by Dean Fixsen, NIRN Co-Founder
Implementation science is based on observations and evidence accumulated since the 1960s. Even at this early stage, it is becoming clear there is a continuum of research, evaluation, and theorizing. One end of the continuum is marked by basic research and the other by applied research.
- Basic research is theory driven, focuses primarily on internal validity, contributes to the general knowledge base and theory building, and has the potential to impact outcomes eventually.
- Applied research is mission/outcome driven, focuses on external validity, contributes to the general knowledge base and to theory building, and has immediate and practical implications for achieving socially significant outcomes.
Applied implementation science is evolving from past and current research and evaluation methods and findings generated by those doing the work of implementation in human services (and other fields). Active implementation frameworks provide a mid-range theory to:
- Organize current knowledge into useful frameworks,
- Develop strategies to support implementation and scale up of evidence-based programs,
- Establish relevant measures of implementation factors in practice, and
- Develop a better laboratory in which imputed causal mechanisms can be studied, in order to
- Improve the predictive validity of the theoretical frameworks and the precision of the measures.
Active implementation frameworks take advantage of transdisciplinary knowledge bases and account for complexity inherent in human interactions in the context of organizations and systems that are at once intractable and ever changing. Active implementation frameworks include:
- Usable intervention criteria – description (philosophy, values, inclusion-exclusion criteria), essential components, operational definitions, fidelity assessments related to positive outcomes
- Implementation stages – exploration, installation, initial implementation, full implementation
- Implementation drivers – competency, organization, leadership, integration
- Improvement cycles – PDSA, usability testing, practice-policy communication
- Implementation teams – expertise in the above, sustainable interventions and outcomes, organization and system change
Active implementation frameworks provide a theoretical base for organizing the field, generating meaningful hypotheses, and more rapidly advancing applied implementation science. Active implementation frameworks are not an end point, but a new beginning for expansion of knowledge related to implementation best practices, science, and policy.