D&I Model Webtool

Combine

There is no D&I model that will perfectly fit every aspect of your D&I project, so it may be necessary to Combine multiple models and/or Adapt a model for your D&I project. The Combine section provides you with strategies on how to use more than one D&I model.

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+/-What are some reasons to combine multiple D&I models?

Reasons you might decide to combine models include:

+/-What is the first step for combining D&I models?

The first step for combining models is to identify multiple models that may support various aspects of your planned work. In the Select section of this webtool you can run multiple searches and choose models for these various purposes, using the key constructs you have identified in the Plan section. Another tool that can guide you with identifying and comparing of multiple models for D&I is T-CaST: an implementation theory comparison and selection tool.

More details about this tool can be found:
Birken, S.A., Rohweder, C.L., Powell, B.J. et al. T-CaST: an implementation theory comparison and selection tool. Implementation Sci 13, 143 (2018) doi:10.1186/s13012-018-0836-4

+/-What are some important considerations when combining multiple D&I Models?

  1. Before assigning roles and operational definitions to each model, you need to address the potential need for adaptations to local context and specific purposes. The separate section on Adapt can help with these steps.
  2. Combining models can increase the complexity of your work. Usually you do not want to attempt to combine more than two models in a single study.
  3. You should clearly identify the role of model you select - each might address different issues and fit different parts of your logic model. You will need to provide a rationale for use of each model and why you chose this particular combination.
  4. If you include multiple models for the same purpose, it may confuse readers/reviewers (unless, you are specifically testing one model versus another).
  5. You should provide description on how and when the various constructs will be operationalized in the course of the project. The Use section can provide you with guidance on how to make sure that your models are well integrated throughout the entire project.

+/-What are some examples of combination of multiple D&I models?

A few publications describing common combinations of models are listed below:

  1. A review of the combined use of the CFIR and TDF:
    Birken, S.A., Powell, B.J., Presseau, J. et al. Combined use of the Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF): a systematic review. Implementation Sci 12, 2 (2017)
  2. An example of how the PRISM and Stirman adaptation and modification framework have been combined:
    Rabin BA, McCreight M, Battaglia C, Ayele R, Burke RE, Hess PL, Frank JW and Glasgow RE (2018) Systematic, Multimethod Assessment of Adaptations Across Four Diverse Health Systems Interventions. Front. Public Health 6:102.
  3. An example of the integration of CFIR and RE-AIM where CFIR is used to contextualize the quantitatively measured RE-AIM outcomes:
    Damschroder LJ, Reardon CM, AuYoung M, Moin T, Datta SK, et al. Implementation findings from a hybrid III implementation-effectiveness trial of the Diabetes Prevention Program (DPP) in the Veterans Health Administration (VHA) (2017) Implementation Sci 12(1):94.
  4. An example of the combined use of EPIS and other models including an economic perspective:
    Bowser, D., Henry, B. F., & McCollister, K. E. (2019). An Overlapping Systems Conceptual Framework to Evaluate Implementation of a Behavioral Health Intervention for Justice–Involved Youth. Health Services Insights, 12, 1178632919855037.
  5. An example of the combined use of EPIS and CFIR as complementary models to support conceptualization and evaluation:
    Hunter, S. B., Han, B., Slaughter, M. E., Godley, S. H., & Garner, B. R. (2017). Predicting evidence-based treatment sustainment: results from a longitudinal study of the Adolescent-Community Reinforcement Approach. Implementation Science, 12(1), 75.
  6. An example of the combination of PRISM and the learning evaluation framework:
    Linke, S. E., Kallenberg, G., Kronick, R., Tai-Seale, M., De-Guzman, K., & Rabin, B. (2020). Integrating “Exercise Is Medicine” into primary care workflow: a study protocol. Translational Behavioral Medicine.