Birken Sarah A, Ko Linda K, Wangen Mary, Wagi Cheyenne R, Bender Miriam, Nilsen Per, Choy-Brown Mimi, Peluso Alexandra, Leeman Jennifer
Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, NC, United States.
Washington School of Public Health, Health Systems and Population Health, Seattle, WA, United States.
Front Health Serv. 2022 Jun 30;2:891507. doi: 10.3389/frhs.2022.891507. eCollection 2022.
Organization theories offer numerous existing, highly relevant, yet largely untapped explanations of the organizational dynamics underlying evidence-based intervention (EBI) implementation. Rooted in ideas regarding power, autonomy, and control, organization theories can explain how and why organizations adopt, implement, and sustain EBI use. Although they have gained visibility, organization theories remain underused in implementation research, perhaps due to their inaccessibility to implementation scientists. To improve access to organization theory among implementation scientists, we summarized organization theories with relevance to implementation science.
Led by the Cancer Prevention and Control Research Network (CPCRN) Organization Theory for Implementation Science workgroup, we employed a modified Delphi process to reach a consensus among 18 experts at the intersection of organization and implementation science regarding organization theories with relevance to implementation science. From texts that described the organization theories, using standardized abstraction forms, two investigators independently abstracted information regarding constructs, propositions regarding how or why constructs might influence implementation, the potential relevance of organization theories' propositions for implementation, and overviews of each theory. The investigators then reconciled discrepancies until reaching consensus. A third investigator reviewed reconciled abstraction forms for accuracy, coherence, and completeness.
We identified nine organization theories with relevance to implementation science: contingency, complexity, institutional, network, organizational learning, resource dependence, sociotechnical, and transaction cost economics. From the theories, we abstracted 70 constructs and 65 propositions. An example proposition from institutional theory is: "Coercive, mimetic, and normative pressures contribute to organizations…within an organizational field [becoming increasingly similar]." These propositions can be operationalized as levers to facilitate EBI implementation.
To increase use in the field, organization theories must be made more accessible to implementation scientists. The abstraction forms developed in this study are now publicly available on the CPCRN website with the goal of increasing access to organization theories among an interdisciplinary audience of implementation scientists through the CPCRN Scholars program and other venues. Next steps include consolidating organization theory constructs into domains and translating the resulting framework for use among researchers, policymakers and practitioners, aiding them in accounting for a comprehensive set of organization theory constructs thought to influence EBI implementation.
组织理论提供了众多关于循证干预（EBI）实施背后组织动态的现有且高度相关但在很大程度上未被挖掘的解释。基于有关权力、自主性和控制的理念，组织理论能够解释组织如何以及为何采用、实施并维持EBI的使用。尽管组织理论已受到关注，但在实施研究中仍未得到充分利用，这可能是因为实施科学家难以接触到这些理论。为了提高实施科学家对组织理论的了解，我们总结了与实施科学相关的组织理论。
在癌症预防与控制研究网络（CPCRN）实施科学组织理论工作组的带领下，我们采用了改良的德尔菲法，以在18位组织与实施科学交叉领域的专家中就与实施科学相关的组织理论达成共识。从描述组织理论的文本中，两位研究人员使用标准化的抽象形式，独立提取了有关构念、关于构念如何或为何可能影响实施的命题、组织理论命题对实施的潜在相关性以及每种理论的概述等信息。然后，研究人员协调差异，直至达成共识。第三位研究人员审查了达成一致的抽象形式的准确性、连贯性和完整性。
我们确定了九种与实施科学相关的组织理论：权变理论、复杂性理论、制度理论、网络理论、组织学习理论、资源依赖理论、社会技术理论和交易成本经济学理论。从这些理论中，我们提取了70个构念和65个命题。制度理论的一个示例命题是：“强制、模仿和规范压力促使组织……在一个组织领域内[变得越来越相似]。”这些命题可以作为促进EBI实施的杠杆加以实施。
为了增加该领域对组织理论的使用，必须让实施科学家更容易接触到组织理论。本研究中开发的抽象形式现已在CPCRN网站上公开提供，目的是通过CPCRN学者计划和其他渠道，让跨学科的实施科学家群体更容易接触到组织理论。下一步包括将组织理论构念整合到各个领域，并将由此产生的框架进行转化，以供研究人员、政策制定者和从业者使用，帮助他们考虑一整套被认为会影响EBI实施的组织理论构念。
