@smharden Specifying implementation strategies to enhance reviewer comprehension of your work 2019 Dissemination & Implementation Science Grant Development Workshop: Understanding, specifying, and applying implementation strategies Samantha M. Harden, PhD, Human Nutrition, Foods, and Exercise, Virginia Tech Omaha, NE August 2019

“The general practitioner in the surgery, the nurse manager on the ward, and the policy maker in the boardroom would be forgiven for losing track of all the new technologies, care pathways, and service models that could potentially improve the quality, safety, or efficiency of care. Yet we know that innovations rarely achieve widespread uptake even when there is robust evidence of their benefits (and especially when such evidence is absent or contested).1” Greenhalgh BMJ 2019;365:l2068 doi: 10.1136/bmj.l2068 (Published 10 May 2019)

APPLY CONCEPTS FOR YOUR WORK PURPOSE OF THE APPLIED TALK Domain Actor Action Target of action Temporality Dose Implementation outcomes affected Justification RESOURCE SHARING RELAY EXAMPLE APPLY CONCEPTS FOR YOUR WORK

Step 1: Step 2: Text: 37607 Step 3: SAMANTHAHARD925 Type out your answer and send it

How do you define implementation strategy? Text: 37607 How do you define implementation strategy?

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What citation do you use for this definition? Text: 37607 What citation do you use for this definition? Text: 37607

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IMPLEMENTATION STRATEGIES Assess for readiness and identify barriers and facilitators Build a coalition Capture and share local knowledge Conduct local needs assessment Create a learning collaborative Develop academic partnerships Inform local opinion leaders Identify and prepare champions Use advisory boards and workgroups Use train-the-trainer strategies Tailor strategies

Wiltsey-Stirman et al., 2013

Sources of Intervention Adaptation Chambers & Norton, 2016 31

Then a miracle occurs Good work, but I think we might need just a little more detail right here.

Specifically…. The intervention/practice/innovation is THE THING Effectiveness research looks at whether THE THING works D&I research looks at how best to help people/places DO THE THING Implementation strategies are the stuff we do to try to help people/places DO THE THING Main implementation outcomes are HOW WELL they DO THE THING KCI Masterclass. Curran et al

Example Lifelong Improvements through Fitness Together is an 8-week community- based physical activity and healthful eating intervention for older adults Effectiveness research looks at whether THE THING works, which is primarily measured 1) attendance and 2) pre, post and 6 month functional fitness assessments D&I research looks at how best to help people/places DO THE THING Implementation strategies are the stuff we do to try to help people/places DO THE THING Dynamic training Zoom “office hours” with program manager (ongoing support) Learning collaborative, early adopters, identify and prepare champions Main implementation outcomes are HOW WELL they DO THE THING Weekly process evaluations (self report fidelity check) Adoption rates In vivo fidelity checks ($$)

Your work The intervention/practice/innovation is THE THING Effectiveness research looks at whether THE THING works D&I research looks at how best to help people/places DO THE THING Implementation strategies are the stuff we do to try to help people/places DO THE THING Main implementation outcomes are HOW WELL they DO THE THING KCI Masterclass. Curran et al

Implementation research: Evidence & Scientific Premise Evidence (for intervention) RCTs linking intervention to outcome Practice guidelines Pilot studies Models and theories Evidence (for implementation strategy) Impact for other interventions Theoretical framework From Ed Ellerbeck 2018 Keynote

Implementation strategies: recommendations for specifying and reporting Domain Clinical Intervention Implementation Strategy Actor Action Target of action Temporality Dose Implementation outcomes affected Justification http://www.implementationscience.com/content/8/1/139

Text: 37607 What was challenging for you in specifying your implementation strategy?

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Text: 37607 How likely are you to use a table like this within the grant to describe your implementation strategy?

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