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Alignment in implementation of evidence-based interventions: a scoping review.

Robert Lundmark1, Henna Hasson2,3, Anne Richter2,3

  • 1Department of Psychology, Umeå University, SE 901 87, Umeå, Sweden. robert.lundmark@umu.se.

Implementation Science : IS
|October 29, 2021
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Summary

Alignment is crucial for implementing evidence-based interventions (EBIs) in healthcare. This review synthesizes how alignment concepts are used in EBI implementation research, identifying strategies and outcomes to guide future efforts.

Keywords:
AlignmentEBIHealthcareImplementation

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Area of Science:

  • Healthcare Management
  • Implementation Science
  • Health Services Research

Background:

  • Alignment, fitting organizational elements with context, is vital for evidence-based intervention (EBI) implementation outcomes.
  • Systematic summarization of research on alignment in EBI implementation is lacking.
  • This scoping review addresses the gap by exploring alignment's application in EBI implementation literature.

Purpose of the Study:

  • To overview how the concept of alignment has been applied in the evidence-based intervention (EBI) implementation literature.
  • To provide a foundation for future implementation efforts in healthcare settings.
  • To identify different conceptualizations, outcomes, and strategies related to alignment in EBI implementation.

Main Methods:

  • Searched four databases (MEDLINE, Cinahl, Embase, Web of Science) for peer-reviewed English articles (2003-2019).
  • Analyzed extracted data using qualitative content analysis for relevant studies.
  • Reported findings according to PRISMA-ScR guidelines for scoping reviews.

Main Results:

  • Reviewed 53 studies from 3629 initial publications, identifying diverse structural and social conceptualizations of alignment.
  • Found alignment is generally considered important for understanding implementation, but few studies assessed it directly.
  • Identified outcomes focused on EBI implementation, sustainment, or healthcare procedures, with key actors and five alignment strategies.

Conclusions:

  • Alignment is recognized as important for evidence-based intervention (EBI) implementation success, though not always the primary research focus.
  • Future research should integrate alignment more explicitly and test its effectiveness on implementation outcomes.
  • This review provides a starting point for incorporating alignment into healthcare implementation strategies.