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What implementation strategies are relational? Using Relational Theory to explore the ERIC implementation strategies.

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Summary

Implementation science benefits from understanding relational exchanges in strategies. Relational Theory analysis of Expert Recommendations for Implementation Change (ERIC) strategies reveals more relational than transactional approaches, highlighting opportunities for enhanced collaboration and power sharing.

Keywords:
Relational Theoryimplementation practiceimplementation strategiesrelational strategiestransactional strategies

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Area of Science:

  • Implementation Science
  • Health Services Research
  • Organizational Behavior

Background:

  • Implementation research has advanced understanding of implementation processes and causal pathways.
  • Current understanding needs to better integrate relational exchanges and interactions within strategies.
  • Critical perspectives and theories like Relational Theory are underutilized in implementation science.

Purpose of the Study:

  • To apply Relational Theory to analyze the relational components within the Expert Recommendations for Implementation Change (ERIC) implementation strategies.
  • To examine how implementation strategies operationalize different types of interactions, exchanges, and alliances.

Main Methods:

  • Qualitative directed content analysis of 73 ERIC implementation strategies.
  • Application of the Relational and Transactional Strategy Continuum measure by three independent reviewers.
  • Categorization of strategies based on relational, transactional, and operational alliance features.

Main Results:

  • A majority of strategies exhibited relational alliance features (36 strategies: 17 highly relational, 19 semi-relational).
  • Fewer strategies were categorized as transactional (19 strategies: 9 highly transactional, 10 semi-transactional).
  • 18 strategies were coded as operational alliances, indicating a mix of relational and transactional elements.

Conclusions:

  • Implementation strategies offer opportunities to further develop relational exchanges, considering actor roles and power dynamics.
  • The Relational and Transactional Strategy Continuum measure can guide practitioners and researchers in selecting and combining strategies.
  • This framework supports the development of strategies that foster positive alliances, communication, and power sharing for improved implementation outcomes.