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Related Experiment Video

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The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

Published on: February 19, 2021

Between and within-site variation in qualitative implementation research.

Justin K Benzer¹, Sarah Beehler, Irene E Cramer

¹Department of Veterans Affairs, Center for Organization, Leadership, and Management Research, Boston, MA, USA. justin.benzer@va.gov

Implementation Science : IS

|January 5, 2013

Summary

Analyzing variations in perceptions across multiple sites is crucial for understanding intervention implementation. Broad sampling helps identify both within-site and between-site themes, revealing key facilitators and barriers.

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Area of Science:

Qualitative research methodology
Healthcare services research
Organizational behavior

Background:

Multisite qualitative studies present challenges in data collection and analysis due to within- and between-site variations.
Lack of consensus exists on accounting for diverse perceptions of organizational context in interventions.
Understanding these variations is critical for effective implementation strategies.

Purpose of the Study:

To analyze key informant perceptions across multiple sites to demonstrate the value of broad sampling.
To identify within-site and between-site implementation themes for interventions.
To inform the design of multisite implementation studies.

Main Methods:

Comparative case studies of four Department of Veterans Affairs (VA) medical centers implementing Primary Care/Mental Health Integration (PC/MHI).
Qualitative analysis of between-profession variation in referral and implementation processes.
Focus on within-site and between-site differences in perceptions.

Main Results:

Key informants identified co-location, consultation-liaison services, space, access, and referral processes as critical.
Within-site themes highlighted the importance of coordination, communication, and collaboration for PC/MHI.
Between-site themes revealed that existing mental healthcare structures influenced implementation, and inter-professional collaboration was vital for overcoming barriers.

Conclusions:

Variation in perceptions across sites and professions identified implementation barriers and facilitators not evident from a single perspective.
Analysis of variation provides insights into barriers for PC/MHI implementation.
Multisite studies should intentionally elicit and analyze within- and between-site variations for robust findings.