Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures.

Stephenie R Chaudoir,Colin H I Barr,Alicia G Dugan

doi:10.1186/1748-5908-8-22

Stephenie R Chaudoir, Colin H I Barr + Show 1 more

Open Access

https://doi.org/10.1186/1748-5908-8-22

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Abstract

BackgroundTwo of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs. In order to address these gaps, the main goals of this paper were to identify a multi-level framework that captures the predominant factors that impact implementation outcomes, conduct a systematic review of available measures assessing constructs subsumed within these primary factors, and determine the criterion validity of these measures in the search articles.MethodWe conducted a systematic literature review to identify articles reporting the use or development of measures designed to assess constructs that predict the implementation of evidence-based health innovations. Articles published through 12 August 2012 were identified through MEDLINE, CINAHL, PsycINFO and the journal Implementation Science. We then utilized a modified five-factor framework in order to code whether each measure contained items that assess constructs representing structural, organizational, provider, patient, and innovation level factors. Further, we coded the criterion validity of each measure within the search articles obtained.ResultsOur review identified 62 measures. Results indicate that organization, provider, and innovation-level constructs have the greatest number of measures available for use, whereas structural and patient-level constructs have the least. Additionally, relatively few measures demonstrated criterion validity, or reliable association with an implementation outcome (e.g., fidelity).DiscussionIn light of these findings, our discussion centers on strategies that researchers can utilize in order to identify, adapt, and improve extant measures for use in their own implementation research. In total, our literature review and resulting measures compendium increases the capacity of researchers to conceptualize and measure implementation-related constructs in their ongoing and future research.

Highlights

Two of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs
We list information about the criterion validity [54] of each measure by examining the original validation source and each search article that utilized the scale, the type of implementation outcome that was assessed in each article, and whether there was evidence that the measure was statistically associated with the implementation outcome assessed
It provides as useful tool to aid researchers as they determine which of five types of factors to examine and which measures to utilize in order to assess constructs within each of these factors

Summary

Introduction

Two of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs. In order to address these gaps, the main goals of this paper were to identify a multi-level framework that captures the predominant factors that impact implementation outcomes, conduct a systematic review of available measures assessing constructs subsumed within these primary factors, and determine the criterion validity of these measures in the search articles. Billions of dollars are spent in countries around the world to support the development of evidence-based health innovations [1,2]—interventions, practices, and guidelines designed to improve human health. Only a small fraction of these innovations are ever implemented into practice [3], and efforts to implement these practices can take many years [4]. There are many ‘moving parts’ to consider that can determine whether implementation efforts succeed or fail

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