to understand its current state and inform future implementation research and practice. Methods We conducted a scoping review following the Joanna Briggs Institute methodology. A comprehensive literature search was performed across seven databases from their inception through April 2024, supplemented by searches in Google Scholar and six review studies, to identify relevant research. We analyzed included studies descriptively to explore determinants, strategies, and outcomes associated with the implementation of evidence-, or policy-based interventions in FMH. Results Of the 1327 records retrieved, 41 implementation studies were included. All studies were conducted in high-income countries and focused on interventions such as risk assessment, rehabilitation, patient support, and technology interventions, primarily using qualitative approaches. Key determinants for implementing interventions in FMH included individual characteristics (e.g., motivation, capacity) and inner setting factors (e.g., intervention compatibility with existing practices, access to knowledge and information). Various strategies, such as using evaluative and iterative strategies, training and educating stakeholders, changing infrastructure, and engaging consumers have been used to facilitate intervention uptake in FMH. Implementation outcomes primarily focused on uptake, fidelity, and acceptability. Conclusions There is a clear need for more implementation research using rigorous study designs in FMH. Multilevel implementation strategies should be employed to address barriers from both the inner settings and individual characteristics, thereby promoting the successful implementation of interventions in FMH. Future implementation research should incorporate a health equity lens throughout the research process to enhance inclusivity and improve reporting on implementation strategies to support replications of interventions in FMH.

Implementation research in forensic mental health: a scoping review #impsci #ImpSciComms

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De-implementation of low-value home-based nursing care: an effect and process evaluation - Implementation Science Communications Background The demand for homecare is increasing, and reducing low-value care is essential for achieving sustainable healthcare. Low-value care refers to practices that are ineffective, inefficient, unwanted, or potentially harmful to the client. This study aimed to evaluate the effects of a tailored, multifaceted deimplementation strategy in reducing low-value home-based nursing care. Methods A prospective, multicenter, convergent parallel mixed method design was employed, including a before-and-after study, using the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework. The effect of reducing low-value home-based nursing care was assessed from client records, focusing on the number of clients receiving care, minutes of care per week, frequency of visits per week, and clients no longer requiring care. The de-implementation process was evaluated qualitatively through individual interviews with de-implementation ambassadors, registered nurses, and nurse assistants, using Directed Qualitative Content Analysis. This approach served to interpret the effects of the deployment of de-implementation ambassadors and the strategies they implemented. Results We observed a reduction in low-value home-based nursing care, with a decrease of 130 h per week in daily showering, bathing and/or dressing; 54 h per week in the assistance with compression stockings; and 8 h per week in changing bandages enabling clients to regain their independence. Important de-implementation strategies included involving clients and relatives in decision making, organizing informational meetings for homecare professionals, and fostering collaboration with other healthcare professionals. Factors that influenced adoption included providing reassurance and using a stepwise approach with clients and relatives. Homecare professionals noted that the de-implementation ambassadors were highly committed to reducing care. De-implementation ambassadors found their role to be intense, challenging, and exciting. Conclusions This evaluation found that the deployment of de-implementation ambassadors, paired with additional de-implementation strategies, enhanced the reduction of low-value home-based nursing care. Providing reassurance and involving clients and their relatives were identified as beneficial for the de-implementation process.

De-implementation of low-value home-based nursing care: an effect and process evaluation #impsci #ImpSciComms

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Integrating HIV prevention services into care settings for people with opioid use disorder (OUD): a study protocol for implementation strategy development and modeling - Implementation Science Communi... Background The overlapping epidemics of opioid use disorder (OUD) and HIV present a critical public health challenge. Although people with OUD frequently engage with healthcare settings, uptake of HIV...

Integrating HIV prevention services into care settings for people with opioid use disorder (OUD): a study protocol for implementation strategy development and modeling #ImpSciComms #impsci

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Testing a multi-faceted strategy to support the implementation of ACEs screenings in primary care: results of a stepped-wedge pilot trial - Implementation Science Communications Background Adverse Childhood Experiences (ACEs) screenings are increasingly being used in primary care clinics to identify toxic stress and potential trauma in children. ACEs are negative life events ...

Testing a multi-faceted strategy to support the implementation of ACEs screenings in primary care: results of a stepped-wedge pilot trial #ImpSciComms #impsci

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Key determinants in implementation processes: a systematic review using the Consolidated Framework for Implementation Research (CFIR) - Implementation Science Communications Background Contextual factors, or determinants, are commonly assessed in implementation studies due to their impact on the implementation process. While a substantial number of determinants have been ...

Key determinants in implementation processes: a systematic review using the Consolidated Framework for Implementation Research (CFIR) #ImpSciComms #impsci

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Beyond the surface of capacity building: a mixed-methods study of the core functions and forms of dissemination and implementation science consultations - Implementation Science Communications Background The number of Dissemination and Implementation Science (DIS) capacity building programs is increasing worldwide. These programs aim to enhance diverse DIS skills through a variety of activi...

Beyond the surface of capacity building: a mixed-methods study of the core functions and forms of dissemination and implementation science consultations #ImpSciComms #impsci

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An evidence-informed, community-engaged approach to designing a large-scale, impact-oriented research funding initiative to foster the implementation of transformative integrated care: a multi-methods... Background Integrated care is a promising strategy to advance system transformation, care coordination, equity, and better health outcomes. Health services and policy research can drive evidence-infor...

Evidence-informed, community-engaged approach to designing a large-scale, impact-oriented research funding initiative to foster the implementation of transformative integrated care #ImpSciComms #impsci

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Developing implementation strategies for digital ICU diaries targeting ICU professionals: an implementation mapping approach - Implementation Science Communications Background Digital Intensive Care Unit (ICU) diaries can enhance the mental health of ICU survivors and their relatives by bridging memory gaps, improving understanding of ICU experiences, and providi...

Developing implementation strategies for digital ICU diaries targeting ICU professionals: an implementation mapping approach #impsci #ImpSciComms

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Proactive planning for contextual fit: the role of the implementation premortem - Implementation Science Communications Background Implementation failure is a major barrier to program success. It is widely acknowledged that context matters—individual, community, and organizational norms, values, environment, and priori...

Proactive planning for contextual fit: the role of the implementation premortem #impsci #ImpSciComms

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Longitudinal evaluation examining implementation and sustainment of an opioid overdose education and naloxone distribution among veterans who are unstably housed - Implementation Science Communication... Background Rigorous implementation evaluations are needed to understand factors that influence implementation and sustainability of evidence-based interventions across contexts. In this study, we cond...

Longitudinal evaluation examining implementation and sustainment of an opioid overdose education and naloxone distribution among veterans who are unstably housed #impsci #ImpSciComms

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Why engagement matters in policy implementation: an examination of the engagement of policy actors in the implementation of a mental health and addictions strategy - Implementation Science Communicati... Background Shifts toward “new public governance” (NPG), where policy decisions and their implementation are “co-produced” by a policy network, have captured the attention of policymakers as an approac...

Why engagement matters in policy implementation: an examination of the engagement of policy actors in the implementation of a mental health and addictions strategy #impsci #ImpSciComms

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Study design and procedures for a hybrid effectiveness-implementation incomplete stepped-wedge cluster-randomized trial to evaluate a differentiated point-of-care HIV diagnosis and management model fo... Background In Malawi and elsewhere in Africa, many children living with HIV are unaware of their status, often because of missed services for the prevention of vertical transmission of HIV (PVTH). Pre...

Hybrid effectiveness-implementation cluster-RCT evaluating a differentiated point-of-care HIV diagnosis and management model for the prevention of vertical transmission of HIV in Malawi #ImpSciComms #impsci

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Characterizing screening champions in the center for disease control and prevention’s Colorectal Cancer Control Program (CRCCP) - Implementation Science Communications Background CDC’s Colorectal Cancer Control Program (CRCCP) aims to increase colorectal cancer (CRC) screening prevalence by implementing evidence-based interventions (EBIs) in health system clinics pa...

Characterizing screening champions in the center for disease control and prevention’s Colorectal Cancer Control Program #impsci #ImpSciComms

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Leveraging intermediaries’ skillsets to build implementation research and practice infrastructure: a qualitative case study - Implementation Science Communications Background Implementation science as a field is rapidly advancing. Moreover, implementation science plays a pivotal role in driving learning health systems to better realize health outcomes and impact...

Leveraging intermediaries’ skillsets to build implementation research and practice infrastructure: a qualitative case study #impsci #ImpSciComms

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Lessons from using the Normalisation Process Theory to understand adherence to guidance on MgSO4 in preterm labour - Implementation Science Communications Background The administration of magnesium sulphate (MgSO4) in preterm labour is an evidence-based intervention recommended by the United Kingdom’s National Institute for Health and Care Excellence (N...

Lessons from using the Normalisation Process Theory to understand adherence to guidance on MgSO4 in preterm labour #ImpSciComms #impsci

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Implementation of diabetes prevention programs into clinical practice and community settings: a systematic search and review - Implementation Science Communications Background Greater understanding of how evidence-based programs have been implemented in clinical practice and community settings is needed. Implementation science can help understand how to best impl...

Implementation of diabetes prevention programs into clinical practice and community settings: a systematic search and review #ImpSciComms #impsci

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Methodological recommendations for assessing the impact of adaptations on outcomes in implementation research - Implementation Science Background A major gap in implementation research is guidance for designing studies to assess the impact of adaptations to interventions and implementation strategies. Many researchers regard experime...

Methodological recommendations for assessing the impact of adaptations on outcomes in implementation research #impsci #ImpSciComms

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View from the window in One New York Plaza back in 2019 when the idea of #ImpSciComms first came into being.

Yesterday saw the journal's first listing in the JCR rankings (other metrics are available) and it's already 15th for Health Policy and Services. #impsci

Proceedings of the 17th Annual Conference on the Science of Dissemination and Implementation in Health - Implementation Science

Proceedings of the 17th Annual Conference on the Science of Dissemination and Implementation in Health #impsci
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