Use of implementation logic models in the Quadruple Aim QUERI: conceptualization and evolution.

Area of Science:

• Implementation Science
• Health Services Research
• Program Evaluation

Background:

• Effective implementation strategies are crucial for translating evidence-based programs into practice.
• Challenges exist in selecting and clearly operationalizing implementation strategies.
• Implementation logic models offer a framework for conceptualizing, evaluating, and communicating strategy use.

Purpose of the Study:

• To describe the application and lessons learned from using implementation logic models in a large multi-study program.
• To illustrate the evolution and adaptation of implementation strategies over time.
• To assess the utility of logic models for clarifying objectives and facilitating communication.

Main Methods:

• Application of implementation logic models within the Quadruple Aim Quality Enhancement Research Initiative (QUERI).
• Utilized two initial implementation strategies: Iterative RE-AIM and Relational Facilitation.
• Documented strategy evolution and adaptation across three health outcomes studies.

Main Results:

• Implementation strategies were dynamic, evolving over time with new additions.
• Logic models visually represented strategy changes and adaptations.
• Found that strategies are often not discrete and require dynamic adaptation based on data and context.

Conclusions:

• Implementation logic models effectively clarify objectives and issues for research teams and partners.
• Challenges arise in logic model construction with multiple or changing strategies.
• Recommended presenting original and updated models, with guidance for future use.