Implementation science is an innovative discipline dedicated to studying and informing the development and investigation of methods to promote the systematic uptake of research findings and other evidence-based practices into real-world contexts and routine practices. This field emerged to address the significant “implementation gap”, which refers to the considerable delay (often between fifteen and twenty years) between when effective interventions are identified in controlled studies (e.g., in academic institutions or research institutes) and when they are adopted into standard practice in real-world settings.
The overarching aims of using implementation science theories, models, and frameworks include: 1) understanding and informing implementation processes; 2) identifying and explaining implementation determinants, which are often categorized as barriers and facilitators and, 3) guiding the evaluation of implementation processes and outcomes. Implementation science plays a crucial role in facilitating the better application of research and evidence to achieve improved implementation outcomes.
By systematically understanding, planning for, and evaluating the implementation process itself, implementation science provides the tools and knowledge to ensure that effective interventions are not only designed well but are also successfully delivered and sustained in the complex, dynamic real world, maximizing their potential for widespread impact. Implementation science focuses on a range of key constructs that influence the successful translation of research into practice:
In essence, implementation science provides the necessary theoretical foundation and practical frameworks to ensure that effective behavior change interventions are successfully translated, adopted, and sustained in diverse real-world contexts, maximizing their impact on the problems being addressed. Several widely used frameworks and models in implementation science guide this systematic approach. For example, they include:
While largely applied in medical settings, implementation science provides a systematic approach for change agents to enhance the effectiveness of their design and implementation of change interventions. By focusing on research findings and evidence-based practices, implementation science offers theories, models, and frameworks that can help change agents understand and inform their implementation interventions. This includes identifying the stages of implementation, from diagnosis of needs to initiation and adoption.
A critical aspect is the necessity of involving appropriate stakeholders in all phases of intervention design, evaluation, and implementation. Their involvement helps in understanding the intervention context, informs strategic decisions, and facilitates recruitment, engagement, cost-effectiveness, and co-ownership. This collaborative design can maximize adoption and fidelity of implementation, as well as sustainability. Ensuring fidelity (whether intervention components are delivered as intended) is a crucial determinant of efficacy. Implementation science provides guidance on planning for and evaluating fidelity, recognizing that an intervention not delivered as designed is likely to be ineffective.
At the same time, implementation science encourages change agents to acknowledge that implementation takes place in a complex, real-world context. This involves considering geographical, sociocultural, socioeconomic, ethical, legal, and political factors. It also recognizes that implementation processes occur in complex adaptive systems with multiple feedback loops and constant variations, rather than linear processes.
By systematically applying these principles and tools from implementation science, change agents can significantly improve the likelihood that their interventions will not only be effective in ideal conditions but also successfully adopted, implemented, and sustained in diverse real-world settings, maximizing their impact. For a more in-depth understanding of implementation science, readers are encouraged to investigate the volume listed in Sources below.
Sources:
Nilsen, P. & Birken, S. eds. (2020), “Handbook on Implementation Science”, Edward Elgar Publishing, United Kingdom.