Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study.

Thomas J Waltz,Monica M Matthieu,Enola K Proctor,Laura J Damschroder,Jeffrey L Smith,Byron J Powell,Joann E Kirchner,Matthew J Chinman

doi:10.1186/s13012-015-0295-0

Abstract

BackgroundPoor terminological consistency for core concepts in implementation science has been widely noted as an obstacle to effective meta-analyses. This inconsistency is also a barrier for those seeking guidance from the research literature when developing and planning implementation initiatives. The Expert Recommendations for Implementing Change (ERIC) study aims to address one area of terminological inconsistency: discrete implementation strategies involving one process or action used to support a practice change. The present report is on the second stage of the ERIC project that focuses on providing initial validation of the compilation of 73 implementation strategies that were identified in the first phase.FindingsPurposive sampling was used to recruit a panel of experts in implementation science and clinical practice (N = 35). These key stakeholders used concept mapping sorting and rating activities to place the 73 implementation strategies into similar groups and to rate each strategy’s relative importance and feasibility. Multidimensional scaling analysis provided a quantitative representation of the relationships among the strategies, all but one of which were found to be conceptually distinct from the others. Hierarchical cluster analysis supported organizing the 73 strategies into 9 categories. The ratings data reflect those strategies identified as the most important and feasible.ConclusionsThis study provides initial validation of the implementation strategies within the ERIC compilation as being conceptually distinct. The categorization and strategy ratings of importance and feasibility may facilitate the search for, and selection of, strategies that are best suited for implementation efforts in a particular setting.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0295-0) contains supplementary material, which is available to authorized users.

Highlights

Poor terminological consistency for core concepts in implementation science has been widely noted as an obstacle to effective meta-analyses
This study provides initial validation of the implementation strategies within the Expert Recommendations for Implementing Change (ERIC) compilation as being conceptually distinct
The categorization and strategy ratings of importance and feasibility may facilitate the search for, and selection of, strategies that are best suited for implementation efforts in a particular setting

Summary

Introduction

Poor terminological consistency for core concepts in implementation science has been widely noted as an obstacle to effective meta-analyses This inconsistency is a barrier for those seeking guidance from the research literature when developing and planning implementation initiatives. Inconsistent terminology complicates literature searches, and researchers have found that search strategy yield and precision indices for implementation and quality improvement studies are moderate at best [2, 3] This limits meta-analytic and replication efforts aimed at rigorously evaluating the effectiveness of implementation strategies and the value of existing literature for those enacting implementation initiatives. Powell et al [8] reviewed the health and mental health literature (including 41 compilations and reviews) and proposed a compilation of 68 discrete implementation strategies involving one action or process This compilation served as the starting point for a subsequent multi-stage project called Expert Recommendations for Implementing Change (ERIC) [9].

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