Faculty of Medicine, Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland.
Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
Front Public Health. 2022 Mar 23;10:836552. doi: 10.3389/fpubh.2022.836552. eCollection 2022.
When empirically supported interventions are implemented in real-world practice settings, the process of how these interventions are implemented is highly relevant for their potential success. Implementation Mapping is a method that provides step-by-step guidance for systematically designing implementation processes that fit the respective intervention and context. It includes needs assessments among relevant stakeholders, the identification of implementation outcomes and determinants, the selection and design of appropriate implementation strategies, the production of implementation protocols and an implementation outcome evaluation. Implementation Mapping is generally conceptualized as a tool to prospectively guide implementation. However, many implementation efforts build on previous or ongoing implementation efforts, i.e., "existing implementation." Learnings from existing implementation may offer insights critical to the success of further implementation activities. In this article, we present a modified Implementation Mapping methodology to be applied when evaluating existing implementation. We illustrate the methodology using the example of evaluating ongoing organized colorectal cancer screening programs in Switzerland. Through this example, we describe how we identify relevant stakeholders, implementation determinants and outcomes as well as currently employed implementation strategies. Moreover, we describe how we compare the types of strategies that are part of existing implementation efforts with those that implementation science would suggest as being suited to address identified implementation determinants. The results can be used for assessing the current state of implementation outcomes, refining ongoing implementation strategies, and informing future implementation efforts.
当经验证的干预措施在实际实践环境中实施时，这些干预措施的实施过程对于其潜在成功至关重要。实施映射是一种方法，为系统地设计符合各自干预措施和背景的实施过程提供了逐步指导。它包括相关利益相关者的需求评估、实施结果和决定因素的确定、适当实施策略的选择和设计、实施协议的制定以及实施结果评估。实施映射通常被概念化为前瞻性指导实施的工具。然而，许多实施工作是基于以前或正在进行的实施工作，即“现有实施”。从现有实施中获得的经验教训可能为进一步实施活动的成功提供关键见解。在本文中，我们提出了一种修改后的实施映射方法，用于评估现有实施情况。我们使用评估瑞士正在进行的结直肠癌筛查计划的例子来说明该方法。通过这个例子，我们描述了如何识别相关利益相关者、实施决定因素和结果以及当前采用的实施策略。此外，我们还描述了如何将现有实施工作中的策略类型与实施科学建议的适合解决已确定的实施决定因素的策略类型进行比较。结果可用于评估当前实施结果的状态、改进正在进行的实施策略，并为未来的实施工作提供信息。
