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Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework

BACKGROUND: Implementation research may play an important role in reducing research waste by identifying strategies that support translation of evidence into practice. Implementation of healthcare interventions is influenced by multiple factors including the organisational context, implementation st...

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Autores principales: Klaic, Marlena, Kapp, Suzanne, Hudson, Peter, Chapman, Wendy, Denehy, Linda, Story, David, Francis, Jill J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793098/
https://www.ncbi.nlm.nih.gov/pubmed/35086538
http://dx.doi.org/10.1186/s13012-021-01171-7
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author Klaic, Marlena
Kapp, Suzanne
Hudson, Peter
Chapman, Wendy
Denehy, Linda
Story, David
Francis, Jill J.
author_facet Klaic, Marlena
Kapp, Suzanne
Hudson, Peter
Chapman, Wendy
Denehy, Linda
Story, David
Francis, Jill J.
author_sort Klaic, Marlena
collection PubMed
description BACKGROUND: Implementation research may play an important role in reducing research waste by identifying strategies that support translation of evidence into practice. Implementation of healthcare interventions is influenced by multiple factors including the organisational context, implementation strategies and features of the intervention as perceived by people delivering and receiving the intervention. Recently, concepts relating to perceived features of interventions have been gaining traction in published literature, namely, acceptability, fidelity, feasibility, scalability and sustainability. These concepts may influence uptake of healthcare interventions, yet there seems to be little consensus about their nature and impact. The aim of this paper is to develop a testable conceptual framework of implementability of healthcare interventions that includes these five concepts. METHODS: A multifaceted approach was used to develop and refine a conceptual framework of implementability of healthcare interventions. An overview of reviews identified reviews published between January 2000 and March 2021 that focused on at least one of the five concepts in relation to a healthcare intervention. These findings informed the development of a preliminary framework of implementability of healthcare interventions which was presented to a panel of experts. A nominal group process was used to critique, refine and agree on a final framework. RESULTS: A total of 252 publications were included in the overview of reviews. Of these, 32% were found to be feasible, 4% reported sustainable changes in practice and 9% were scaled up to other populations and/or settings. The expert panel proposed that scalability and sustainability of a healthcare intervention are dependent on its acceptability, fidelity and feasibility. Furthermore, acceptability, fidelity and feasibility require re-evaluation over time and as the intervention is developed and then implemented in different settings or with different populations. The final agreed framework of implementability provides the basis for a chronological, iterative approach to planning for wide-scale, long-term implementation of healthcare interventions. CONCLUSIONS: We recommend that researchers consider the factors acceptability, fidelity and feasibility (proposed to influence sustainability and scalability) during the preliminary phases of intervention development, evaluation and implementation, and iteratively check these factors in different settings and over time. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13012-021-01171-7.
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spelling pubmed-87930982022-01-27 Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework Klaic, Marlena Kapp, Suzanne Hudson, Peter Chapman, Wendy Denehy, Linda Story, David Francis, Jill J. Implement Sci Systematic Review BACKGROUND: Implementation research may play an important role in reducing research waste by identifying strategies that support translation of evidence into practice. Implementation of healthcare interventions is influenced by multiple factors including the organisational context, implementation strategies and features of the intervention as perceived by people delivering and receiving the intervention. Recently, concepts relating to perceived features of interventions have been gaining traction in published literature, namely, acceptability, fidelity, feasibility, scalability and sustainability. These concepts may influence uptake of healthcare interventions, yet there seems to be little consensus about their nature and impact. The aim of this paper is to develop a testable conceptual framework of implementability of healthcare interventions that includes these five concepts. METHODS: A multifaceted approach was used to develop and refine a conceptual framework of implementability of healthcare interventions. An overview of reviews identified reviews published between January 2000 and March 2021 that focused on at least one of the five concepts in relation to a healthcare intervention. These findings informed the development of a preliminary framework of implementability of healthcare interventions which was presented to a panel of experts. A nominal group process was used to critique, refine and agree on a final framework. RESULTS: A total of 252 publications were included in the overview of reviews. Of these, 32% were found to be feasible, 4% reported sustainable changes in practice and 9% were scaled up to other populations and/or settings. The expert panel proposed that scalability and sustainability of a healthcare intervention are dependent on its acceptability, fidelity and feasibility. Furthermore, acceptability, fidelity and feasibility require re-evaluation over time and as the intervention is developed and then implemented in different settings or with different populations. The final agreed framework of implementability provides the basis for a chronological, iterative approach to planning for wide-scale, long-term implementation of healthcare interventions. CONCLUSIONS: We recommend that researchers consider the factors acceptability, fidelity and feasibility (proposed to influence sustainability and scalability) during the preliminary phases of intervention development, evaluation and implementation, and iteratively check these factors in different settings and over time. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13012-021-01171-7. BioMed Central 2022-01-27 /pmc/articles/PMC8793098/ /pubmed/35086538 http://dx.doi.org/10.1186/s13012-021-01171-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Systematic Review
Klaic, Marlena
Kapp, Suzanne
Hudson, Peter
Chapman, Wendy
Denehy, Linda
Story, David
Francis, Jill J.
Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework
title Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework
title_full Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework
title_fullStr Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework
title_full_unstemmed Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework
title_short Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework
title_sort implementability of healthcare interventions: an overview of reviews and development of a conceptual framework
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793098/
https://www.ncbi.nlm.nih.gov/pubmed/35086538
http://dx.doi.org/10.1186/s13012-021-01171-7
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