Implementation Science

Implementation science (IS), the study of methods to promote the uptake of research findings and evidence-based practices (EBP) into routine service delivery (Carlisle et al.), has become a significant driving force in improving health and health care at scale (Chambers et al.). IS generally focuses on identifying and prioritizing barriers to and facilitators of EBP use (i.e., determinants) (Damschroder et al.); selecting, tailoring, and evaluating implementation strategies (e.g., training, consultation) that actively promote intervention adoption, high-quality delivery, and sustainment (Powell et al.); and evaluating implementation outcomes (Proctor et al.).

In IS research, the thing being studied must be backed by evidence. Curran makes the following key IS distinctions:

  • Intervention/Practice/Innovation is the thing
  • Effectiveness research looks at whether the thing works
  • Implementation research looks at how best to help people/places do the thing
  • Implementation strategies are the stuiff we do to try to help people/places do the thing
  • Main implementation outcomes are how much and how well they do the thing

What is the role of Implementation Science in Human-Centered Design projects?

Implementation science (IS) shares common objectives with human-centered design and offers complementary perspectives for thinking about what outcomes to prioritize in redesign as well as frameworks for considering what might be redesigned.

Implementation science starts with an evidence-based practice and seeks to improve its high quality uptake and sustainment. This lends itself to organization- or population-level measures of success, such as adoption and reach, which compliment more individual-level measures in HCD, such as engagement. Additionally, implementation science keeps a focus on adoption with fidelity – that is, does the intervention happen as necessary for it to achieve the desired mechanisms of change and health outcomes?

Frameworks in implementation science also help consider what factors must be considered and how they may be modified. For example, the consolidated framework for implementation research (CFIR) provides a set contracts, across five domains, that can inform systematic assessment of barriers and facilitators to adoption. The FRAME (Framework for Reporting Adaptations and Modifications-Enhanced) supports a systematic way of characterizing adaptations made to an intervention as part of implementation. While HCD often emphasizes meeting users or organizations where they are, implementation science frameworks also highlight the potential opportunity (or need) to support implementation by adapting aspects of the individual (e.g., training) or organization (e.g., changed workflows).

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