1. 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

2. 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 Midterm Workshop
Odense, 10 October 2018

3. 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 Midterm Workshop
Odense, 10 October 2018

4. 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 Midterm Workshop
Odense, 10 October 2018

5. 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 Midterm Workshop
Odense, 10 October 2018

8. 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 Midterm Workshop
Odense, 10 October 2018

9. 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 Midterm Workshop
Odense, 10 October 2018

10. 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 Midterm Workshop
Odense, 10 October 2018

11. 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 Midterm Workshop
Odense, 10 October 2018

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