Moullin Joanna C, Dickson Kelsey S, Stadnick Nicole A, Albers Bianca, Nilsen Per, Broder-Fingert Sarabeth, Mukasa Barbara, Aarons Gregory A
Faculty of Health Sciences, School of Pharmacy and Biomedical Sciences, Curtin University, Kent Street, Bentley, Søborg, Western Australia 6102 Australia.
Child and Adolescent Services Research Center, 3665 Kearny Villa Rd., Suite 200N, San Diego, CA 92123 USA.
Implement Sci Commun. 2020 Apr 30;1:42. doi: 10.1186/s43058-020-00023-7. eCollection 2020.
Recent reviews of the use and application of implementation frameworks in implementation efforts highlight the limited use of frameworks, despite the value in doing so. As such, this article aims to provide recommendations to enhance the application of implementation frameworks, for implementation researchers, intermediaries, and practitioners.
Ideally, an implementation framework, or multiple frameworks should be used prior to and throughout an implementation effort. This includes both in implementation science research studies and in real-world implementation projects. To guide this application, outlined are ten recommendations for using implementation frameworks across the implementation process. The recommendations have been written in the rough chronological order of an implementation effort; however, we understand these may vary depending on the project or context: (1) select a suitable framework(s), (2) establish and maintain community stakeholder engagement and partnerships, (3) define issue and develop research or evaluation questions and hypotheses, (4) develop an implementation mechanistic process model or logic model, (5) select research and evaluation methods (6) determine implementation factors/determinants, (7) select and tailor, or develop, implementation strategy(s), (8) specify implementation outcomes and evaluate implementation, (9) use a framework(s) at micro level to conduct and tailor implementation, and (10) write the proposal and report. Ideally, a framework(s) would be applied to each of the recommendations. For this article, we begin by discussing each recommendation within the context of frameworks broadly, followed by specific examples using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework.
The use of conceptual and theoretical frameworks provides a foundation from which generalizable implementation knowledge can be advanced. On the contrary, superficial use of frameworks hinders being able to use, learn from, and work sequentially to progress the field. Following the provided ten recommendations, we hope to assist researchers, intermediaries, and practitioners to improve the use of implementation science frameworks.
近期有关实施框架在实施工作中的使用和应用的综述强调，尽管使用框架具有价值，但框架的使用仍然有限。因此，本文旨在为实施研究人员、中介机构和从业者提供增强实施框架应用的建议。
理想情况下，应在实施工作之前及整个过程中使用一个或多个实施框架。这包括在实施科学研究以及实际实施项目中。为指导这一应用，本文概述了在整个实施过程中使用实施框架的十条建议。这些建议大致按照实施工作的时间顺序编写；然而，我们理解这些建议可能因项目或背景而异：（1）选择合适的框架；（2）建立并维持社区利益相关者的参与和伙伴关系；（3）界定问题并制定研究或评估问题及假设；（4）制定实施机制过程模型或逻辑模型；（5）选择研究和评估方法；（6）确定实施因素/决定因素；（7）选择、调整或制定实施策略；（8）明确实施结果并评估实施情况；（9）在微观层面使用框架进行并调整实施；（10）撰写提案和报告。理想情况下，每个建议都应应用一个框架。在本文中，我们首先在框架的广泛背景下讨论每个建议，然后使用探索、准备、实施、维持（EPIS）框架给出具体示例。
概念和理论框架的使用为推进可推广的实施知识提供了基础。相反，对框架的表面使用阻碍了对其的运用、借鉴以及按顺序推进该领域的工作。遵循所提供的十条建议，我们希望能帮助研究人员、中介机构和从业者改进实施科学框架的使用。
