Related Notes 1. [[Implementation Strategies]] 2. [[Implementation Science Theories and Frameworks]] 3. [[050 - Implementation Science Index]] **Table of Implementation Strategies Their Theoretical Underpinning** _(Source of the Implementation Strategies from [Balis LE, Houghtaling B, Harden SM. Using implementation strategies in community settings: an introduction to the Expert Recommendations for Implementing Change (ERIC) compilation and future directions. Transl Behav Med. 2022 Nov 16;12(10):965-978. doi: 1](https://pubmed.ncbi.nlm.nih.gov/36039843/).)_ - [[Eric strategy .pdf]] -- I read the paper and cross-reference them to the theories and framework.. [[C202003141100 Clinical Methodology, having a broad intention behind interventions #intentions]] so we know why we are doing what we are doing. | | | | | | | | | --- | ---------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------ | ------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------- | -------------------------------------------------- | | No | Implementation Strategies | CFIR | Stakeholder Theory | TRA/TPB Components Addressed | Social Cognitive Theory | DOI | | 1 | Use evaluative and iterative strategies: Assess for readiness and identify barriers and facilitators | **Inner Setting** (Readiness for Implementation), **Process** (Planning) | Involves understanding stakeholder perspectives to identify barriers and facilitators, ensuring their concerns are addressed. | Perceived Behavioral Control: Identifying barriers and facilitators affects individuals’ perceptions of control over the behavior. | Environmental Factors, Reciprocal Determinism | Implementation, Confirmation Stages | | 2 | Audit and provide feedback | **Process** (Reflecting & Evaluating) | | | Reinforcements, Expectations | Observability, Confirmation Stage | | 3 | Conduct cyclical small tests of change | **Process** (Executing, Reflecting & Evaluating) | | Perceived Behavioral Control: Small tests enhance confidence in ability to perform the behavior. | Self-Efficacy, Behavioral Capability | Trialability, Implementation Stage | | 4 | Conduct local needs assessment | **Outer Setting** (Patient Needs & Resources), **Inner Setting** (Readiness for Implementation), **Process** (Planning) | Involves understanding stakeholder perspectives to identify barriers and facilitators, ensuring their concerns are addressed. | Attitude Toward the Behavior: Understanding needs can shape positive attitudes; Perceived Behavioral Control: Identifies resources influencing control. | Environmental Factors, Reciprocal Determinism | | | 5 | Develop a formal implementation blueprint | **Process** (Planning) | | Perceived Behavioral Control: Clear plans enhance confidence in executing behaviors. | Behavioral Capability, Self-Efficacy, Expectations | Complexity, Compatibility | | 6 | Develop and implement tools for quality-monitoring | **Intervention Characteristics** (Design Quality & Packaging), **Process** (Reflecting & Evaluating) | | | Reinforcements, Expectations | Relative Advantage, Observability | | 7 | Develop and organize quality monitoring systems | **Inner Setting** (Implementation Climate), **Process** (Reflecting & Evaluating) | | | Reinforcements, Environmental Factors | Observability, Relative Advantage | | 8 | Obtain and use priority population and support network feedback | **Outer Setting** (Patient Needs & Resources), **Process** (Engaging) | Directly collects feedback from stakeholders, integrating their insights into the implementation process. | | | Communication Channels, Social System | | 9 | Purposely re-examine the implementation | **Process** (Reflecting & Evaluating) | | | Self-Efficacy, Reinforcements, Reciprocal Determinism | Confirmation Stage | | 10 | Stage implementation scale-up | **Process** (Planning, Executing) | | | | Time, Implementation Stage | | 11 | Provide interactive assistance | **Process** (Engaging), **Characteristics of Individuals** (Knowledge & Beliefs) | | Perceived Behavioral Control: Support increases individuals’ confidence in their ability to perform the behavior. | Self-Efficacy, Behavioral Capability | Implementation Stage, Communication Channels | | 12 | Centralize technical assistance | **Inner Setting** (Structural Characteristics), **Process** (Engaging) | | | | | | 13 | Facilitation | **Process** (Engaging, Executing), **Characteristics of Individuals** (Self-Efficacy) | | Perceived Behavioral Control: Facilitators help remove barriers, enhancing control; Subjective Norms: Support signals social approval. | Self-Efficacy, Behavioral Capability | | | 14 | Provide local technical assistance | **Process** (Engaging), **Characteristics of Individuals** (Knowledge & Beliefs) | | Perceived Behavioral Control: Technical help increases ability to perform behaviors. | Self-Efficacy, Behavioral Capability | Implementation Stage, Communication Channels | | 15 | Provide supervision | **Inner Setting** (Implementation Climate), **Process** (Executing), **Characteristics of Individuals** (Self-Efficacy) | | | Self-Efficacy, Reinforcements | | | 16 | Adapt and tailor to context | **Intervention Characteristics** (Adaptability), **Process** (Executing) | | Attitude Toward the Behavior: Tailoring increases relevance, improving attitudes; Perceived Behavioral Control: Adaptation can reduce barriers. | Environmental Factors, Reciprocal Determinism | Compatibility, Complexity | | 17 | Promote adaptability | **Intervention Characteristics** (Adaptability), **Process** (Executing) | | Perceived Behavioral Control: Encouraging adaptability empowers individuals to handle variations, enhancing control. | Environmental Factors, Reciprocal Determinism | Compatibility, Trialability | | 18 | Tailor strategies | **Intervention Characteristics** (Adaptability), **Process** (Planning, Executing) | | | Environmental Factors, Reciprocal Determinism | Compatibility, Complexity | | 19 | Use data experts | **Process** (Engaging), **Characteristics of Individuals** (Knowledge & Beliefs) | | Perceived Behavioral Control: Expert support enhances ability to perform behavior; Attitude: Data can influence beliefs about outcomes. | Behavioral Capability, Environmental Factors | Observability, Communication Channels | | 20 | Use data warehousing techniques | **Inner Setting** (Access to Knowledge & Information), **Process** (Executing) | | | | | | 21 | Develop partner relationships | **Outer Setting** (Cosmopolitanism), **Process** (Engaging) | Builds strategic alliances with stakeholders (partners), recognizing their influence and fostering mutual benefits. | | Environmental Factors, Reciprocal Determinism | Social System, Communication Channels | | 22 | Build a coalition | **Outer Setting** (Cosmopolitanism), **Process** (Engaging) | Unites multiple stakeholders to collaborate towards shared goals, reflecting the interconnectedness emphasized in Stakeholder Theory. | | Environmental Factors, Reciprocal Determinism | Communication Channels, Social System | | 23 | Capture and share local knowledge | **Inner Setting** (Networks & Communications), **Process** (Reflecting & Evaluating) | Values and disseminates stakeholder knowledge, promoting inclusivity and shared understanding among all parties involved. | | Environmental Factors, Reciprocal Determinism | Observability, Communication Channels | | 24 | Conduct local consensus discussions | **Inner Setting** (Culture), **Process** (Engaging) | Facilitates dialogue among stakeholders to reach common agreement, ensuring their voices shape decisions. | | Environmental Factors, Reciprocal Determinism | Communication Channels, Persuasion Stage | | 25 | Develop academic partnerships | **Outer Setting** (Cosmopolitanism), **Process** (Engaging) | Engages educational stakeholders, acknowledging their role and expertise as valuable to implementation success. | | Environmental Factors, Reciprocal Determinism | Social System, Communication Channels | | 26 | Develop an implementation glossary | **Process** (Planning), **Intervention Characteristics** (Design Quality & Packaging) | | | Behavioral Capability | | | 27 | Identify and prepare champions | **Process** (Engaging), **Characteristics of Individuals** (Leadership) | Empowers influential stakeholders to advocate for the initiative, leveraging their support to enhance adoption. | Subjective Norms: Champions influence peers’ perceptions of social expectations; Attitude: Champions can positively influence attitudes. | Expectations, Observational Learning, Self-Efficacy | Early Adopters, Social System | | 28 | Identify early adopters | **Process** (Engaging), **Characteristics of Individuals** (Individual Stage of Change) | Recognizes and engages stakeholders who are likely to adopt innovations early, facilitating broader acceptance within the community. | Subjective Norms: Early adopters set social norms that others may follow. | Expectations, Observational Learning | Early Adopters, Social System | | 29 | Inform local opinion leaders | **Process** (Engaging), **Inner Setting** (Culture) | Involves key stakeholders who can influence others, ensuring they are informed and supportive of the implementation efforts. | Subjective Norms: Opinion leaders shape perceptions of social pressures and norms. | Expectations, Observational Learning | Early Adopters, Communication Channels | | 30 | Involve executive boards | **Inner Setting** (Leadership Engagement), **Process** (Engaging) | Engages top-level stakeholders in decision-making, aligning organizational strategies with stakeholder interests. | | | | | 31 | Model and simulate change | **Process** (Planning), **Intervention Characteristics** (Trialability), **Characteristics of Individuals** (Knowledge & Beliefs) | | Attitude Toward the Behavior: Demonstrations can enhance positive attitudes; Perceived Behavioral Control: Modeling increases confidence. | Observational Learning, Self-Efficacy (Modeling) | Trialability, Observability<br><br>Knowledge Stage | | 32 | Obtain formal commitments | **Inner Setting** (Readiness for Implementation), **Process** (Engaging) | | | | | | 33 | Organize implementation team meetings | **Inner Setting** (Networks & Communications), **Process** (Engaging) | | | Environmental Factors, Reciprocal Determinism | | | 34 | Promote network weaving | **Outer Setting** (Cosmopolitanism), **Process** (Engaging) | Enhances connections among stakeholders to facilitate collaboration and information sharing, acknowledging their interdependence. | | Environmental Factors, Reciprocal Determinism | Social System, Communication Channels | | 35 | Recruit, designate, and train for leadership | **Inner Setting** (Leadership Engagement), **Process** (Engaging), **Characteristics of Individuals** (Knowledge & Beliefs) | | | | | | 36 | Use advisory boards and workgroups | **Process** (Engaging), **Inner Setting** (Networks & Communications) | Incorporates stakeholder input through advisory roles, integrating diverse perspectives into the implementation process. | | | Social System, Persuasion Stage | | 37 | Use an implementation advisor | **Process** (Engaging), **Characteristics of Individuals** (Knowledge & Beliefs) | | | | | | 38 | Visit other sites | **Outer Setting** (Cosmopolitanism), **Process** (Engaging) | Engages with external stakeholders to learn from their experiences, promoting mutual learning and collaboration. | | Observational Learning, Environmental Factors (Modeling) | Innovators, Communication Channels | | 39 | Train and educate collaborators | **Process** (Executing), **Characteristics of Individuals** (Knowledge & Beliefs) | Invests in stakeholder capacity building, enhancing their ability to contribute effectively to the implementation. | Perceived Behavioral Control: Training increases skills and confidence; Attitude: Education can improve beliefs about the behavior. | Behavioral Capability, Self-Efficacy | | | 40 | Conduct educational meetings | **Process** (Engaging), **Characteristics of Individuals** (Knowledge & Beliefs) | Provides stakeholders with information and education, fostering understanding and engagement in the initiative. | Attitude Toward the Behavior: Education influences attitudes; Perceived Behavioral Control: Increases knowledge and confidence. | Behavioral Capability, Self-Efficacy | Communication Channels, Knowledge Stage | | 41 | Conduct educational outreach visits | **Process** (Engaging), **Characteristics of Individuals** (Knowledge & Beliefs) | Delivers education directly to stakeholders in their settings, strengthening relationships and addressing their specific needs. | Attitude, Perceived Behavioral Control, Subjective Norms: Personal visits can influence attitudes, increase skills, and convey social support. | | Communication Channels, Persuasion Stage | | 42 | Conduct ongoing training | **Process** (Executing), **Characteristics of Individuals** (Knowledge & Beliefs) | | Perceived Behavioral Control: Continuous learning enhances competence and control over the behavior. | Behavioral Capability, Self-Efficacy | Implementation Stage, Knowledge Stage | | 43 | Create a learning collaborative | **Inner Setting** (Learning Climate), **Process** (Engaging) | Establishes a forum for stakeholders to share knowledge and learn collectively, promoting stakeholder engagement and shared goals. | | Behavioral Capability, Environmental Factors | Communication Channels, Social System | | 44 | Develop educational materials | **Intervention Characteristics** (Design Quality & Packaging), **Process** (Planning) | | Attitude Toward the Behavior: Materials can positively influence beliefs; Perceived Behavioral Control: Resources aid understanding and skills. | | Complexity, Knowledge Stage | | 45 | Distribute educational materials | **Process** (Executing), **Characteristics of Individuals** (Knowledge & Beliefs) | | Attitude, Perceived Behavioral Control: Access to information influences attitudes and ability. | | Complexity, Knowledge Stage | | 46 | Make training dynamic | **Process** (Executing), **Characteristics of Individuals** (Self-Efficacy) | | Perceived Behavioral Control: Engaging training boosts confidence and skill; Attitude: Positive experiences enhance attitudes. | Self-Efficacy, Behavioral Capability | Complexity, Implementation Stage | | 47 | Provide ongoing consultation | **Process** (Engaging), **Characteristics of Individuals** (Knowledge & Beliefs) | | Perceived Behavioral Control: Consultation supports problem-solving, increasing control. | Self-Efficacy, Behavioral Capability | | | 48 | Shadow other experts | **Process** (Engaging), **Characteristics of Individuals** (Knowledge & Beliefs) | | Perceived Behavioral Control: Learning from experts enhances skills and confidence; Attitude: Positive role models influence attitudes. | Observational Learning, Self-Efficacy<br><br>Observational Learning, Self-Efficacy (Modeling) | Trialability, Observability | | 49 | Use train-the-trainer strategies | **Process** (Executing), **Characteristics of Individuals** (Knowledge & Beliefs) | | Perceived Behavioral Control: Expanding training capacity increases overall competence; Subjective Norms: Trained peers influence norms. | Behavioral Capability, Self-Efficacy | Early Adopters, Social System | | 50 | Work with educational institutions | **Outer Setting** (Cosmopolitanism), **Process** (Engaging) | Partners with educational stakeholders, recognizing their influence and resources in supporting implementation efforts. | | | | | 51 | Support delivery agents | **Process** (Engaging), **Inner Setting** (Implementation Climate) | | | | | | 52 | Create new delivery agent teams | **Inner Setting** (Structural Characteristics), **Process** (Engaging) | | | | | | 53 | Develop resource sharing agreements | **Outer Setting** (Cosmopolitanism), **Process** (Engaging) | Collaborates with stakeholders to share resources, fostering mutual benefits and acknowledging shared interests. | | Environmental Factors, Reciprocal Determinism | Social System, Communication Channels | | 54 | Facilitate relay of program data to delivery agents | **Inner Setting** (Access to Knowledge & Information), **Process** (Executing) | | | Behavioral Capability, Environmental Factors | | | 55 | Remind implementers | **Process** (Executing), **Characteristics of Individuals** (Knowledge & Beliefs) | | Perceived Behavioral Control: Reminders help manage tasks; Subjective Norms: Reinforces expectations. | Self-Efficacy, Reinforcements | Confirmation Stage, Communication Channels | | 56 | Revise professional roles | **Inner Setting** (Implementation Climate), **Characteristics of Individuals** (Role Identity) | | | | | | 57 | Engage priority populations | **Outer Setting** (Patient Needs & Resources), **Process** (Engaging) | Actively involves key stakeholder groups (e.g., patients, community members) to ensure their needs and perspectives are central to the implementation. | Attitude, Subjective Norms: Involving target groups can shift attitudes and norms; Perceived Behavioral Control: Empowers participation. | Environmental Factors, Reciprocal Determinism | Persuasion Stage, Social System | | 58 | Increase demand | **Outer Setting** (External Policies & Incentives), **Process** (Executing) | Engages stakeholders (e.g., consumers) to stimulate interest and demand, aligning organizational objectives with stakeholder needs. | Attitude Toward the Behavior: Marketing can enhance desirability; Subjective Norms: Creates perception that behavior is expected or popular. | Expectations, Reinforcements | Time, Persuasion Stage | | 59 | Intervene with priority population to enhance uptake and adherence | **Outer Setting** (Patient Needs & Resources), **Process** (Executing) | Works directly with stakeholders to improve adoption and adherence, acknowledging their role in successful implementation. | Perceived Behavioral Control: Support interventions increase ability to perform behavior; Attitude: Positive interactions improve attitudes. | Self-Efficacy, Environmental Factors | Time, Implementation Stage | | 60 | Involve priority population and support network | **Outer Setting** (Patient Needs & Resources), **Process** (Engaging) | Engages stakeholders and their support systems, recognizing their importance in achieving implementation goals. | Subjective Norms: Engaging social networks influences perceived social pressure; Attitude: Support can enhance positive attitudes. | Environmental Factors, Observational Learning | | | 61 | Prepare priority population to actively participate | **Outer Setting** (Patient Needs & Resources), **Process** (Engaging) | Equips stakeholders with necessary information and resources, facilitating their active involvement and valuing their contributions. | Perceived Behavioral Control: Preparation increases confidence; Attitude: Understanding benefits improves attitudes. | Self-Efficacy, Behavioral Capability | Knowledge, Persuasion Stages | | 62 | Use mass media | **Outer Setting** (External Policies & Incentives), **Process** (Engaging) | Communicates with a broad audience of stakeholders to inform and engage them, ensuring transparency and inclusivity. | Attitude, Subjective Norms: Media campaigns can shape attitudes and perceptions of social norms. | Expectations, Observational Learning | Communication Channels, Knowledge Stage | | 63 | Utilize financial strategies | **Outer Setting** (External Policies & Incentives), **Inner Setting** (Available Resources) | | | Environmental Factors, Reinforcements | | | 64 | Access new funding | **Outer Setting** (External Policies & Incentives), **Inner Setting** (Available Resources) | | | Environmental Factors, Reinforcements | | | 65 | Alter incentive/allowance structures | **Outer Setting** (External Policies & Incentives), **Inner Setting** (Implementation Climate) | Adjusts incentives to align with stakeholder motivations, acknowledging their interests and influencing positive behaviors. | Attitude Toward the Behavior: Incentives can make behavior more appealing; Perceived Behavioral Control: Financial incentives reduce barriers. | Reinforcements, Expectations | Time, Decision Stage | | 66 | Develop disincentives | **Outer Setting** (External Policies & Incentives), **Inner Setting** (Implementation Climate) | | | Reinforcements, Expectations | Time, Decision Stage | | 67 | Fund and contract for evidence-based program | **Outer Setting** (External Policies & Incentives), **Inner Setting** (Available Resources) | | | | | | 68 | Make billing easier | **Inner Setting** (Available Resources), **Process** (Executing) | Simplifies processes for stakeholders (e.g., patients, providers), considering their convenience and enhancing their experience. | Perceived Behavioral Control: Simplifying processes increases ease of performing behavior. | Self-Efficacy, Environmental Factors | | | 69 | Place evidence-based program on fee-for-service lists/formularies | **Outer Setting** (External Policies & Incentives), **Inner Setting** (Available Resources) | | | Environmental Factors, Reinforcements | | | 70 | Use capitated payment | **Outer Setting** (External Policies & Incentives), **Inner Setting** (Available | | | | | | 71 | Use other payment schemes | **Outer Setting** (External Policies & Incentives), **Inner Setting** (Available Resources) | implements financial strategies that consider stakeholder preferences and needs, promoting fairness and mutual benefit. | Perceived Behavioral Control: Flexible payments reduce barriers; Attitude: May improve perceptions of the behavior’s value. | Environmental Factors, Reinforcements | | | 72 | Change infrastructure | **Inner Setting** (Structural Characteristics) | Modifies organizational structures to better serve stakeholders, enhancing their experiences and outcomes. | Perceived Behavioral Control: Improved infrastructure makes behavior easier to perform. | Environmental Factors, Self-Efficacy | Compatibility, Implementation Stage | | 73 | Change accreditation or membership requirements | **Outer Setting** (External Policies & Incentives) | | | Environmental Factors, Expectations | Social System, Decision Stage | | 74 | Change liability laws | **Outer Setting** (External Policies & Incentives) | | | Environmental Factors, Expectations | Social System, Decision Stage | | 75 | Change physical structure and equipment | **Inner Setting** (Structural Characteristics) | Improves facilities and equipment to meet stakeholder needs, recognizing the impact on their satisfaction and effectiveness. | Perceived Behavioral Control: Better equipment increases ability to perform behavior; Attitude: Modern facilities may enhance attitudes. | Environmental Factors, Self-Efficacy | Compatibility, Implementation Stage | | 76 | Change record systems | **Inner Setting** (Access to Knowledge & Information), **Intervention Characteristics** (Complexity) | | | Environmental Factors, Behavioral Capability | Compatibility, Relative Advantage | | 77 | Change service sites | **Inner Setting** (Structural Characteristics), **Outer Setting** (Patient Needs & Resources) | Adjusts service locations for better stakeholder access and convenience, demonstrating responsiveness to their needs. | | Environmental Factors | Compatibility, Implementation Stage | | 78 | Create or change credentialing or licensure standards | **Outer Setting** (External Policies & Incentives) | | | Environmental Factors, Expectations | Social System, Decision Stage | | 79 | Mandate change | **Outer Setting** (External Policies & Incentives), **Inner Setting** (Implementation Climate) | Implements changes requiring stakeholder compliance, highlighting the need to consider stakeholder acceptance and potential resistance. | Subjective Norms: Mandates establish expectations; Perceived Behavioral Control: May reduce perceived autonomy but clarify requirements. | Reinforcements, Environmental Factors | Social System, Decision Stage | | 80 | Stage a dissemination organization | **Outer Setting** (Cosmopolitanism), **Process** (Engaging) | Establishes an entity focused on spreading information to stakeholders, emphasizing their central role in dissemination efforts. | | Environmental Factors, Reciprocal Determinism | Social System, Communication Channels |