Chokron Garneau Hélène, Cheng Hannah, Kim Jane, Abdel Magid Maryam, Chin-Purcell Lia, McGovern Mark
Stanford Center for Dissemination and Implementation, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine,, Palo Alto, CA, USA.
Implement Sci Commun. 2025 Apr 25;6(1):50. doi: 10.1186/s43058-025-00726-9.
Successful implementation and sustainment of interventions is heavily influenced by context. Yet the complexity and dynamic nature of context make it challenging to connect and translate findings across implementation efforts. Existing methods to assess context are typically qualitative, limiting potential replicability and utility. Existing quantitative measures and the siloed nature of implementation efforts limit possibilities for data poolinXg and harmonization. The Inventory of Factors Affecting Successful Implementation and Sustainment (IFASIS) was developed to be a pragmatic, quantitative, organizational-level assessment of contextual factors. The intention is to characterize context with a measure that may enhance replication and reproducibility of findings beyond single implementation case studies. Here, we present the development and validation of the IFASIS.
A literature review was conducted to identify major concepts of established theories and frameworks to be retained. IFASIS data were examined in relation to implementation outcomes gathered from two studies. Psychometric validation efforts included content and face validity, reliability, internal consistency, and predictive and concurrent validity. Predictive validity was evaluated using generalized estimating equations (GEE) for longitudinal data on three implementation outcomes: reach, effectiveness, and implementation quality. Pragmatic properties were also evaluated.
The IFASIS is a 27-item, team-based, instrument that quantitatively operationalizes context. Two rating scales capture current state and importance of each item to an organization. It demonstrated strong reliability, internal consistency, and predictive and concurrent validity. There were significant associations between higher IFASIS scores and improved implementation outcomes. A one-unit increase in total IFASIS score corresponded to a 160% increase in the number of patients receiving a medication (reach). IFASIS domains of factors outside the organization, factors within the organization, and factors about the intervention, and subscales of organizational readiness, community support, and recipient needs and values, were predictive of successful implementation outcomes. IFASIS scores were also significantly associated with measures of implementation quality.
The IFASIS is a psychometrically and pragmatically valid instrument to assess contextual factors in implementation endeavors. Its ability to predict key implementation outcomes and facilitate data pooling across projects suggests it can play an important role in advancing the field.
干预措施的成功实施和持续推进在很大程度上受到背景因素的影响。然而，背景的复杂性和动态性使得在不同的实施工作中联系和转化研究结果具有挑战性。现有的评估背景的方法通常是定性的，限制了潜在的可重复性和实用性。现有的定量测量方法以及实施工作的孤立性限制了数据汇总和协调的可能性。影响成功实施和持续推进的因素清单（IFASIS）旨在成为一种实用的、定量的、针对组织层面的背景因素评估工具。其目的是通过一种测量方法来描述背景，这种方法可能会增强研究结果在单个实施案例研究之外的可重复性和再现性。在此，我们介绍IFASIS的开发和验证过程。
进行了一项文献综述，以确定要保留的既定理论和框架的主要概念。将IFASIS数据与从两项研究中收集的实施结果相关联进行检查。心理测量学验证工作包括内容效度、表面效度、信度、内部一致性以及预测效度和同时效度。使用广义估计方程（GEE）对关于三个实施结果的纵向数据进行预测效度评估：覆盖范围、有效性和实施质量。还评估了实用性。
IFASIS是一个由27个项目组成的、基于团队的工具，用于对背景进行定量操作。两个评分量表分别衡量每个项目对组织的当前状态和重要性。它显示出很强的信度、内部一致性、预测效度和同时效度。IFASIS得分较高与改善的实施结果之间存在显著关联。IFASIS总分增加一个单位对应于接受药物治疗的患者数量增加160%（覆盖范围）。组织外部因素、组织内部因素以及干预措施相关因素的IFASIS领域，以及组织准备情况、社区支持和接受者需求与价值观的子量表，都可预测成功的实施结果。IFASIS得分也与实施质量的测量结果显著相关。
IFASIS是一种在心理测量学和实用性方面都有效的工具，可用于评估实施工作中的背景因素。它预测关键实施结果以及促进跨项目数据汇总的能力表明，它可以在推动该领域发展方面发挥重要作用。
