Expanding the pragmatic lens in implementation science: why stakeholder perspectives matter

Area of Science:

• Implementation Science
• Health Services Research
• Public Health

Background:

• Pragmatism is vital in implementation science for aligning methods with stakeholder needs.
• Current pragmatic measures often use a narrow definition from evidence-based healthcare, potentially excluding public stakeholder concerns.
• Public stakeholders, with expertise from lived experience, may have different views on pragmatism.

Purpose of the Study:

• To explore stakeholder perspectives on pragmatic measures within implementation science theory.
• To understand how public stakeholders define and perceive pragmatism in the context of implementation.

Main Methods:

• Convened a working group of eight stakeholders with lived experience.
• Developed educational materials (video, flyer) to facilitate discussion.
• Conducted three meetings using abductive analysis to explore stakeholder views.

Main Results:

• Stakeholders identified a restricted definition of pragmatism as a concern.
• Concerns were raised about potential measurement biases.
• A need for holistic, pluralistic approaches incorporating diverse perspectives was emphasized.

Conclusions:

• The study highlights the risk of distorting implementation science methods without broad stakeholder input.
• Neglecting diverse pragmatic philosophies can limit stakeholder involvement in designing implementation methods and service transformation.
• Incorporating lived experience can evolve pragmatic measures and metrics in implementation science.