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Title: Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework.
Austin Authors: Klaic, Marlena;Kapp, Suzanne;Hudson, Peter;Chapman, Wendy;Denehy, Linda;Story, David A ;Francis, Jill J
Affiliation: Anaesthesia
Department of Allied Health, Peter McCallum Cancer Centre, Melbourne, Australia
Department of Critical Care, The University of Melbourne, Melbourne, Australia
Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada.. Department of Health Services Research, Peter McCallum Cancer Centre, Melbourne, Australia
The Royal Melbourne Hospital, Allied Health Department, Melbourne, Australia
Centre for Digital Transformation of Health, The University of Melbourne, Melbourne, Australia
The University of Melbourne, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, Department of Nursing, Melbourne, Australia
Centre for Palliative Care, St Vincent's Hospital, Melbourne, Australia
End-of-life Care Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
The University of Melbourne, School of Health Sciences, Melbourne, Australia
Issue Date: 27-Jan-2022
Date: 2022
Publication information: Implementation Science 2022; 17(1): 10
Abstract: 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. 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. 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. 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.
DOI: 10.1186/s13012-021-01171-7
ORCID: 0000-0003-2328-0503
Journal: Implementation Science : IS
PubMed URL: 35086538
PubMed URL:
Type: Journal Article
Subjects: Framework
Healthcare interventions
Implementation research
Implementation science
Implementation strategies
Appears in Collections:Journal articles

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