Abstract:
BACKGROUND:There is a need to unpack the empirical, practical, and personal challenges within participatory approaches advocated to optimize implementation. The unpredictable, chaotic nature of participatory approaches complicates application of implementation theories, methods, and strategies which do not address researchers' situatedness within participatory processes. As an implementation scientist, addressing one's own situatedness through critical reflection is important to unearth how conscious and unconscious approaches, including ontological and epistemological underpinnings, influence the participatory context, process, and outcomes. Therefore, the aim of this exploratory work is to investigate the heretofore blind spot toward the lived experience of implementation researchers within the participatory process. METHODS:We developed an integrated research-practice partnership (IRPP) to inform the implementation of a gestational weight gain (GWG) control program. Within this IRPP, one investigator conducted a 12-month autoethnography. Data collection and triangulation included field notes, cultural artifacts, and systematic timeline tracking. Data analysis included ethnographic-theoretical dialogue and restorying to synthesize key events and epiphanies into a narrative. RESULTS:Analysis revealed the unpredicted evolution of the GWG program into a maternal health fair and three themes within the researchers' lived experience: (1) permeable work boundaries, (2) individual and collective blind spots toward the ontological and epistemological underpinnings of implementation paradigms, and (3) maladaptive behaviors seemingly reinforced by the research culture. These themes contributed to the chaos of implementation and to researchers' experience of inadequate recovery from cognitive, emotional, and practical demands. These themes also demonstrated the importance of contextual factors, subjectivity, and value-based judgments within implementation research. CONCLUSION:Building on extant qualitative research guidelines, we suggest that researchers anchor their approach to implementation in reflexivity, intentionally and iteratively reflecting on their own situatedness. Through this autoethnography, we have elucidated several strategies based on critical reflection including examining philosophical underpinnings of research, adopting restorative practices that align with one's values, and embracing personal presence as a foundation of scientific productivity. Within the predominant (post-) positivism paradigms, autoethnography may be criticized as unscientifically subjective or self-indulgent. However, this work demonstrates that autoethnography is a vehicle for third-person observation and first-person critical reflection that is transformative in understanding and optimizing implementation contexts, processes, and outcomes.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Steketee AM,Archibald TG,Harden SMdoi
10.1186/s13012-020-01002-1subject
Has Abstractpub_date
2020-09-03 00:00:00pages
70issue
1issn
1748-5908pii
10.1186/s13012-020-01002-1journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Though the knowledge base on implementation strategies is growing, much remains unknown about how to most effectively operationalize these strategies in diverse contexts. For example, while evidence shows that champions can effectively support implementation efforts in some circumstances, little has been rep...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01048-1
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:General dental practitioners (GDPs) regularly prescribe antibiotics to manage dental infections although most infections can be treated successfully by local measures. Published guidance to support GDPs to make appropriate prescribing decisions exists but there continues to be wide variation in dental antibi...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0372-z
更新日期:2016-01-29 00:00:00
abstract:BACKGROUND:Significant gaps related to measurement issues are among the most critical barriers to advancing implementation science. Three issues motivated the study aims: (a) the lack of stakeholder involvement in defining pragmatic measure qualities; (b) the dearth of measures, particularly for implementation outcomes...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0287-0
更新日期:2015-07-22 00:00:00
abstract:BACKGROUND:The World Health Organization recommends that nations implement evidence-based nutritional guidelines and policies in settings such as schools and childcare services to improve public health nutrition. Understanding the causal mechanism by which implementation strategies exert their effects could enhance gui...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0734-9
更新日期:2018-03-12 00:00:00
abstract:BACKGROUND:Organizational factors are considered to be an important influence on health workers' uptake of interventions that improve their practices. These are additionally influenced by factors operating at individual and broader health system levels. We sought to explore contextual influences on worker motivation, a...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-43
更新日期:2009-07-23 00:00:00
abstract:BACKGROUND:Evidence-based guidelines for the management of mild traumatic brain injury (mTBI) in the emergency department (ED) are now widely available, and yet, clinical practice remains inconsistent with the guidelines. The Neurotrauma Evidence Translation (NET) intervention was developed to increase the uptake of gu...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-018-0834-6
更新日期:2018-12-05 00:00:00
abstract:BACKGROUND:Community health worker (CHW)-delivered support visits to children living with HIV and their caregivers significantly reduced odds of virological failure among the children in the ZENITH trial conducted in Zimbabwe. We conducted a process evaluation to assess fidelity, acceptability, and feasibility of this ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0762-5
更新日期:2018-05-23 00:00:00
abstract:BACKGROUND:In the 21st century, government and industry are supplementing hierarchical, bureaucratic forms of organization with network forms, compatible with principles of devolved governance and decentralization of services. Clinical networks are employed as a key health policy approach to engage clinicians in improv...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-108
更新日期:2012-11-02 00:00:00
abstract:BACKGROUND:Every safety-critical industry devotes considerable time and resource to investigating and analysing accidents, incidents and near misses. The systematic analysis of incidents has greatly expanded our understanding of both the causes and prevention of harm. These methods have been widely employed in healthca...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0695-4
更新日期:2017-12-28 00:00:00
abstract:BACKGROUND:The impact of efforts by healthcare organizations to enhance the use of evidence to improve organizational processes through training programs has seldom been assessed. We therefore endeavored to assess whether and how the training of mid- and senior-level healthcare managers could lead to organizational cha...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-9-53
更新日期:2014-05-02 00:00:00
abstract:BACKGROUND:Denmark has inferior cancer survival rates compared with many European countries. The main reason for this is suggested to be late diagnosis at advanced cancer stages. Cancer diagnostic work-up begins in general practice in 85% of all cancer cases. Thus, general practitioners (GPs) play a key role in the dia...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-014-0159-z
更新日期:2014-11-07 00:00:00
abstract:BACKGROUND:A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful t...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-117
更新日期:2012-12-03 00:00:00
abstract:BACKGROUND:Teaching the content of clinical practice guidelines (CPGs) is important to both clinical care and graduate medical education. The objective of this study was to determine the characteristics of curricula for teaching the content of CPGs in family medicine and internal medicine residency programs in the Unit...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-59
更新日期:2009-09-21 00:00:00
abstract:BACKGROUND:With the current funding climate and need for advancements in implementation science, there is a growing demand for grantsmanship workshops to increase the quality and rigor of proposals. A group-based implementation science-focused grantsmanship workshop, the Implementation Development Workshop (IDW), is on...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0429-z
更新日期:2016-05-06 00:00:00
abstract:BACKGROUND:One of the fastest growing risk groups for early onset of diabetes is women with a recent pregnancy complicated by gestational diabetes, and for this group, Latinas are the largest at-risk group in the USA. Although evidence-based interventions, such as the Diabetes Prevention Program (DPP), which focuses on...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0426-2
更新日期:2016-05-18 00:00:00
abstract:BACKGROUND:The WISE (Whole System Informing Self-management Engagement) approach encompasses creating, finding, and implementing appropriate self-care support for people with long-term conditions. A training package for primary care to introduce the approach was developed and underwent formative evaluation. This entail...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-7
更新日期:2010-01-29 00:00:00
abstract:BACKGROUND:Improved quality of care is a policy objective of health care systems around the world. Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice, and hence to reduce inappropriate care. It includes the study of in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-52
更新日期:2008-12-17 00:00:00
abstract:BACKGROUND:Electronic guideline-based decision support systems have been suggested to successfully deliver the knowledge embedded in clinical practice guidelines. A number of studies have already shown positive findings for decision support systems such as drug-dosing systems and computer-generated reminder systems for...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-82
更新日期:2009-12-30 00:00:00
abstract:BACKGROUND:A recent review of frameworks used in dissemination and implementation (D&I) science described 61 judged to be related either to dissemination, implementation, or both. The current use of these frameworks and their contributions to D&I science more broadly has yet to be reviewed. For these reasons, our objec...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0628-2
更新日期:2017-07-28 00:00:00
abstract:BACKGROUND:The translation of research into policy and practice is enhanced by policymakers who can recognise and articulate their information needs and researchers that understand the policymakers' environment. As researchers, we sought to understand the policymaking process and how research evidence may contribute in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0315-0
更新日期:2015-09-03 00:00:00
abstract:BACKGROUND:Implementation of multifaceted interventions typically involves many diverse elements working together in interrelated ways, including intervention components, implementation strategies, and features of local context. Given this real-world complexity, implementation researchers may be interested in a new mat...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01070-3
更新日期:2020-12-11 00:00:00
abstract:BACKGROUND:Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review ...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/1748-5908-8-20
更新日期:2013-02-14 00:00:00
abstract:BACKGROUND:Numerous agencies are providing training, technical assistance, and other support to build community-based practitioners' capacity to adopt and implement evidence-based prevention interventions. Yet, little is known about how best to design capacity-building interventions to optimize their effectiveness. Wan...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-015-0272-7
更新日期:2015-05-29 00:00:00
abstract:BACKGROUND:Use of direct oral anticoagulants (DOAC) is rapidly growing for treatment of atrial fibrillation and venous thromboembolism. However, incorrect dosing of these medications is common and puts patients at risk of adverse drug events. One way to improve safe prescribing is the use of population health tools, in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01044-5
更新日期:2020-09-21 00:00:00
abstract:BACKGROUND:In Belgium, the construction of the national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, healthcare providers, Evidence-Based Medicine (EBM) partners, and vend...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-8-83
更新日期:2013-08-05 00:00:00
abstract::Economic evaluations can inform decisions about the efficiency and allocation of resources to implementation strategies-strategies explicitly designed to inform care providers and patients about the best available research evidence and to enhance its use in their practices. These strategies are increasingly popular in...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/s13012-014-0168-y
更新日期:2014-12-18 00:00:00
abstract:BACKGROUND:The rate of avoidable caesarean sections (CS) could be reduced through multifaceted strategies focusing on the involvement of health professionals and compliance with clinical practice guidelines (CPGs). Quality improvements for CS (QICS) programmes (QICS) based on this approach, have been implemented in Can...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
doi:10.1186/s13012-014-0182-0
更新日期:2014-12-11 00:00:00
abstract:BACKGROUND:There is growing interest in the use of cognitive, behavioural, and organisational theories in implementation research. However, the extent of use of theory in implementation research is uncertain. METHODS:We conducted a systematic review of use of theory in 235 rigorous evaluations of guideline disseminati...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-14
更新日期:2010-02-09 00:00:00
abstract:BACKGROUND:Implementation of clinical research results is challenging, yet the responsibility for implementation is seldom addressed. The process from research to the use of clinical research results in health care can be facilitated by research funders. In this paper, we report the roles of ten Swedish research funder...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0290-5
更新日期:2015-07-17 00:00:00
abstract:BACKGROUND:Like in many settings, implementation of evidence-based practices often fall short in pediatric intensive care units (PICU). Very few prior studies have applied implementation science frameworks to understand how best to improve practices in this unique environment. We used the relatively new integrated Prom...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-021-01080-9
更新日期:2021-01-28 00:00:00