Use of implementation theory: a focus on PARIHS

Area of Science:

• Health Services Research
• Implementation Science
• Theory Application in Research

Background:

• Limited understanding and application of theory in implementation research leads to inconsistent intervention effectiveness.
• Enhanced comprehension of direct experiences with theory can improve implementation research and intervention potency.

Purpose of the Study:

• To characterize experiences with and applications of the Promoting Action on Research Implementation in Health Services (PARIHS) framework.
• To explore the utility and perceived strengths/weaknesses of the PARIHS framework in diverse implementation research settings.

Main Methods:

• A qualitative study design utilizing document reviews and interviews.
• Focused on nine implementation research centers to investigate the 'why' and 'how' of PARIHS utilization.
• Assessed identified strengths and weaknesses of the PARIHS framework.

Main Results:

• PARIHS demonstrated varied application in purpose, level, method, and extent across and within research centers.
• Commonly observed was a lack of early-career investigator use of implementation theory.
• Variability in theory application was linked to center characteristics, investigator attributes, and PARIHS framework features.

Conclusions:

• Provides insights for researchers and theorists on the application of a prominent implementation framework (PARIHS).
• Identifies specific areas for enhancing the PARIHS framework and general theory utilization in research.
• Aims to support the development of theory-driven research programs for improved health services implementation.