Content area
Full text
Introduction
Brief history of Implementation Science
Many experts suggest that Implementation Science arose in the field of healthcare in response to a persistent and documented form of service failure (Durlak and Dupre, 2008; Meyers et al. , 2012; Kelly, 2013). Promising and empirically tested interventions and programs were not delivering expected results or showing a demonstrable impact on desired outcomes. Even when they did, failures of transferability (i.e. failure to get interventions to work in different contexts) brought an increasing concern about the complex nature of the links between existing scientific evidence on programs and their actual application (Kelly, 2013).
In the field of healthcare, concerns arose as early as the mid-1940s, when evidence began to accumulate that interventions rolled out in clinical settings did not produce the outcomes promised through empirical rounds of testing in controlled settings (Kelly, 2013). Initially, inquiries focused on why these interventions and programs were not implemented effectively and with fidelity. In the 1960s and 1970s, researchers also found that the design and focus of policy had little to do with the successful implementation of programs, even when the policy in question prescribed "empirically tested" programs (Pressman and Wildawsky, 1984). Glasgow et al. (2012, p. 1,274) assert: "Despite demonstrable benefits of many new medical discoveries, we have done a surprisingly poor job of putting research findings into practice". The authors make the point that the discovery of new and improved interventions is important; but to realize the benefits of these interventions, greater attention needs to be paid to dissemination and implementation to enhance the reach, adoption, use and maintenance of these new discoveries.
There is a growing body of literature asserting that the nature of implementation processes actually influences desired outcomes (Meyers et al. , 2012; Kelly, 2012). Indeed, researchers have found a powerful link among the behaviors, beliefs and values of practitioners involved in implemented programs and the outcomes of that implementation (Aarons et al. , 2012). Practitioners should not carry sole responsibility for the act of implementing tested interventions; rather, accountability for the quality of program implementation should also extend to developers and researchers (Meyers et al. , 2012). Moreover, the role of intermediaries is emerging as a major requirement to ensure high-quality and sustainable implementation.
Despite...