Article type
Abstract
Background: Theoretical underpinnings are paramount to the comprehensive understanding of how and why evidence implementation in health care succeeds or fails. Over the past 2 decades, a plethora of theoretical approaches, models, and frameworks have emerged, making it challenging to select the most suitable methodology for implementation initiatives. The JBI approach to evidence implementation stands out as a pragmatic, comprehensive, 7-phase process model designed to guide the "planning" and "doing" of integrating evidence into practice. Beyond its practical application, the JBI approach serves as a scaffold for the exploration and integration of various theories, models, and frameworks (TMFs) within the realm of implementation science and behavior change.
Objectives: The presentation aims to provide a descriptive exploration of how different TMFs have been incorporated into the JBI 7-phase process model by diverse implementation project teams from various geographical contexts.
Methods: Insights from case studies, with a nested content analysis, of evidence implementation projects are shared, highlighting the TMFs integrated with the JBI 7-phase model and how they were operationalized in real-world implementation projects.
Results: Integration with TMFs primarily occurred in JBI phases 2 (engage change agents), 3 (assessment of context), 5 (implement changes), and 6 (reassessment of practice/evaluation of change). The integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) model was used for stakeholder and change agent identification, while Strengths, Weaknesses, Opportunities and Threats (SWOT) and Consolidated Framework for Implementation Research (CFIR) were commonly utilized for evaluating context and readiness to change. CFIR also aided in identifying barriers and enablers. Expert Recommendations for Implementing Change (ERIC) assisted in implementation strategy selection. The RE-AIM framework facilitated the evaluation of change and outcomes. Despite variations in team experiences, there was consensus that the JBI process model served as a valuable overarching framework, complementing existing TMFs in implementation and behavior change.
Conclusions: The JBI 7-phase process model to evidence implementation proves to be a flexible and compatible model with major TMFs in the implementation science field. The synergistic approach not only enhances the methodology for evidence integration but also holds promise for positively impacting healthcare practices, ultimately leading to improved patient outcomes and enhanced quality of care.
Objectives: The presentation aims to provide a descriptive exploration of how different TMFs have been incorporated into the JBI 7-phase process model by diverse implementation project teams from various geographical contexts.
Methods: Insights from case studies, with a nested content analysis, of evidence implementation projects are shared, highlighting the TMFs integrated with the JBI 7-phase model and how they were operationalized in real-world implementation projects.
Results: Integration with TMFs primarily occurred in JBI phases 2 (engage change agents), 3 (assessment of context), 5 (implement changes), and 6 (reassessment of practice/evaluation of change). The integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) model was used for stakeholder and change agent identification, while Strengths, Weaknesses, Opportunities and Threats (SWOT) and Consolidated Framework for Implementation Research (CFIR) were commonly utilized for evaluating context and readiness to change. CFIR also aided in identifying barriers and enablers. Expert Recommendations for Implementing Change (ERIC) assisted in implementation strategy selection. The RE-AIM framework facilitated the evaluation of change and outcomes. Despite variations in team experiences, there was consensus that the JBI process model served as a valuable overarching framework, complementing existing TMFs in implementation and behavior change.
Conclusions: The JBI 7-phase process model to evidence implementation proves to be a flexible and compatible model with major TMFs in the implementation science field. The synergistic approach not only enhances the methodology for evidence integration but also holds promise for positively impacting healthcare practices, ultimately leading to improved patient outcomes and enhanced quality of care.