Theories, models and frameworks of implementation science_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Wenjia ^1,2 ^# , XU Dong ³ ^# ,  LI Hui ^1,2 , CHEN Yaolong ⁴ , DU Liang ⁵ , ZHOU Yingfeng ⁶ , JIN Yinghui ⁷ , WANG Yangyang ^1,2

1. Key Research Department of Standardization of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine (the Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou 510120, P.R.China;
2. Engineering and Technology Research Center of Standardization of Traditional Chinese Medicine, Guangzhou 510120, P.R.China;
3. Sun Yat-sen Global Health Institute, School of Public Health, Sun Yat-sen University, Guangzhou 510275, P.R.China;
4. WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou 730000, P.R.China;
5. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
6. Fudan University Centre for Evidence-based Nursing: a Joanna Briggs Institute Centre of Excellence, Shanghai 200032, P.R.China;
7. Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, P.R.China;

Corresponding author：

LI Hui, Email: lihuitcm@126.com

Keywords：

Implementation science; Theory; Model; Framework

DOI：

10.7507/1672-2531.202003238

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Implementation science is a new field that aims to scale up and sustain the application of evidence-based practice. It primarily studies the dissemination, adoption, evaluation, and improvement, etc. of the implementation process of evidence-based practice. In recent years, tens of implementation theories, frameworks and models have been developed. We systematically collected 41 of them and classified them into several categories. The first is the classical theories which are extended from the traditional social science and used as the predecessors of the implementation science. The second category is the implementation science frameworks/models that are derived from the first category, and can be divided into four groups: 1) the implementation models that explain the law of a certain aspect in the implementation; 2) the implementation determinants frameworks that summarize and classify the implementation determinants; 3) the process models that discuss how research translates into practice; 4) the evaluation models that evaluate the implementation and outcome. The implementation science theories can provide implementation researchers with valuable guidance for development of implementation strategies and evaluation of implementation outcomes.

Citation： CHEN Wenjia, XU Dong, LI Hui, CHEN Yaolong, DU Liang, ZHOU Yingfeng, JIN Yinghui, WANG Yangyang. Theories, models and frameworks of implementation science. Chinese Journal of Evidence-Based Medicine, 2020, 20(8): 986-992. doi: 10.7507/1672-2531.202003238 Copy

1.	U.S. Agency For International Development. Acting on the call: ending preventable maternal and child deaths. Athena Information Solutions Pvt. Ltd, 2014. Available at: https://www.usaid.gov/sites/default/files/documents/1864/USAID_ActingOnTheCall_2014.pdf.
2.	Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. London: SAGE Publications, 2011, 104: 510-520.
3.	Balas EA, Boren SA. Managing clinical knowledge for health care improvement. Yearb Med Inform, 2000, (1): 65-70.
4.	屈智勇, 郭帅, 张维军, 等. 实施科学对我国心理健康服务体系建设的启示. 北京师范大学学报(社会科学版), 2017, (2): 29-36.
5.	Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci, 2015, 10: 53.
6.	Bauer MS, Damschroder L, Hagedorn H, et al. An introduction to implementation science for the non-specialist. BMC Psychol, 2015, 3(1): 32.
7.	Nutley S, Walter I, Davies HTO. From knowing to doing: a framework for understanding the evidence-into-practice agenda. Evaluation, 2003, 9(2): 125-148.
8.	Kuhl J, Beckmann J, Ajzen I, et al. Action control: from cognition to behavior. Berlin, Heidelberg: Springer, 1985.
9.	Vasta R, Bandura A. Six theories of child development: revised formulations and current issues. London: Jessica Kingsley, 1992.
10.	Triandis HC. Interpersonal behavior. London: Brooks/Cole Pub. Co, 1977.
11.	Rogers EM. Diffusion of innovations (Fifth edition). New York: Free Press, 2003.
12.	Dearing JW. Applying diffusion of innovation theory to intervention development. Res Social Work Prac, 2009, 19(5): 503-518.
13.	Dadich A, Doloswala N. What can organisational theory offer knowledge translation in healthcare? A thematic and lexical analysis. BMC Health Serv Res, 2018, 18(1): 351.
14.	Orlikowski WJ. Improvising organizational transformation over time: a situated change perspective. Inform Syst Res, 1996, 7(1): 63-92.
15.	Sahin I. Detailed review of Rogers' diffusion of innovations theory and educational technology-related studies based on Rogers' theory. Tojet, 2006, 5(2): 514.
16.	Greenhalgh T, Robert G, Macfarlane F, et al. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q, 2004, 82(4): 581-629.
17.	Huberman M. Research utilization: The state of the art. Know P, 1994, 7(4): 13-33.
18.	Cochrane LJ, Olson CA, Murray S, et al. Gaps between knowing and doing: Understanding and assessing the barriers to optimal health care. J Contin Educ Health, 2007, 27(2): 94-102.
19.	Damschroder LJ, Aron DC, Keith RE, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci, 2009, 4: 50.
20.	Cane J, O'Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci, 2012, 7: 37.
21.	Michie S. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care, 2005, 14(1): 26-33.
22.	Wensing MJP, Oxman A, Baker R, et al. Tailored implementation for chronic diseases (TICD): A project protocol. Implement Sci, 2011, 6: 103.
23.	Flottorp SA, Oxman AD, Krause J, et al. A checklist for identifying determinants of practice: a systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice. Implement Sci, 2013, 8: 35.
24.	Kitson A, Harvey G, Mccormack B. Enabling the implementation of evidence based practice: a conceptual framework. Qual Health Care, 1998, 7(3): 149-158.
25.	顾莺, 胡雁. PARIHS循证实践概念框架的应用研究进展. 解放军护理杂志, 2015, 32(8): 45-47.
26.	Harvey G, Kitson A. PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice. Implement Sci, 2015, 11: 57.
27.	张立华, 顾莺. 临床实践变革的概念框架: 从PARIHS到i-PARIHS. 中国循证医学杂志, 2019, 19(6): 741-747.
28.	Jacobson N, Butterill D, Goering P. Development of a framework for knowledge translation: understanding user context. J Health Serv Res Policy, 2003, 8(2): 94-99.
29.	Fixsen DL, Naoom SF, Blase KA, et al. Implementation research: a synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network, 2005.
30.	Blanchard C, Livet M, Ward C, et al. The active implementation frameworks: A roadmap for advancing implementation of Comprehensive Medication Management in Primary care. Res Soc Admin Pharm, 2017, 13(5): 922-929.
31.	Grol R. Personal paper: Beliefs and evidence in changing clinical practice. BMJ, 1997, 315(7105): 418-421.
32.	Grol R, Grimshaw J. Evidence-based implementation of evidence-based medicine. Joint Comm J Qual Improv, 1999, 25(10): 503-513.
33.	Durlak JA, Dupre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Commun Psychol, 2008, 41(3-4): 327-350.
34.	Weiner BJ, Belden CM, Bergmire DM, et al. The meaning and measurement of implementation climate. Implement Sci, 2011, 6: 78.
35.	Klein KJ, Sorra OS. The challenge of innovation implementation. Acad Manage Rev, 1996, 21(4): 1055-1080.
36.	Shaker AZ, Gerard G. Absorptive capacity: a review, reconceptualization, and extension. Acad Manage Rev, 2002, 27(2): 185-203.
37.	Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci, 2011, 6: 42.
38.	Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci, 2013, 8: 117.
39.	May C, Finch T. Implementing, embedding, and integrating practices: an outline of normalization process theory. Sociology, 2009, 43(3): 535-554.
40.	Graham ID, Logan J, Harrison MB, et al. Lost in knowledge translation: Time for a map? J Contin Educ Health, 2006, 26(1): 13-24.
41.	Meyers DC, Durlak JA, Wandersman A. The quality implementation framework: a synthesis of critical steps in the implementation process. Am J Commun Psychol, 2012, 50(3): 462-480.
42.	Feldstein AC, Glasgow RE. A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Jt Comm J Qual Patient Saf, 2008, 34(4): 228-243.
43.	Aarons GA, Aarons GA, Hurlburt M, et al. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Hlth, 2011, 38(1): 4-23.
44.	Moullin JC, Dickson KS, Stadnick NA, et al. Systematic review of the exploration, preparation, implementation, sustainment (EPIS) framework. Implement Sci, 2019, 14: 11.
45.	Titler MG, Kleiber C, Steelman VJ, et al. The Iowa model of evidence-based practice to promote quality care. Crit Care Nurs Clin North Am, 2001, 13(4): 497.
46.	Dearholt SL, Dang D. Johns Hopkins nursing evidence-based practice: model and guidelines: AORN Journal (2nd Edition). Indianapolis: Sigma Theta Tau International, 2013.
47.	Landry R, Amara N, Lamari M. Climbing the ladder of research utilization: evidence from social science research. Sci Commun, 2001, 22(4): 396-422.
48.	Stetler CB. Research utilization: defining the concept. J Nurs Scholarship, 1985, 17(2): 40-44.
49.	Stetler CB. Updating the Stetler model of research utilization to facilitate evidence-based practice. Nurs Outlook, 2001, 49(6): 272-279.
50.	Peters DH, Tran NT, Adam T, et al. Implementation research in health: a practical guide. World Health Organization, 2013. Available at: https://apps.who.int/iris/handle/10665/91758.
51.	李慧, 谢润生, 陈文嘉, 译. 健康领域的实施研究实用指南. Geneva: WHO, 2020. Available at: https://apps.who.int/iris/handle/10665/91758.
52.	Melnyk BM, Fineout OE, Mays MZ. The evidence-based practice beliefs and implementation scales: Psychometric properties of two new instruments. Worldviews Evid Based Nurs, 2008, 5(4): 208-216.
53.	Funk SG, Champagne MT, Wiese RA, et al. Barriers: The barriers to research utilization scale. Appl Nurs Res, 1991, 4(1): 39-45.
54.	Green LW, Kreuter MW, Deeds SG, et al. Health education planning: a diagnostic approach. Mountain View, California: Mayfield Publishers, 1980.
55.	Crosby R, Noar SM. What is a planning model? An introduction to PRECEDE-PROCEED. J Public Health Dent, 2011, 71: S7-15.
56.	Green LW, Kreuter MW. Health education planning: an educational and environmental approach. Mountain View, California: Mayfield Publishers, 1991.
57.	Proctor EK, Landsverk J, Aarons G, et al. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health, 2009, 36(1): 24-34.
58.	Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health, 1999, 89(9): 1322-1327.
59.	Gurses AP, Murphy DJ, Martinez EA, et al. A practical tool to identify and eliminate barriers to compliance with evidence-based guidelines. Jt Comm J Qual Patient Saf, 2009, 35(10): 526.
60.	Birken SA, Rohweder CL, Powell BJ, et al. T-CaST: an implementation theory comparison and selection tool. Implement Sci, 2018, 13: 17.

1. U.S. Agency For International Development. Acting on the call: ending preventable maternal and child deaths. Athena Information Solutions Pvt. Ltd, 2014. Available at: https://www.usaid.gov/sites/default/files/documents/1864/USAID_ActingOnTheCall_2014.pdf.
2. Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. London: SAGE Publications, 2011, 104: 510-520.
3. Balas EA, Boren SA. Managing clinical knowledge for health care improvement. Yearb Med Inform, 2000, (1): 65-70.
4. 屈智勇, 郭帅, 张维军, 等. 实施科学对我国心理健康服务体系建设的启示. 北京师范大学学报(社会科学版), 2017, (2): 29-36.
5. Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci, 2015, 10: 53.
6. Bauer MS, Damschroder L, Hagedorn H, et al. An introduction to implementation science for the non-specialist. BMC Psychol, 2015, 3(1): 32.
7. Nutley S, Walter I, Davies HTO. From knowing to doing: a framework for understanding the evidence-into-practice agenda. Evaluation, 2003, 9(2): 125-148.
8. Kuhl J, Beckmann J, Ajzen I, et al. Action control: from cognition to behavior. Berlin, Heidelberg: Springer, 1985.
9. Vasta R, Bandura A. Six theories of child development: revised formulations and current issues. London: Jessica Kingsley, 1992.
10. Triandis HC. Interpersonal behavior. London: Brooks/Cole Pub. Co, 1977.
11. Rogers EM. Diffusion of innovations (Fifth edition). New York: Free Press, 2003.
12. Dearing JW. Applying diffusion of innovation theory to intervention development. Res Social Work Prac, 2009, 19(5): 503-518.
13. Dadich A, Doloswala N. What can organisational theory offer knowledge translation in healthcare? A thematic and lexical analysis. BMC Health Serv Res, 2018, 18(1): 351.
14. Orlikowski WJ. Improvising organizational transformation over time: a situated change perspective. Inform Syst Res, 1996, 7(1): 63-92.
15. Sahin I. Detailed review of Rogers' diffusion of innovations theory and educational technology-related studies based on Rogers' theory. Tojet, 2006, 5(2): 514.
16. Greenhalgh T, Robert G, Macfarlane F, et al. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q, 2004, 82(4): 581-629.
17. Huberman M. Research utilization: The state of the art. Know P, 1994, 7(4): 13-33.
18. Cochrane LJ, Olson CA, Murray S, et al. Gaps between knowing and doing: Understanding and assessing the barriers to optimal health care. J Contin Educ Health, 2007, 27(2): 94-102.
19. Damschroder LJ, Aron DC, Keith RE, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci, 2009, 4: 50.
20. Cane J, O'Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci, 2012, 7: 37.
21. Michie S. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care, 2005, 14(1): 26-33.
22. Wensing MJP, Oxman A, Baker R, et al. Tailored implementation for chronic diseases (TICD): A project protocol. Implement Sci, 2011, 6: 103.
23. Flottorp SA, Oxman AD, Krause J, et al. A checklist for identifying determinants of practice: a systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice. Implement Sci, 2013, 8: 35.
24. Kitson A, Harvey G, Mccormack B. Enabling the implementation of evidence based practice: a conceptual framework. Qual Health Care, 1998, 7(3): 149-158.
25. 顾莺, 胡雁. PARIHS循证实践概念框架的应用研究进展. 解放军护理杂志, 2015, 32(8): 45-47.
26. Harvey G, Kitson A. PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice. Implement Sci, 2015, 11: 57.
27. 张立华, 顾莺. 临床实践变革的概念框架: 从PARIHS到i-PARIHS. 中国循证医学杂志, 2019, 19(6): 741-747.
28. Jacobson N, Butterill D, Goering P. Development of a framework for knowledge translation: understanding user context. J Health Serv Res Policy, 2003, 8(2): 94-99.
29. Fixsen DL, Naoom SF, Blase KA, et al. Implementation research: a synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network, 2005.
30. Blanchard C, Livet M, Ward C, et al. The active implementation frameworks: A roadmap for advancing implementation of Comprehensive Medication Management in Primary care. Res Soc Admin Pharm, 2017, 13(5): 922-929.
31. Grol R. Personal paper: Beliefs and evidence in changing clinical practice. BMJ, 1997, 315(7105): 418-421.
32. Grol R, Grimshaw J. Evidence-based implementation of evidence-based medicine. Joint Comm J Qual Improv, 1999, 25(10): 503-513.
33. Durlak JA, Dupre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Commun Psychol, 2008, 41(3-4): 327-350.
34. Weiner BJ, Belden CM, Bergmire DM, et al. The meaning and measurement of implementation climate. Implement Sci, 2011, 6: 78.
35. Klein KJ, Sorra OS. The challenge of innovation implementation. Acad Manage Rev, 1996, 21(4): 1055-1080.
36. Shaker AZ, Gerard G. Absorptive capacity: a review, reconceptualization, and extension. Acad Manage Rev, 2002, 27(2): 185-203.
37. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci, 2011, 6: 42.
38. Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci, 2013, 8: 117.
39. May C, Finch T. Implementing, embedding, and integrating practices: an outline of normalization process theory. Sociology, 2009, 43(3): 535-554.
40. Graham ID, Logan J, Harrison MB, et al. Lost in knowledge translation: Time for a map? J Contin Educ Health, 2006, 26(1): 13-24.
41. Meyers DC, Durlak JA, Wandersman A. The quality implementation framework: a synthesis of critical steps in the implementation process. Am J Commun Psychol, 2012, 50(3): 462-480.
42. Feldstein AC, Glasgow RE. A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Jt Comm J Qual Patient Saf, 2008, 34(4): 228-243.
43. Aarons GA, Aarons GA, Hurlburt M, et al. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Hlth, 2011, 38(1): 4-23.
44. Moullin JC, Dickson KS, Stadnick NA, et al. Systematic review of the exploration, preparation, implementation, sustainment (EPIS) framework. Implement Sci, 2019, 14: 11.
45. Titler MG, Kleiber C, Steelman VJ, et al. The Iowa model of evidence-based practice to promote quality care. Crit Care Nurs Clin North Am, 2001, 13(4): 497.
46. Dearholt SL, Dang D. Johns Hopkins nursing evidence-based practice: model and guidelines: AORN Journal (2nd Edition). Indianapolis: Sigma Theta Tau International, 2013.
47. Landry R, Amara N, Lamari M. Climbing the ladder of research utilization: evidence from social science research. Sci Commun, 2001, 22(4): 396-422.
48. Stetler CB. Research utilization: defining the concept. J Nurs Scholarship, 1985, 17(2): 40-44.
49. Stetler CB. Updating the Stetler model of research utilization to facilitate evidence-based practice. Nurs Outlook, 2001, 49(6): 272-279.
50. Peters DH, Tran NT, Adam T, et al. Implementation research in health: a practical guide. World Health Organization, 2013. Available at: https://apps.who.int/iris/handle/10665/91758.
51. 李慧, 谢润生, 陈文嘉, 译. 健康领域的实施研究实用指南. Geneva: WHO, 2020. Available at: https://apps.who.int/iris/handle/10665/91758.
52. Melnyk BM, Fineout OE, Mays MZ. The evidence-based practice beliefs and implementation scales: Psychometric properties of two new instruments. Worldviews Evid Based Nurs, 2008, 5(4): 208-216.
53. Funk SG, Champagne MT, Wiese RA, et al. Barriers: The barriers to research utilization scale. Appl Nurs Res, 1991, 4(1): 39-45.
54. Green LW, Kreuter MW, Deeds SG, et al. Health education planning: a diagnostic approach. Mountain View, California: Mayfield Publishers, 1980.
55. Crosby R, Noar SM. What is a planning model? An introduction to PRECEDE-PROCEED. J Public Health Dent, 2011, 71: S7-15.
56. Green LW, Kreuter MW. Health education planning: an educational and environmental approach. Mountain View, California: Mayfield Publishers, 1991.
57. Proctor EK, Landsverk J, Aarons G, et al. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health, 2009, 36(1): 24-34.
58. Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health, 1999, 89(9): 1322-1327.
59. Gurses AP, Murphy DJ, Martinez EA, et al. A practical tool to identify and eliminate barriers to compliance with evidence-based guidelines. Jt Comm J Qual Patient Saf, 2009, 35(10): 526.
60. Birken SA, Rohweder CL, Powell BJ, et al. T-CaST: an implementation theory comparison and selection tool. Implement Sci, 2018, 13: 17.

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