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Understanding the implementation of evidence-informed policies and practices from a policy perspective: a critical interpretive synthesis
Heather L Bullock
McMaster University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3657-6525
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Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the scholarship in all three fields. This means policymakers, researchers and practitioners may find it challenging to draw from theory that adequately reflects their implementation efforts.
Methods: We developed an integrated theoretical framework of the implementation process from a policy perspective by combining findings from these fields using the critical interpretive synthesis method. We began with the compass question: how is policy currently described in implementation theory and processes and what aspects of policy are important for implementation success? We then searched 12 databases as well as grey literature and supplemented these documents with other sources to fill conceptual gaps. Using a grounded and interpretive approach to analysis, we built the framework constructs, drawing largely from the theoretical literature and then tested and refined the framework using empirical literature.
Results: A total of 11,434 documents were retrieved and assessed for eligibility and 35 additional documents were identified through other sources. Eighty-six unique documents were ultimately included in the analysis. Our findings indicate that policy is described as: 1) the context; 2) a focusing lens; 3) the innovation itself; 4) a lever of influence; 5) an enabler/facilitator or barrier; or 6) an outcome. Policy actors were also identified as important participants or leaders of implementation. Our analysis led to the development of a two-part conceptual framework, including process and determinant components.
Conclusions: This framework begins to bridge the divide between disciplines and offers a new way of thinking about implementation processes at the systems level. It offers researchers, policymakers and implementers with a new way of thinking about implementation and can be used for planning or evaluating implementation efforts.
Keywords
Implementation science, Public policy, Evidence-based health care, Systematic review, Critical interpretive synthesis
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On 02 Dec, 2020
Editor assigned
On 01 Dec, 2020
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On 01 Dec, 2020
Editor invited
On 01 Dec, 2020
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Received 17 Sep, 2020
Editorial decision: Major revision
On 17 Sep, 2020
Review #2 received
Received 05 Sep, 2020
Reviewer #2 agreed
On 22 Aug, 2020
Reviewer #1 agreed
On 21 Aug, 2020
Reviewers invited
Invitations sent on 17 Aug, 2020
Editor assigned
On 11 Aug, 2020
Submission checks complete
On 10 Aug, 2020
Editor invited
On 10 Aug, 2020
First submitted
On 08 Aug, 2020
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Subject Areas
Health Policy
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This preprint is under consideration at Implementation Science. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Understanding the implementation of evidence-informed policies and practices from a policy perspective: a critical interpretive synthesis
Heather L Bullock
McMaster University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3657-6525
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
No community comments so far
Editor assigned
On 03 Jan, 2021
Submission checks complete
On 03 Jan, 2021
Editor invited
On 03 Jan, 2021
Version 2
Posted 18 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 02 Dec, 2020
Editor assigned
On 01 Dec, 2020
Submission checks complete
On 01 Dec, 2020
Editor invited
On 01 Dec, 2020
No comments provided
Review #1 received
Received 17 Sep, 2020
Editorial decision: Major revision
On 17 Sep, 2020
Review #2 received
Received 05 Sep, 2020
Reviewer #2 agreed
On 22 Aug, 2020
Reviewer #1 agreed
On 21 Aug, 2020
Reviewers invited
Invitations sent on 17 Aug, 2020
Editor assigned
On 11 Aug, 2020
Submission checks complete
On 10 Aug, 2020
Editor invited
On 10 Aug, 2020
First submitted
On 08 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
Background: The fields of implementation science and knowledge translation have evolved somewhat independently from the field of policy implementation research, despite calls for better integration. As a result, implementation theory and empirical work do not often reflect the implementation experience from a policy lens nor benefit from the scholarship in all three fields. This means policymakers, researchers and practitioners may find it challenging to draw from theory that adequately reflects their implementation efforts.
Methods: We developed an integrated theoretical framework of the implementation process from a policy perspective by combining findings from these fields using the critical interpretive synthesis method. We began with the compass question: how is policy currently described in implementation theory and processes and what aspects of policy are important for implementation success? We then searched 12 databases as well as grey literature and supplemented these documents with other sources to fill conceptual gaps. Using a grounded and interpretive approach to analysis, we built the framework constructs, drawing largely from the theoretical literature and then tested and refined the framework using empirical literature.
Results: A total of 11,434 documents were retrieved and assessed for eligibility and 35 additional documents were identified through other sources. Eighty-six unique documents were ultimately included in the analysis. Our findings indicate that policy is described as: 1) the context; 2) a focusing lens; 3) the innovation itself; 4) a lever of influence; 5) an enabler/facilitator or barrier; or 6) an outcome. Policy actors were also identified as important participants or leaders of implementation. Our analysis led to the development of a two-part conceptual framework, including process and determinant components.
Conclusions: This framework begins to bridge the divide between disciplines and offers a new way of thinking about implementation processes at the systems level. It offers researchers, policymakers and implementers with a new way of thinking about implementation and can be used for planning or evaluating implementation efforts.
Figure 1
Figure 1
Figure 1
Figure 1