Is implementation research out of step with implementation practice? Pathways to effective implementation support over the last decade

This is a guest post from Joann Cattlin, PhD Student, College of Global, Urban and Social Studies

RMIT University. Joann is reviewed the following article:

Metz, A., Jensen, T., Farley, A., & Boaz, A. (2022). Is implementation research out of step with implementation practice? Pathways to effective implementation support over the last decade. Implementation Research and Practice3, 26334895221105585.

Background: There is growing interest in the lived experience of professionals who provide implementation support (i.e. implementation support practitioners). However, there remains limited knowledge about their experiences and how those experiences can contribute to the knowledge base on what constitutes successful and sustainable implementation support models. This study aimed to examine pathways of implementation support practice, as described by experienced professionals actively supporting systems’ uptake and sustainment of evidence to benefit children and families.

Plain language summary:  Over the past few years, professionals in the field of implementation science have identified a growing gap between implementation research and implementation practice. While this issue has been highlighted informally, the field is lacking a shared understanding and clear way forward to reconcile this gap. In this paper, the authors describe how professionals providing implementation support have shifted their implementation practice over time through systematic observations of what works (and what does not work) for supporting and sustaining evidence use in service systems to improve population outcomes. The authors share the impressive leaps forward made in the field of implementation practice – from didactic training to responsive and tailored implementation strategies to co-created and relationship-based implementation solutions. The paper concludes with a call to action to the field for the creation of a virtuous learning cycle between professionals conducting implementation research and professionals providing implementation support to change practice as a way to produce a more robust and relevant science of implementation.

This paper reports on the lived experiences of implementation support practitioners (ISP) in the United States as they reflect on the changes in their practices over the last 15 years. The participants work in the field of child welfare within university implementation centres or non-profit intermediary organisations.  The data was collected through 17 semi structured interviews.

As a someone unfamiliar with the practices of implementation science in community organisations, this article provided useful introduction to key concepts as well as the work of implementation professionals. The study provides a window into the reflective practice of these experienced staff and the iterative development of their approaches in response to the needs of the communities and organisations they work with.

The reporting of data and analysis is well organised and is represented in framework that identifies how their practices align with implementation science practices.  This framework provides a useful point of reference throughout the article for locating and comparing the experiences of individual participants. The authors reflect several times on experiences that do not neatly fit into the framework. While it is not suggested in the article, this framework could serve as a framework for capability development or training resources for implementation professionals.

The results of the study indicate that these professionals evolved their practices in response to the needs of the community and the practices that proved most effective. They took a critical and reflective approach to implementing certain practices, such as scaling up of practices through training programs.  The key findings from the study were:

  1. Implementation support professionals have evolved their roles based on their experience, evolving knowledge about implementation practice and evaluation of the outcomes of these practices.
  2. The main implementation support approaches were push, push/pull and co-creation.
  3. Implementation support professionals demonstrated a range of technical skills, such as using data and conducting improvement cycles, as well as interpersonal skills, such as relationship building, which could inform development of capacity building programs.

The authors conclude that Implementation science research may be out of step with implementation practice and recommend more systematic study of the experiences of implementation professionals through a virtuous learning cycle.

Questions for brokers:

  1. This research focused on implementation professionals in the US – do the findings ring true for other sectors and countries? Are they transferable across sectors and countries?
  2. How can implementation science research tap into the experiences and learnings of implementation professionals more effectively?
  3. Implementation science needs to improve its approach to implementation – what are the barriers and challenges?

Research Impact Canada is producing this journal club series to make evidence on KMb more accessible to knowledge brokers and to create online discussion about research on knowledge mobilization. It is designed for knowledge brokers and other knowledge mobilization stakeholders. Read this open access article. Then come back to this post and join the journal club by posting your comments