Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda

By Enola K. Proctor, Hiie Silmere, R. Raghavan, Peter Hovmand, Gregory A. Aarons, Alicia C. Bunger, Richard T. Griffey, Melissa A. Hensley. Administration and Policy in Mental Health and Mental Health Services Research, 2010

6,736 citations recorded by the source corpus.

An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. This paper advances the concept of “implementation outcomes” distinct from service system and clinical treatment outcomes. This paper proposes a heuristic, working “taxonomy” of eight conceptually distinct implementation outcomes—acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability—along with their nominal definitions. We propose a two-pronged agenda for research on implementation outcomes. Conceptualizing and measuring implementation outcomes will advance understanding of implementation processes, enhance efficiency in implementation research, and pave the way for studies of the comparative effectiveness of implementation strategies.

Subfields: General Health Professions

View Paper: https://www.semanticscholar.org/paper/3c7cf782e4094a7d66d8ad5da80a8083a8e72307

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In General Health Professions

Citations in the corpus

The student voice in well-being: a case study of participatory action research in positive education (2019, background): “Second, the involvement of young people can help to make an intervention more effective through appropriate fit (Proctor et al. 2011) and student buy-in Levin (2000).”
Implementation strategies: recommendations for specifying and reporting (2013, methodology): “[47,49,50], and we direct readers to the dissemination and implementation section of the Grid Enabled Measurement Initiative and the Seattle Implementation Research Collaborative’s measures project for repositories of implementation outcomes [82,83].”
Increasing New Teachers’ Specific Praise Using a Within-School Consultation Intervention (2015, result): “The choice to focus on teachers’ specific praise rates is consistent with the focus on implementation outcomes advanced in the implementation science literature (e.g., Proctor et al., 2011).”
From Classification to Causality: Advancing Understanding of Mechanisms of Change in Implementation Science (2018, methodology): “strategy and the latter being one of eight implementation outcomes (1).”
The updated Consolidated Framework for Implementation Research based on user feedback (2022, background): “The CFIR Outcomes Addendum provides high-level guidance for identifying implementation outcomes by drawing on other frameworks [81, 82].”
The Implementation Research Logic Model: a method for planning, executing, reporting, and synthesizing implementation projects (2020, methodology): “Implementation outcomes are the effects of deliberate and purposive actions to implement new treatments, practices, and services [21].”
RE-AIM Planning and Evaluation Framework: Adapting to New Science and Practice With a 20-Year Review (2019, background): “First, there have been recent calls to more explicitly describe strategies and context (80, 81) as well as test mediating relationships between implementation strategies and implementation outcomes (82).”
Making sense of implementation theories, models and frameworks (2015, background): “[126] have developed a framework of implementation outcomes that can be applied to evaluate implementation endeavours.”
Experimental and Quasi-Experimental Designs in Implementation Research (2019, background): “Second, as a corollary of this point, implementation RCTs typically feature different outcome measures than efficacy or effectiveness RCTs, with an emphasis on the extent to which a health intervention was successfully implemented rather than an evaluation of the health effects of that intervention ”
Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures (2013, methodology): “For example, fidelity, or ‘the degree to which an intervention was implemented as it was prescribed in the original protocol or as it was intended by the program developers’ [6], necessarily involves and is affected by patient-level factors.”