Table 1.

Steps for Conducting Implementation Science and Pre-Intervention Planning Research

I. PRE-INTERVENTION PLANNING STEPS

1. Describe the evidence to be translated and its relation to a health problem. Steps 1 and 2 can occur concurrently

a. What evidence (health related behavior, test, procedure, treatment, intervention, program) will be translated?

b. Justify the evidence is ready to be translated (including in the local context)

c. What health problem will translation of the evidence improve? Justify selection of this health problem as a priority in the setting you plan to work.

2. Identify stakeholder communities and conduct outreach to work with them. (if not completed in step 1)

a. List key communities/stakeholders involved in translating your evidence

b. Consider vested interests of key communities/stakeholders

c. Describe plan for engaging communities/stakeholders

3. Describe the Evidence-Practice Gap

a. Performance gap. What is the difference between current and ideal practice and behaviors? What are the underlying conditions and context?

b. Outcome gap. How much improvement in health outcomes (safety, effectiveness, efficiency, patient-centeredness, timeliness and/or eliminating disparities in care) could be achieved if the performance gap was eliminated?

c. Could unintended consequences result from attempts to change practices or conditions contributing to performance gap?

4. Determine the Population, Organization and/or Stakeholder Readiness for Change

a. Strategic. Is addressing the problem area part of strategic priorities?

b. Structural. Are there local programs or resources that will facilitate implementation and sustain the improvement activity after the project team is done?

II. INTERVENTION DESIGN STEPS

1. Describe evidence-practice gap in behavioral terms (Who needs to do what differently?)

2. Select behaviors upon which to frame the implementation strategy

3. Identify barriers and enablers of selected behaviors using a theoretical framework

4. Select evidence-based strategies for behavior change (using the chosen theory or framework)

III. IMPLEMENTATION STRATEGY EVALUATION STEPS

1. Identify and measure mediators of change

NOTE: may repeat some steps above or look at institutional/community behavior change theories and frameworks.

2. Select process, implementation and health outcomes

3. Select appropriate and feasible study designs