Making sense of implementation theories, models and frameworks.

Area of Science:

• Implementation Science
• Health Services Research
• Theory Development

Background:

• Implementation science increasingly utilizes theoretical approaches for understanding implementation processes.
• Existing literature lacks a clear taxonomy for the diverse theories, models, and frameworks used.
• This study aims to categorize these theoretical approaches to enhance their application and foster dialogue.

Purpose of the Study:

• To propose a novel taxonomy distinguishing categories of theories, models, and frameworks in implementation science.
• To facilitate the appropriate selection and application of theoretical approaches in implementation research and practice.
• To promote cross-disciplinary communication among implementation researchers.

Main Methods:

• Literature review and synthesis of existing theoretical approaches in implementation science.
• Development of a proposed taxonomy categorizing theories, models, and frameworks.
• Analysis of the aims, characteristics, and limitations of different theoretical categories.

Main Results:

• Theoretical approaches serve three aims: guiding research translation (process models), explaining influences on outcomes (determinant frameworks, theories), and evaluating implementation (evaluation frameworks).
• A proposed taxonomy categorizes these approaches into five distinct groups, though not always recognized as separate in current literature.
• Determinant frameworks often lack specific "how-to" guidance, while process models may not systematically identify determinants.

Conclusions:

• Awareness of the differences between theoretical approaches is crucial for effective selection and application in implementation science.
• Process models offer temporal guidance but may lack detailed determinant identification, whereas determinant frameworks identify influences but often lack process orientation.
• The proposed taxonomy aids in clarifying the roles and limitations of different theoretical approaches, supporting better implementation research and practice.