Content area
Full text
The field of implementation research is growing, but it is not well understood despite the need for better research to inform decisions about health policies, programmes, and practices. This article focuses on the context and factors affecting implementation, the key audiences for the research, implementation outcome variables that describe various aspects of how implementation occurs, and the study of implementation strategies that support the delivery of health services, programmes, and policies. We provide a framework for using the research question as the basis for selecting among the wide range of qualitative, quantitative, and mixed methods that can be applied in implementation research, along with brief descriptions of methods specifically suitable for implementation research. Expanding the use of well designed implementation research should contribute to more effective public health and clinical policies and programmes.
Defining implementation research
Implementation research attempts to solve a wide range of implementation problems; it has its origins in several disciplines and research traditions (supplementary table A). Although progress has been made in conceptualising implementation research over the past decade, 1 considerable confusion persists about its terminology and scope. 2 3 4 The word "implement" comes from the Latin "implere," meaning to fulfil or to carry into effect. 5 This provides a basis for a broad definition of implementation research that can be used across research traditions and has meaning for practitioners, policy makers, and the interested public: "Implementation research is the scientific inquiry into questions concerning implementation-the act of carrying an intention into effect, which in health research can be policies, programmes, or individual practices (collectively called interventions)."
Implementation research can consider any aspect of implementation, including the factors affecting implementation, the processes of implementation, and the results of implementation, including how to introduce potential solutions into a health system or how to promote their large scale use and sustainability. The intent is to understand what, why, and how interventions work in "real world" settings and to test approaches to improve them.
Principles of implementation research
Implementation research seeks to understand and work within real world conditions, rather than trying to control for these conditions or to remove their influence as causal effects. This implies working with populations that will be affected by an intervention, rather than selecting beneficiaries who may...