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A Pragmatic Approach to Guide Implementation Evaluation Research: Strategy Mapping for Complex Interventions.

Alexis K Huynh1, Alison B Hamilton1,2, Melissa M Farmer1

  • 1VA Greater Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, CA, United States.

Frontiers in Public Health
|June 6, 2018
PubMed
Summary
This summary is machine-generated.

This study introduces a strategy mapping method to detail the timing and content of multiple implementation strategies in complex health interventions. This approach aids in rigorous evaluation and planning for complex intervention implementation.

Keywords:
complex interventionsevaluationimplementation blueprintimplementation strategiesstrategy mapping

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Area of Science:

  • Implementation Science
  • Health Services Research
  • Program Evaluation

Background:

  • Implementation science faces challenges in specifying multiple strategies for complex interventions.
  • The Cardiovascular (CV) Toolkit project aims to reduce CV risk by enhancing women's service engagement.
  • This project utilizes an enhanced Replicating Effective Programs (REP) strategy across four phases.

Purpose of the Study:

  • To describe a novel method for mapping implementation strategies in real-time.
  • To support the detailed description of timing and content of bundled strategies.
  • To provide a structured process for developing implementation evaluation plans.

Main Methods:

  • Strategy mapping was applied using Proctor's rubric for strategy specification.
  • A matrix detailed strategies, conceptual groups, REP phases, actors, actions, targets, dose, and outcomes.
  • The matrix was iteratively refined with the implementation team, including simulation for validation.

Main Results:

  • Mapping revealed distinct patterns in strategy timing across REP phases.
  • Stakeholder engagement and training strategies were prominent in early phases (pre-conditions, pre-implementation).
  • Maintenance and evolution phases focused on communication, re-examination, and audit/feedback strategies.

Conclusions:

  • The study proposes an approach for mapping implementation strategies in complex, multi-level interventions.
  • This method supports rigorous evaluation and planning for implementation activities.
  • Developing pragmatic tools is crucial for advancing implementation research and practice.