Abstract
BackgroundThe PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavours. However, as a conceptual framework it still remains untested and therefore its contribution to the overall development and testing of theory in the field of implementation science is largely unquantified.DiscussionThis being the case, the paper provides an integrated summary of our conceptual and theoretical thinking so far and introduces a typology (derived from social policy analysis) used to distinguish between the terms conceptual framework, theory and model – important definitional and conceptual issues in trying to refine theoretical and methodological approaches to knowledge translation.Secondly, the paper describes the next phase of our work, in particular concentrating on the conceptual thinking and mapping that has led to the generation of the hypothesis that the PARiHS framework is best utilised as a two-stage process: as a preliminary (diagnostic and evaluative) measure of the elements and sub-elements of evidence (E) and context (C), and then using the aggregated data from these measures to determine the most appropriate facilitation method. The exact nature of the intervention is thus determined by the specific actors in the specific context at a specific time and place.In the process of refining this next phase of our work, we have had to consider the wider issues around the use of theories to inform and shape our research activity; the ongoing challenges of developing robust and sensitive measures; facilitation as an intervention for getting research into practice; and finally to note how the current debates around evidence into practice are adopting wider notions that fit innovations more generally.SummaryThe paper concludes by suggesting that the future direction of the work on the PARiHS framework is to develop a two-stage diagnostic and evaluative approach, where the intervention is shaped and moulded by the information gathered about the specific situation and from participating stakeholders. In order to expedite the generation of new evidence and testing of emerging theories, we suggest the formation of an international research implementation science collaborative that can systematically collect and analyse experiences of using and testing the PARiHS framework and similar conceptual and theoretical approaches.We also recommend further refinement of the definitions around conceptual framework, theory, and model, suggesting a wider discussion that embraces multiple epistemological and ontological perspectives.
Highlights
The PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavours
In order to expedite the generation of new evidence and testing of emerging theories, we suggest the formation of an international research implementation science collaborative that can systematically collect and analyse experiences of using and testing the PARiHS framework and similar conceptual and theoretical approaches
The objective of the current phase of our work is to build on the concept analysis and clarification undertaken in phases one and two, and to evaluate the current framework through the development and testing of diagnostic and evaluative instruments to assist in the process of knowledge translation
Summary
Conceptual frameworks, theories, and models of knowledge translation: seeking greater clarity There is a growing interest in the literature around clarification of terminology used in implementation science and around the use of such mental devices as conceptual frameworks, theories, and models [15]. "...given the need for multiple disciplinary languages and given the multiple levels of analysis involved in http://www.implementationscience.com/content/3/1/1 studying configural relationships between rules, relevant aspects of the world and cultural phenomena, the study of institutions does depend on theoretical work undertaken at three levels, namely frameworks, theories and models" Both Sabatier [30] and Ostrom [31] argue that for the effective development of policy theory the following distinctions can be made. For example, in Ostrom's analysis, the question would be whether the elements as identified in the PARiHS framework survive continuous scrutiny and testing against multiple theories at multiple levels within the organisation that have a relevance and coherence to research implementation strategies Long as this is the case, the elements remain intact: once exceptions begin to emerge, the basic tenets of the conceptual framework are placed under further scrutiny. Do the elements and sub-elements have equal weighting in getting evidence into practice?
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