Translational framework for implementation evaluation and research: implementation strategies derived from...

Area of Science:

• Health Services Research
• Implementation Science
• Social Science

Background:

• Existing implementation strategy taxonomies (e.g., ERIC, EPOC) often lack theoretical grounding and empirical testing.
• Few implementation strategies are explicitly derived from theory or rigorously tested against data.
• This study addresses this gap by developing a taxonomy grounded in Normalization Process Theory (NPT).

Purpose of the Study:

• To develop a taxonomy of implementation strategies explicitly derived from Normalization Process Theory (NPT).
• To provide empirically grounded and actionable strategies for health and social care innovation implementation.
• To enhance understanding of how new practices become embedded and sustained in practice.

Main Methods:

• Conducted a qualitative evidence synthesis of studies utilizing NPT in implementation projects.
• Identified implementation mechanisms from included studies using the NPT coding manual.
• Translated identified mechanisms into candidate implementation strategies, tested through iterative qualitative content analysis.

Main Results:

• Included 63 papers after rigorous screening and quality assessment from 9,147 initial references.
• Identified 24 general strategies linked to NPT constructs and 96 micro-strategies across four domains (leadership, information, empowerment, service user involvement).
• Each strategy was explicitly linked to a specific NPT construct.

Conclusions:

• The developed NPT taxonomy offers a theory-based, empirically grounded set of actionable implementation strategies.
• Strategies support practical decision-making across planning, delivery, and sustainment phases of implementation.
• This taxonomy aids in tailoring interventions and understanding the dynamic nature of implementation in diverse health and social care contexts.