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Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research

Implementation research often fails to have its intended impact on what programs actually do. Embedding research within target organizational systems represents an effective response to this problem. However, contradictions associated with the approach often prevent its application. We present case...

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Detalles Bibliográficos
Autores principales: Phillips, James F., MacLeod, Bruce B., Kachur, S. Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Global Health: Science and Practice 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087429/
https://www.ncbi.nlm.nih.gov/pubmed/33795362
http://dx.doi.org/10.9745/GHSP-D-20-00169
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author Phillips, James F.
MacLeod, Bruce B.
Kachur, S. Patrick
author_facet Phillips, James F.
MacLeod, Bruce B.
Kachur, S. Patrick
author_sort Phillips, James F.
collection PubMed
description Implementation research often fails to have its intended impact on what programs actually do. Embedding research within target organizational systems represents an effective response to this problem. However, contradictions associated with the approach often prevent its application. We present case studies of the application of embedded implementation research in Bangladesh, Ghana, and Tanzania where initiatives to strengthen community-based health systems were conducted using the embedded science model. In 2 of the cases, implementation research standards that are typically embraced without question were abandoned to ensure pursuit of embedded science. In the third example, statistical rigor was sustained, but this feature of the design was inconsistent with embedded science. In general, rigorous statistical designs employ units of observation that are inconsistent with organizational units that managers can control. Structural contradictions impede host institution ownership of research processes and utilization of results. Moreover, principles of scientific protocol leadership are inconsistent with managerial leadership. These and other embedded implementation science attributes are reviewed together with contradictions that challenged their pursuit in each case. Based on strategies that were effectively applied to offsetting challenges, a process of merging research with management is proposed that is derived from computer science. Known as “agile science,” this paradigm combines scientific rigor with management decision making. This agile embedded research approach is designed to sustain scientific rigor while optimizing the integration of learning into managerial decision making.
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spelling pubmed-80874292021-05-04 Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research Phillips, James F. MacLeod, Bruce B. Kachur, S. Patrick Glob Health Sci Pract Original Articles Implementation research often fails to have its intended impact on what programs actually do. Embedding research within target organizational systems represents an effective response to this problem. However, contradictions associated with the approach often prevent its application. We present case studies of the application of embedded implementation research in Bangladesh, Ghana, and Tanzania where initiatives to strengthen community-based health systems were conducted using the embedded science model. In 2 of the cases, implementation research standards that are typically embraced without question were abandoned to ensure pursuit of embedded science. In the third example, statistical rigor was sustained, but this feature of the design was inconsistent with embedded science. In general, rigorous statistical designs employ units of observation that are inconsistent with organizational units that managers can control. Structural contradictions impede host institution ownership of research processes and utilization of results. Moreover, principles of scientific protocol leadership are inconsistent with managerial leadership. These and other embedded implementation science attributes are reviewed together with contradictions that challenged their pursuit in each case. Based on strategies that were effectively applied to offsetting challenges, a process of merging research with management is proposed that is derived from computer science. Known as “agile science,” this paradigm combines scientific rigor with management decision making. This agile embedded research approach is designed to sustain scientific rigor while optimizing the integration of learning into managerial decision making. Global Health: Science and Practice 2021-03-31 /pmc/articles/PMC8087429/ /pubmed/33795362 http://dx.doi.org/10.9745/GHSP-D-20-00169 Text en © Phillips et al. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-20-00169
spellingShingle Original Articles
Phillips, James F.
MacLeod, Bruce B.
Kachur, S. Patrick
Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research
title Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research
title_full Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research
title_fullStr Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research
title_full_unstemmed Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research
title_short Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research
title_sort bugs in the bed: addressing the contradictions of embedded science with agile implementation research
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087429/
https://www.ncbi.nlm.nih.gov/pubmed/33795362
http://dx.doi.org/10.9745/GHSP-D-20-00169
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