The ItFits toolkit: From knowledge to practice IMA Midterm Workshop Odense, 8-9 October 2018 The ItFits toolkit: From knowledge to practice Tracy Finch, Sebastian Potthoff, Tim Rapley, Christiaan Vis, Jordi Piera Northumbria University

Why think about implementation facilitation? Much of the US $100 billion/year worldwide investment in biomedical and health research is wasted because of dissemination and implementation failures “One of the most consistent findings from clinical and health services research is the failure to translate research in practice or policy”1 “All breakthrough, no follow through” Woolf (2006) One size never fits all when it comes to innovating change within local (practice) contexts. This presentation will introduce the ItFits-toolkit as an evidence-based package of tools and guidance from implementation science for tailoring innovation and implementation efforts to local goals, barriers and resources. As a self-guided process, It-Fits aims to make ideas from implementation science accessible for innovators and implementers within the healthcare setting, to enable more efficient focusing of effort on problems of implementation that matter locally.    1Grimshaw et al (2012); Cooksey (2006) ImpleMentAll – G.A. 733025 Midterm Workshop Odense, 10 October 2018

Tailoring implementation strategies “A process whereby implementation strategies1 are adapted to address factors that facilitate or impede current and/or new organisational practices” 1 Powell et al Impl Sci 2015 ImpleMentAll – G.A. 733025 Midterm Workshop Odense, 10 October 2018

Evidence for tailoring Tailored intervention vs. non-tailored interventions1 Meta-regression analysis of trials OR 1.56 (95% confidence interval 1.27 to 1.93, P value < 0.001) Lessons learned from TICD study2 Tailored implementation strategies = small effects on primary/secondary outcomes Need for continuous monitoring/adaptation of strategies Need to involve stakeholders more in design 1 Baker et al. Cochrane Database Syst Rev. 2015; 2 Wensing, Implementation Science, 2017 TICD study ImpleMentAll – G.A. 733025 Midterm Workshop Odense, 10 October 2018

ItFits toolkit: Introduction Digitally accesible toolkit for tailoring local implementation activities to key barriers to iCBT Evidence-based ‘packaging’ of established knowledge, theories, methods and tools to support implementation work in iCBT Self-guided process, but supported by WP2 team through: Embedded explanatory videos in each step ‘Ask a question’ facilitation via toolkit platform Regular teleconf/webinar with WP2 team/sites in intervention phase ImpleMentAll – G.A. 733025 Midterm Workshop Odense, 10 October 2018

Model diagram Module 1 Identify Module 2 Match Module 3 Design Determinants eHealth (Vis et al, 2018) Taxonomy of strategies (Powell et al, 2015) Prioritising with APEASE criteria (Michie et al, 2011) Design with TIDieR checklist (Hoffmann et al, 2014) Normalization (May et al, 2011) Implementation outcomes (Proctor et al, 2011) Module 1 Identify Module 2 Match Module 3 Design Module 4 Apply and review initialise verify & discuss finalise initialise verify & discuss finalise initialise verify & discuss finalise initialise verify & discuss finalise ImpleMentAll – G.A. 733025 Midterm Workshop Odense, 10 October 2018

ImpleMentAll – G.A. 733025 Midterm Workshop Core principles Be pragmatic Focus on realistic, achievable, next steps Be focused Focus on one thing at a time, don’t try to do everything at once Be different Do not only focus on things that you feel most comfortable with or the things you would normally do ImpleMentAll – G.A. 733025 Midterm Workshop Odense, 10 October 2018

ImpleMentAll – G.A. 733025 Midterm Workshop Core principles Be pragmatic Focus on realistic, achievable, next steps Be focused Focus on one thing at a time, don’t try to do everything at once Be different Do not only focus on things that you feel most comfortable with or the things you would normally do Be open Listen to your stakeholders Be organised Each step needs an identified owner to take responsibility for delivery Be flexible The same solution may not work for everyone, so be prepared adapt your plans and ideas ImpleMentAll – G.A. 733025 Midterm Workshop Odense, 10 October 2018

ImpleMentAll – G.A. 733025 Midterm Workshop Summary Translating research into practice = difficult, lenghty & costly Tailored implementation strategies can improve uptake ItFits = digitally accesible toolkit that supports implementers in translating innovations into practice Focuses on ongoing tailoring & active stakeholder engagement ImpleMentAll – G.A. 733025 Midterm Workshop Odense, 10 October 2018

On behalf of ImpleMentAll WPs 1, 2 & 4 ImpleMentAll – G.A. 733025 Midterm Workshop Odense,10 October 2018