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Updated: Aug 8, 2025

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Exploring the intersection of hermeneutics and implementation: a scoping review.

Martha L P MacLeod1,2, Graham McCaffrey3, Erin Wilson4

  • 1School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada. martha.macleod@unbc.ca.

Systematic Reviews
|March 2, 2023
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Summary

A hermeneutic approach enhances health program implementation by addressing human dimensions and fostering new understandings. This review highlights how combining hermeneutics with implementation science can improve effectiveness and sustainability.

Keywords:
HealthHermeneuticsImplementationImplementingScoping review

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Area of Science:

  • Implementation Science
  • Hermeneutics
  • Health Services Research

Background:

  • Effective implementation of health programs, services, and practices remains a challenge, often falling short of intended outcomes.
  • Existing implementation frameworks may not fully capture the complexities of real-world application.
  • A novel approach integrating implementation science with hermeneutics is explored to address these gaps.

Purpose of the Study:

  • To conduct a scoping review summarizing existing knowledge on the application of hermeneutic approaches in health program implementation.
  • To identify how hermeneutics can inform and improve the process of implementing health initiatives.

Main Methods:

  • A Gadamerian hermeneutic approach was applied to the JBI scoping review methodology.
  • Searches were conducted across eight health databases using terms like "implementation" and "hermeneutics."
  • A diverse research team screened studies, identified characteristics, and analyzed hermeneutic and implementation components.

Main Results:

  • Six articles were retained, exploring the intersection of hermeneutics and implementation across various health contexts.
  • Studies consistently addressed underlying assumptions, human dimensions, power dynamics, and knowledge creation during implementation.
  • The hermeneutic process, specifically the "fusion of horizons," was shown to generate essential new understandings for effective action.

Conclusions:

  • The combination of hermeneutics and implementation science is rare but offers significant potential for improving implementation success.
  • Hermeneutic approaches can foster the relational and contextual foundations crucial for effective and sustainable implementation.
  • Understanding and articulating these hermeneutic strategies can benefit implementers and implementation researchers.