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The case for prioritizing implementation strategy fidelity measurement: benefits and challenges

Implementation strategies are systematic approaches to improve the uptake and sustainability of evidence-based interventions. They frequently focus on changing provider behavior through the provision of interventions such as training, coaching, and audit-and-feedback. Implementation strategies often...

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Autores principales: Akiba, Christopher F, Powell, Byron J, Pence, Brian W, Nguyen, Minh X B, Golin, Carol, Go, Vivian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849000/
https://www.ncbi.nlm.nih.gov/pubmed/34791480
http://dx.doi.org/10.1093/tbm/ibab138
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author Akiba, Christopher F
Powell, Byron J
Pence, Brian W
Nguyen, Minh X B
Golin, Carol
Go, Vivian
author_facet Akiba, Christopher F
Powell, Byron J
Pence, Brian W
Nguyen, Minh X B
Golin, Carol
Go, Vivian
author_sort Akiba, Christopher F
collection PubMed
description Implementation strategies are systematic approaches to improve the uptake and sustainability of evidence-based interventions. They frequently focus on changing provider behavior through the provision of interventions such as training, coaching, and audit-and-feedback. Implementation strategies often impact intermediate behavioral outcomes like provider guideline adherence, in turn improving patient outcomes. Fidelity of implementation strategy delivery is defined as the extent to which an implementation strategy is carried out as it was designed. Implementation strategy fidelity measurement is under-developed and under-reported, with the quality of reporting decreasing over time. Benefits of fidelity measurement include the exploration of the extent to which observed effects are moderated by fidelity, and critical information about Type-III research errors, or the likelihood that null findings result from implementation strategy fidelity failure. Reviews of implementation strategy efficacy often report wide variation across studies, commonly calling for increased implementation strategy fidelity measurement to help explain variations. Despite the methodological benefits of rigorous fidelity measurement, implementation researchers face multi-level challenges and complexities. Challenges include the measurement of a complex variable, multiple data collection modalities with varying precision and costs, and the need for fidelity measurement to change in-step with adaptations. In this position paper, we weigh these costs and benefits and ultimately contend that implementation strategy fidelity measurement and reporting should be improved in trials of implementation strategies. We offer pragmatic solutions for researchers to make immediate improvements like the use of mixed methods or innovative data collection and analysis techniques, the inclusion of implementation strategy fidelity assessment in reporting guidelines, and the staged development of fidelity tools across the evolution of an implementation strategy. We also call for additional research into the barriers and facilitators of implementation strategy fidelity measurement to further clarify the best path forward.
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spelling pubmed-88490002022-02-17 The case for prioritizing implementation strategy fidelity measurement: benefits and challenges Akiba, Christopher F Powell, Byron J Pence, Brian W Nguyen, Minh X B Golin, Carol Go, Vivian Transl Behav Med Methods & Measures Implementation strategies are systematic approaches to improve the uptake and sustainability of evidence-based interventions. They frequently focus on changing provider behavior through the provision of interventions such as training, coaching, and audit-and-feedback. Implementation strategies often impact intermediate behavioral outcomes like provider guideline adherence, in turn improving patient outcomes. Fidelity of implementation strategy delivery is defined as the extent to which an implementation strategy is carried out as it was designed. Implementation strategy fidelity measurement is under-developed and under-reported, with the quality of reporting decreasing over time. Benefits of fidelity measurement include the exploration of the extent to which observed effects are moderated by fidelity, and critical information about Type-III research errors, or the likelihood that null findings result from implementation strategy fidelity failure. Reviews of implementation strategy efficacy often report wide variation across studies, commonly calling for increased implementation strategy fidelity measurement to help explain variations. Despite the methodological benefits of rigorous fidelity measurement, implementation researchers face multi-level challenges and complexities. Challenges include the measurement of a complex variable, multiple data collection modalities with varying precision and costs, and the need for fidelity measurement to change in-step with adaptations. In this position paper, we weigh these costs and benefits and ultimately contend that implementation strategy fidelity measurement and reporting should be improved in trials of implementation strategies. We offer pragmatic solutions for researchers to make immediate improvements like the use of mixed methods or innovative data collection and analysis techniques, the inclusion of implementation strategy fidelity assessment in reporting guidelines, and the staged development of fidelity tools across the evolution of an implementation strategy. We also call for additional research into the barriers and facilitators of implementation strategy fidelity measurement to further clarify the best path forward. Oxford University Press 2021-11-15 /pmc/articles/PMC8849000/ /pubmed/34791480 http://dx.doi.org/10.1093/tbm/ibab138 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the Society of Behavioral Medicine. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Methods & Measures
Akiba, Christopher F
Powell, Byron J
Pence, Brian W
Nguyen, Minh X B
Golin, Carol
Go, Vivian
The case for prioritizing implementation strategy fidelity measurement: benefits and challenges
title The case for prioritizing implementation strategy fidelity measurement: benefits and challenges
title_full The case for prioritizing implementation strategy fidelity measurement: benefits and challenges
title_fullStr The case for prioritizing implementation strategy fidelity measurement: benefits and challenges
title_full_unstemmed The case for prioritizing implementation strategy fidelity measurement: benefits and challenges
title_short The case for prioritizing implementation strategy fidelity measurement: benefits and challenges
title_sort case for prioritizing implementation strategy fidelity measurement: benefits and challenges
topic Methods & Measures
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8849000/
https://www.ncbi.nlm.nih.gov/pubmed/34791480
http://dx.doi.org/10.1093/tbm/ibab138
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