What is Implementation Science?

Implementation Science is the scientific study of methods and strategies that facilitate the adoption of evidence-based practices and research findings into routine health care and public health settings with the goal of improving the quality and effectiveness of health services and pediatric care.

The field of implementation science seeks to systematically close the gap between what we know and what we do and answer the question, “How can we overcome the research-to-practice gap to integrate the “thing” into practice.” This is done by identifying and addressing the barriers that hinder and/or facilitators that support the uptake of proven health interventions and evidence-based practices. This relatively new field includes the study of influences on healthcare professionals and organizational behavior.

Implementation science is a scientific discipline focused on understanding the best ways to implement evidence-based practices and de-implement non-evidence-based practices in real world settings.

Key features of implementation science:

• Enhances evidence-based healthcare.
• Focuses on strategies and outcomes.
• Contains rigorous scientific methods and conceptual frameworks.
• Multi-disciplinary science; closely aligned with clinical epidemiology, behavioral medicine, and social science.

Implementation strategies are actions taken to enhance adoption, implementation, and sustainability of evidence-based interventions. They may be educational, organizational, financial, or technological in nature.

Implementation Science Resources:

Is my research area ready for Implementation?

When defining implementation science, come very non-scientific language can be helpful:

• The intervention/practice/innovation is THE THING
• Effectiveness research looks at whether THE THING works
• Implementation research looks at how best to help people/places DO THE THING
• Implementation strategies are the stuff we do to try to help people/places Do THE THING
• Main implementation outcomes are HOW MUCH and HOW WELL they DO THE THING

Read more here. 

Click here to find out how you can to determine the readiness of your practice-of-interest for implementation science.

Click here for resources on how to conduct implementation science research.

Click here for a Consolidated Framework for Implementation Research wiki (most common framework for identifying facilitators/barriers to implementation, and a matching tool to determine strategies needed).

How can I learn more about Implementation Science?
 

Click here for brief instructional video about Implementation Science.

Training opportunities at Penn:

There are three different options for intro IS material at Penn.

• HPR 6110 Summer Implementation Science Institute – 4 day intensive: 
  “The purpose of the Implementation Science Institute is to provide participants with the tools to design and execute rigorous implementation science research. The Institute will give an introduction to the foundations of implementation science (i.e., terminology, conceptual models and frameworks, study design). Students will also receive an overview of advanced topics including implementation strategies and sustainability. The course directors will cover tips for grant writing, skill development and time will be spent writing specific aims for Implementation Science grants. We will also explicitly describe how principles of implementation science can be applied to practical implementation efforts.”
   
• IMP 6000 - Foundations in Implementation Science- Fall virtual IS course (through certificate, contact is Kate O’Boyle kathryn.oboyle@pennmedicine.upenn.edu):
  “The purpose of this course is to introduce participants to the Foundations in Implementation Science (i.e., terminology, conceptual models and frameworks, study design). Participants will develop an in-depth understanding of the historical and theoretical underpinnings of implementation science, preparing them to describe the positionality of their research within the broader field. Relevant theories and frameworks will be addressed in the context of multiple disciplines, such as healthcare, social work, education, and criminal justice. Significant group work will prepare participants to evaluate the appropriate usage of frameworks, theories, and models in the design and execution of IS research.”
   
• HPR 6200 - Implementation Science in Health and Healthcare- Spring in person course (through MSHP, contact is mshp@pennmedicine.upenn.edu)
  “The purpose of this course is to provide participants with the tools to design and execute rigorous implementation science research. The Institute will give an introduction to the foundations of implementation science (i.e., terminology, conceptual models and frameworks, study design). Students will also receive an overview of advanced topics including implementation strategies and sustainability. The course directors will cover tips for grant writing and skills development, and time will be spent writing specific aims for implementation science grants. We will also explicitly describe how principles of implementation science can be applied to practical implementation efforts.”
   

How can I meet Colleagues, workshop my ideas, or stay up to date on Implementation Research?
 

Attend implementation science focused events:

• Clinical Futures holds quarterly Pillar Activities. Please fill out the REDcap here to be added to our listserv for these opportunities.
• Visit PISCE@LDI. Join the listserv here. 
   

Clinical Futures Projects Involving Implementation Science Methodology:

Eliminating Monitor Overuse (EMO)

Continuous pulse oximetry monitoring of oxygen saturation is a common intervention used while treating bronchiolitis. However, overuse of pulse oximetry monitoring in stable patients no longer needing extra oxygen can lead to prolonged hospitalizations, increased risk of harm, and contribute to alarm fatigue. The EMO trial has two goals. The first seeks to identify effective strategies for de-implementing the overuse of pulse oximetry practices in infants experiencing bronchiolitis. The second centers on sustainability – or understanding how best to maintain these reductions in pulse oximetry practices over time. Prior work has shown successful reductions in the use of pulse oximetry in the short term.

Faculty Contributor: Chris Bonafide, MD, MSCE

Implementing the Sleep Well! Intervention in Urban Primary Care

Behavioral sleep problems such as insomnia and insufficient sleep are associated with deleterious childhood physical and mental health outcomes. However, these outcomes are modifiable, particularly in early development. This K23 project addresses a critical need for accessible, evidence-based behavioral sleep interventions for lower-socioeconomic status (SES) children. Sleep Well!, an effective behavioral sleep intervention was adapted so that its contents and service delivery methods are appropriate for lower-SES preschoolers and the primary care context. Pilot data support feasibility and acceptability of the intervention.

Affiliate Faculty Contributor: Ariel Williamson, PhD

Health Coaching to Improve Comprehensive HIV and Sexually Transmitted Infection Prevention in Adolescent Primary Care

Pediatric primary care providers (PCPs) are well-­positioned to expand pre-­exposure prophylaxis (PrEP) delivery as HIV and sexually transmitted infection (STI) infection rates continue to rise in the United States. However, sexual health service delivery in primary care is hampered by PCP time constraints and competing demands. There is a critical need for both behavioral interventions to increase PrEP uptake and reduce STIs in adolescents and implementation strategies to disseminate PrEP and enhanced sexual health services in adolescent primary care. This trial’s main goals are implementation optimization and testing of a PrEP-inclusive health coaching intervention to reduce HIV and STI incidence among adolescents and young adults, which aims to be scalable across primary care networks.

Faculty Contributor: Sarah Wood, MD, MPH