The degree to which an EBI or implementation strategy is changes or modified by a user before, during, and after adoption and implementation suit the needs of the setting or to improve the fit to local conditions.
Intervention features that are not essential to the target user and are not supported by evidence or theory and thus are assumed to be modifiable without major impact on intervention effectiveness (e.g., provision of an additional class as part of a parenting intervention addressing trauma related to natural disasters).
Decision of the community or organization to commit to and initiate an EBI.
Utilizes computer simulations to examine how elements of a system behave as a function of their interactions with each other and their environment.
Section of the tool that provides access to assessments including measures, checklists, and others. [D&I GEM is currently unavailable and we are working to problem solve a new way to link to assessments/measures.]
Process of distinguishing between different subgroups of users and creating targeted marketing and distribution strategies for each subgroup.
Big P Policy
Formal government policies, including laws, administrative rules, regulations.
Institutions, groups, or individuals that span the divide between researchers and users, enable communication between these two groups, and are accountable in some fashion to both groups.
Activites that build resources within the target setting to enable the continued delivery of an intervention after after external support is terminated.
Characteristics of the Intervention
Include important facets that impact decision-making related to the initial uptake, implementation, and sustained used of the innovation.
The original publication(s) of the TMF.
The behavior embedded in highly complex systems or models with large numbers of interacting components (e.g., agents, artifacts, and groups) and the ongoing, repeated interactions create local rules and rich, collective behaviors.
Community-Based Participatory Research
A collaborative approach to research that equitable involves all partners throughout the life cycle of the research process.
Including and engaging with members and stakeholders from target communities that experience sub-optimal health or undesirable health outcomes.
The critical process of seeking consent from members of the community using a variety of means, such as holding town hall style discussions or community voting.
A range of learning objectives, knowledge, and skills required to be successful and efficient as a D&I researcher
Complexity can emerge from the properties of the intervention as well as the interaction between the intervention and context. Key considerations for the complexity of the intervention include the number, diversity, and interaction of core components; target behaviors; expertise and skills needed for the delivery and receipt of the intervention target groups, settings, and socioecological levels; and the level of flexibility allowed for the delivery of the intervention.
Configurational Comparative Methods
Set of innovative techniques that strengthen both qualitative and quantitative approaches.
Name of the construct developed by classifying/aligning the elements abstracted from TMFs.
The definition/flexibility of the TMF constructs. Construct flexibility is measured on a 1-5 scale, with Broad (1) meaning constructs are loosely outlined and defined allowing for greater flexibility to apply the TMF to a wide array of D&I activities and contexts, or Operational (5) meaning constructs are detailed with step-by-step actions for completion of D&I research.
A set of characteristics and circumstances that consist of active and unique factors within which the implementation of an intervention is embedded.
The active ingredients of the intervention that are essential to achieving the desired outcomes of the intervention.
Changes to an intervention in order to increase an intervention’s cultural relevance and appropriateness.
D &/or I
The focus on dissemination and/or implementation activities. D-only focuses on an active approach of spreading evidence-based interventions to target audience via determined channels using planned strategies. D=I, D>I, and I>D means there is some focus on both dissemination and implementation. I-only focuses on process of putting to use or integrating evidence-based interventions within a setting.
Competencies related to D&I that are categorized into four domains: (1) background and rationale (e.g., identifying gaps in D&I research); (2) theory and approaches (e.g., identifying appropriate conceptual models); (3) design and analysis (e.g., describing core components of external validity); and (4) practice-based considerations (e.g., considering the perspectives of different stakeholders).
Stopping or abandoning practices that are not proved to be effective and are possibly harmful.
The definition of the construct.
Designing for Dissemination and Sustainment
Refers to principles and methods for enhancing the fit between a health program, policy, or practice, and the context in which it is intended to be adopted.
Factors that influence the effectiveness and implementation of an intervention, such as barriers (e.g., time and resource costs) or facilitators (e.g., skilled personnel and financial incentives).
Used to characterize factors that might influence implementation outcomes.
The passive, untargeted, unplanned, and uncontrolled spread of new interventions.
An active approach of spreading interventions to the target audience via determined channels using planned strategies.
Dissemination Effectiveness Studies
Involve the collection and analysis of multiple, both quantitative and qualitative data in a single study to answer research question using a parallel, sequential, or converted approach.
Effects of dissemination or the outcomes of targeted distribution of information related to an innovation, intervention, or best practice to a specific public health or clinical practice audience.
The systematic study of processes and factors that lead to widespread use of an EBI by the target population.
Mechanisms and approaches used to communicate and spread information about interventions to targeted users.
Dissemination Field Agent
Dissemination field agents work to generate awareness, provide training, and support use of evidence-based, practice-ready programs by adopters.
Economic evaluations in D&I address the question: How can organizations and systems invest in the D&I of evidence-based practices to maximize the value produced? The purpose of economic evaluation is to maximize outcomes related to health that are subject to a set of constraints.
Evaluates the initial impact of an intervention (whether it does more good than harm among the individuals in the target population) when it is delivered under optimal or laboratory conditions (or in an ideal setting).
Determines the impact of an intervention with demonstrated efficacy when it is delivered under “real-world” conditions.
Typically embedded in the community and organizational system where such a clinical/ preventive intervention would ultimately be delivered.
Components abstracted from each TMF and aligned with the given construct.
Equity Oriented Implementation
Explicit attention to the culture, history, values, and needs of the community integrated into the principles, strategies, frameworks, and tools of implementation science.
Evidence-Based Interventions (EBI)
Interventions that have a certain level of evidence of efficacy or effectiveness and are deemed ready for D&I.
Evidence-Informed Practice or Intervention
Expands the traditional EBI terminology and intends to emphasize that healthcare and population health should always be context sensitive and use a person- or client-focused (stakeholder) perspective and not be limited to the mere synthesis and application of scientific evidence.
Evidence Synthesis Approaches
Used to summarize existing knowledge about D&I research and practice.
Citations of studies that have use the TMF as an outline for their study.
Expert Recommendations for Implementing Change Strategies (ERIC)
Expert Recommendations for Implementing Change (ERIC) refers to a compilation of implementation strategies developed to support systematic reporting of implementation strategies both prospectively and retrospectively.
Degree to which implementation strategy is changed or modified by a user before, during, or after adoption.
The extent to which the core intervention elements (or implementation strategies) are successfully delivered as intended within a setting and conceptualized as the continuation of elements found to be necessary for intervention effectiveness.
Field of Origin
The field of study in which the Theory, Model, Framework (TMF) originated.
Formative Audience Research
Seeks to describe the characteristics of policymakers with the goal of informing the design and distribution of dissemination material.
Frameworks convey an overarching structure, outline of a system, or plan consisting of various interacting descriptive elements and categories.
Ongoing process of assessing needs, correcting historical inequities, creating conditions for optimal outcomes by members of all social identity groups.
Health Equity Lens
Set of field glasses that allows one to see both overt and subtle injustices at work, including the historical, social, political, and environmental contexts.
(Also known as user-centered design) Is focused on developing compelling and intuitive products, grounded in knowledge about the people and contexts where an innovation will be deployed.
Hybrid Effectiveness-Implementation Design
Hybrid study designs that blend the design characteristics of effectiveness and implementation studies to generate more timely uptake of desirable interventions.
Extent to which an intervention, policy, or practice is easily implementable in a new setting.
The actively planned process of putting evidence to use or integrating new interventions within a specific setting.
Cost related to the development and execution of the implementation strategy that targets one or more specific Evidence-Based Intervention (EBI).
A set of behaviors, attitudes, and practices within the umbrella of general leadership focused on specific strategic imperatives related to adoption and use of Evidence-Based Practices (EBPs).
The effects of deliberate and purposive actions to implement new treatments, practices, and services.
Research that seeks to understand the process and factors that are associated with successful integration of EBIs within a particular setting (e.g., a worksite or school).
The systematic process or methods, techniques, activities, and resources that support the adoption, integration, and sustainment of EBIs into usual settings.
A sub-type of implementation science and refers to systems-level work to improve the quality, safety, and value of healthcare with an emphasis on creating generalizable knowledge.
Research evidence that is being implemented in a new setting.
Assesses the extent to which the EBI is integrated within the culture of the recipient setting or community through policies and practice.
The focus of D&I efforts (the thing).
Interventional Implementation Study
Includes pilot studies of evidence on feasability, acceptability, potential effectiveness; efficiancy oriented small scale studies; effectiveness oriented large trials of implementation programs.
Intermediary and Purveyor Organizations (IPOs)
Develop, implement, disseminate, and support best practice programs or services.
A knowledge broker is an intermediary (individual or organization) who facilitates and fosters the interactive process between producers (i.e., researchers) and users (i.e., practitioners, policymakers) of knowledge through a broad range of activities.
The term used by the Canadian Health Services Research Foundation and describes the interactive and iterative process of imparting meaningful knowledge between knowledge users (i.e., stakeholders) and producers, such that knowledge users (i.e., stakeholders) receive relevant and easily usable information and producers receive information about users’ research needs.
The term used by the Canadian Institutes of Health Research (CIHR) to denote “a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically sound application of knowledge.”
A commonly used term both within and outside of the healthcare sector and is defined as the process of getting (research) knowledge from producers to potential users (i.e., stakeholders).
Learn As You Go Design
Design and undergo adaptation and modification based on information gained during the conduct of the study.
Learning Healthcare System
Defined by the Institute of Medicine (IOM), as a system in which “science, informatics, incentives, and culture are aligned for continuous improvement and innovation, with best practices seamlessly embedded in the delivery process and new knowledge captured as an integral by-product of the delivery experience.”
A logic model is a diagram that describes in detail how a program or intervention operationally works to achieve benefits and captures the logical flow and linkages that exist within the program or intervention and its proximal and distal outcomes.
Refers to services and clinical practices that provide little to no clinical benefit.
Refers to the ability of the recipient setting or community to continuously deliver the health benefits achieved when the intervention was first implemented.
Marketing and Distributing Systems
Bring products and services from their point of development to their point of use.
Tool used in evaluation of a D&I project. [D&I GEM is currently unavailable and we are working to problem solve a new way to link to assessments/measures.]
Three main components to be considered: moderators, mediators, outcomes.
Mechanisms explain how or why interventions create change. They are the underlying processes and drivers of change.
Mediating variables or mediators are variables that reside in a causal pathway between the independent and dependent variables. Mediators cause variation in the dependent variable and are influenced by the independent variable.
Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones.
Involve the collection and analysis of multiple, both quantitative and qualitative data in a single study to answer research question using a parallel, sequential, or converted approach.
Moderators or moderating variables, synonymous with “effect modifiers,” refer to variation in the magnitude of an outcome across levels of another variable (i.e., moderator). In behavioral interventions, dose or adherence to the intervention protocol are examples of moderating variables.
Includes both theories and frameworks that enhance dissemination and implementation research by making the spread of evidence-based interventions more likely.
Multiphase Optimization Strategy Implementation Trials
Can be used to identify and test an optimized intervention; three phases include: preparation, optimization, evaluation.
Multiple Streams Model
Multiple streams model of public policymaking identifies how three independent streams that flow through the policy system: politics, problems, and policy.
Number of TMFs
The number of TMFs that include elements aligned with the given construct.
Number of Times Cited
The # of times the original publication for the TMF was cited as indicated by Google Scholar since 2016.
Observational Implementation Study
Studies of naturally occurring policy and practice-led implementation process.
The employees’ perceptions of and reaction to the characteristics of the work environment.
The organizational norms and expectations regarding how people behave and how things are done in an organization.
The extent to which organizational members are psychologically and behaviorally prepared to implement a new intervention.
End results of EBIs, often different from those in traditional health research.
Participatory Implementation Science
An iterative process alongside a variety of stakeholders to co-produce knowledge and create system-level change in order to integrate evidence into real-world and community settings.
Participatory System Dynamics
Participatory system dynamics (PSD) builds on the rich theoretical and methodological foundation of group model building, but emphasizes embedded, participatory action research principles and processes.
Policy Diffusion Studies
A complement to studies focused on the uses of research evidence at the policymaker level, policy diffusion studies seek to understand how policy adoption spreads across geopolitical units.
Policy Dissemination Research
Seeks to understand the processes and factors that are associated with successful integration of evidence-based intervention within a particular setting.
Policy Implementation Research
Understand complexities of the policy process and increase the likelihood that evidence reaches policymakers and influences their decisions so that the population health benefits of scientific progress are maximized.
The TMF is intended to be used by practitioners.
Pragmatic Clinical Trial
Clinical trials concerned with producing answers to questions faced by decision makers.
Key characteristics: measuring outcomes important to stakeholders, low burden from both a data collection and analysis perspective, broad applicability, sensitive change, yield information that enhances patient engagement.
Pragmatic Explanatory Continuum Indicator Summary
Tool to support researchers in deciding where their research study falls on the pragmatic explanatory continuum for different aspects of the study design.
Constructs that act as precursors to implementation and dissemination of interventions
Merges information on genomic, biological, behavioral, environmental, and other data on individuals in order to identify factors that can support individualized treatment.
Precision Public Health
Involves the collection of more accurate population- and individual-level data on genes, exposures, behaviors, and other social/economic health determinants to enhance public health action and reduce health disparities in the population by using more precision data for action.
The concerted and ongoing activities that are undertaken systematically by diverse stakeholders to improve care.
Critical in identifying factors that facilitate or hinder the implementation of EBIs in diverse settings and explain why implementation efforts succeed or fail.
Qualitative Comparative Analysis
Form of CMM that can be used to examine complex combinations of explanatory factors associated with implementation outcomes when traditional statistical methods are not possible because of limited number of cases.
Hierarchal structure of oppression that operates at multiple levels and across systems to create, reinforce, and maintain inequities based on racial characteristics.
Rapid, Responsive, Relevant Research
Provides a framework and set of strategies for a rapid learning health research approach and address limitations of traditional health research.
Rapid Qualitative Assessment
Described as research designed to address the need for cost-effective and timely results in rapidly changing situations.
Ability of program to engage its ultimate target audience in terms of both quantity and quality.
A method for reviewing and synthesizing information about complex, real-world interventions using an explanatory approach and focusing on what works for whom, in what circumstances, in what respects and how.
The TMF is intended to be used by researchers.
The process by which specific research-based knowledge (science) is implemented in practice.
The process of reproducing key aspects of a well-defined innovation with the intent of achieving the desired outcomes and building the evidence for that innovation.
Broadening an innovation to a setting or target population that is different from previous implementations.
Deliberate efforts to increase the impact of health service innovations successfully tested in pilot or experimental projects so as to benefit more people and to foster policy and program development on a lasting basis.
Map key concepts underpinning a research area and the main sources and types of evidence available and can be efficiently used to explore complex areas or areas that have not been reviewed before.
Sequential, Multiple Assignment, Randomized Trial Design
Develop adaptive interventions and adaptive implementation strategies and involve multiple intervention stages, each indicating a decision point in the development of the adaptive intervention.
Small p Policy
Localized, small-scale policies, including organizational changes, administrative or institutational policies, or non governmental professional policies.
Standards For Reporting Implementation Studies
Offers authors and and publishers guidelines for reporting context, adoption, and adaptation strategies, and evalutation methods for both the intervention and implementation strategy.
Uses a sequential rollout of the intervention to target sites or individuals in a manner that all sites or participants will receive the intervention by the end of the trial.
The level of the framework at which the TMF operates. Individual includes personal characteristics; Organization includes hospitals, service organizations, and factories; Community includes local government and neighborhoods; System includes hospital systems and government; Policy includes changes in policy.
Social Network Analysis
The process of systematically investigating social networks and the relationships and flows among social actors.
Te deliberate inclusion and meaningful interaction and engagement with stakeholders (e.g., clinicians, patients, funders, community members) during the research process.
Strategies for D&I
The D&I strategies promote and integrate evidence-based practice into real-world settings and are central to D&I science, which seeks to evaluate the effectiveness of strategies to integrate EBIs into specific settings.
The process of replicating an initiative or intervention within a new health system or community setting.
Extent to which EBI can deliver its intended benefits over an extended period of time after external support from the donor agency is terminated.
Outcome of interest in an implementation science study indicating an intervention needs to be implemented over time.
System Dynamics Modeling
A problem-oriented modeling approach originally developed for business but with wide-ranging applicability from public health to economics.
The process of understanding how things influence one another other within a whole and is based on the premise that societal problems are complex and that the response to these complex problems is only possible by intervening at multiple levels and with the engagement of stakeholders and settings across the different levels, including the home, school, workplace, community, region, and country.
Template for Intervention Description and Replication Checklist
Prompts authors to describe interventions in sufficient detail to allow their replication.
Theories Models and Frameworks (TMF)
There are a large number of theories, models, and frameworks (TMFs) that shape the way that we think about D&I research and guide our planning, implementation, and evaluation activities.
Attempt to explain the causal pathways of implementation processes and provide an overarching explanation of how and why relationships between variables lead to specific events.
The process of applying scientific evidence to real-world practice.
Translational research encompasses research with the explicit goal to produce more meaningful, applicable, and relevant research results and to speed the real-world application of scientific evidence.
Type 1 Evidence
Concerned with etiology and burden and defines the cause of a particular outcome (e.g., health condition).
Type 2 Evidence
Focuses on the relative impact of a specific intervention to address a particular outcome (e.g., health condition).
Type 3 Evidence
Concerned with the type of information that is needed for the adaptation and implementation of an EBI.
These are ratings given by users of the tool.
Expectations expected to yield lower benefits as they move towards sustainability due to the added complexity of heterogenous beneficiaries, implementers, and settings.