Policy in implementation science: Considerations for measurement-based care in the Canadian Armed Forces

Policy, an intricate and often-overlooked aspect of implementation science (IS), can be leveraged to facilitate the mobilization and uptake of evidence-based practices. However, there are varying conceptualizations of policy in research and practice, and multiple approaches to the policy-making process. This article brings together a selection of literature and current guidance on policy using an IS lens, focusing specifically on the use of policy as an implementation strategy or lever to increase the uptake of interventions and evidence-based practices. The article uses the Canadian Armed Forces' (CAF's) implementation of measurement-based care (MBC) as a case example to discuss IS implications regarding policy. The CAF adopted an MBC system in 2014, coinciding with the consistent evolution of its mental health system. Although MBC is mandatory within the parameters outlined in the current directive (policy), adherence has consistently fallen below target level. The authors provide a brief overview of early implementation milestones for MBC in the CAF and describe the guiding policy in its current form. The authors draw from the IS literature on policy development and implementation, including elements of contextual adaptation and stakeholder consultation, to frame a series of considerations for refining the policy approach to MBC in the CAF.