Abstract
BackgroundThe Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework.MethodsThis citation analysis commenced from four core articles representing the key stages of the framework’s development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail.ResultsThe citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated.ConclusionsIn line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.
Highlights
There has been an increased use of theoretical frameworks in the field of implementation science in the last decade, with most developed in the last two decades [1, 2]
The PARIHS framework has been described as a determinant framework in that it specifies determinants that act as barriers and enablers influencing implementation outcomes [2]
131 references categorized as books, book chapters, conference proceedings, and publications written in non-English language were excluded
Summary
There has been an increased use of theoretical frameworks in the field of implementation science in the last decade, with most developed in the last two decades [1, 2]. While theoretical frameworks are increasingly being cited, more research is needed to understand how they are chosen and applied, and how their use relates to improved implementation outcomes [1, 4]. Skolarus et al [1] identified Kitson et al [5] as one of the two primary originating sources of influence in their citation analysis of dissemination and implementation frameworks. The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework
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