Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1103E McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA.
End-of-Life, Hospice, and Palliative Care Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC, 27709, USA.
Implement Sci. 2017 Oct 30;12(1):124. doi: 10.1186/s13012-017-0656-y.
Theories provide a synthesizing architecture for implementation science. The underuse, superficial use, and misuse of theories pose a substantial scientific challenge for implementation science and may relate to challenges in selecting from the many theories in the field. Implementation scientists may benefit from guidance for selecting a theory for a specific study or project. Understanding how implementation scientists select theories will help inform efforts to develop such guidance. Our objective was to identify which theories implementation scientists use, how they use theories, and the criteria used to select theories.
We identified initial lists of uses and criteria for selecting implementation theories based on seminal articles and an iterative consensus process. We incorporated these lists into a self-administered survey for completion by self-identified implementation scientists. We recruited potential respondents at the 8th Annual Conference on the Science of Dissemination and Implementation in Health and via several international email lists. We used frequencies and percentages to report results.
Two hundred twenty-three implementation scientists from 12 countries responded to the survey. They reported using more than 100 different theories spanning several disciplines. Respondents reported using theories primarily to identify implementation determinants, inform data collection, enhance conceptual clarity, and guide implementation planning. Of the 19 criteria presented in the survey, the criteria used by the most respondents to select theory included analytic level (58%), logical consistency/plausibility (56%), empirical support (53%), and description of a change process (54%). The criteria used by the fewest respondents included fecundity (10%), uniqueness (12%), and falsifiability (15%).
Implementation scientists use a large number of criteria to select theories, but there is little consensus on which are most important. Our results suggest that the selection of implementation theories is often haphazard or driven by convenience or prior exposure. Variation in approaches to selecting theory warn against prescriptive guidance for theory selection. Instead, implementation scientists may benefit from considering the criteria that we propose in this paper and using them to justify their theory selection. Future research should seek to refine the criteria for theory selection to promote more consistent and appropriate use of theory in implementation science.
理论为实施科学提供了综合架构。理论的未充分使用、表面使用和误用对实施科学构成了重大科学挑战，并且可能与从该领域的众多理论中进行选择的挑战有关。实施科学家可能会从为特定研究或项目选择理论的指导中受益。了解实施科学家如何选择理论将有助于为制定此类指导提供信息。我们的目标是确定实施科学家使用的理论，他们使用理论的方式以及选择理论的标准。
我们根据开创性文章和迭代共识过程确定了最初的理论使用和选择标准清单。我们将这些清单纳入了一项自我管理的调查中，供自我认定的实施科学家填写。我们在第 8 届传播和实施科学年度会议上以及通过几个国际电子邮件列表来招募潜在的受访者。我们使用频率和百分比来报告结果。
来自 12 个国家的 223 名实施科学家对该调查做出了回应。他们报告使用了来自多个学科的 100 多种不同理论。受访者报告说，使用理论主要是为了确定实施决定因素，为数据收集提供信息，增强概念清晰度并指导实施计划。在调查中提出的 19 条标准中，选择理论最常用的标准包括分析水平（58％），逻辑一致性/合理性（56％），经验支持（53％）和描述变革过程（54％）。选择理论最少使用的标准包括丰度（10％），独特性（12％）和可证伪性（15％）。
实施科学家使用大量标准来选择理论，但是对于哪些标准最重要，没有达成共识。我们的研究结果表明，实施理论的选择通常是偶然的，或者是由便利性或先前的经验驱动的。选择理论方法的差异表明，不应针对理论选择提出规范性指导。相反，实施科学家可能会从考虑我们在本文中提出的标准中受益，并使用这些标准来证明其理论选择的合理性。未来的研究应寻求完善理论选择的标准，以促进在实施科学中更一致，更适当的使用理论。
