Designing implementation science strategies collection

From our 'Getting started...' webpage

Designing appropriate implementation strategies is central to the success of any implementation effort. These strategies represent the specific methods or techniques used to integrate evidence-based interventions into existing healthcare systems and practices. Selecting and tailoring them appropriately can determine whether an intervention is successfully adopted, implemented, and sustained.

Effective implementation strategies should be co-developed with key stakeholders and grounded in a detailed understanding of the local context. They can be discrete (a single, focused approach) or multifaceted (a coordinated set of discrete strategies). Regardless of scope, strategies should be described and reported in a standardised way to enable replication, adaptation, and broader learning across settings.

Recommended reading:

  • Getting a clinical innovation into practice: An introduction to implementation strategies (Kirchner et al. 2020) – click here

  • A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project (Powell et al. 2015) – click here

  • Use of concept mapping to characterise relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study (Waltz et al. 2015) – click here

To find out how to get started with implementation research, click here.

From our Fundamentals Programme

We continue with understanding how to design and test appropriate implementation strategies within real-world contexts.

In this lecture from our Fundamentals Programme, Leslie Johnson introduces the concept of implementation strategies—what they are, how they differ from evidence-based interventions, and how to select and tailor them effectively. Leslie emphasises the importance of establishing a shared language for implementation strategies to enhance comparability, transparency, and reproducibility across studies.

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Next, Vilma Irazola builds on this foundation in a lecture on study designs for implementation research. She explains the diverse methodological approaches used in implementation science, including mixed-method and hybrid designs, and highlights the importance of balancing implementation and clinical outcome evaluation.

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Finally, Enola Proctor concludes this module with a lecture on choosing and using implementation outcomes. She outlines key types of implementation outcomes—such as adoption and feasibility—and provides guidance on selecting and reporting them in alignment with contextual barriers, implementation stages, and theoretical frameworks.

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For more information and to access the full Fundamentals Programme click here.

From our Advanced Programme

Next, we move on to explore the design and testing of implementation strategies within the context of scaling up non-communicable disease (NCD) programmes for population-level impact.

In this lecture from our Advanced Programme, Serene Yoong introduces the methods, tools, and study designs used to investigate scale up. Serene highlights how rigorous, contextually grounded designs can generate robust evidence for effective and sustainable public health interventions. Learners are guided through approaches for structuring research questions, aligning design types with study aims, and accounting for practical considerations such as data availability, feasibility, and external policy drivers.

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Next, Lisa Hirschhorn examines strategies for interventions at scale, focusing on how to select, tailor, and optimise implementation strategies for large-scale delivery. Lisa emphasises the importance of mapping contextual factors to mechanisms of change and desired outcomes, and the role of rigorous documentation in enhancing transparency and learning across diverse settings.

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Following this, Vilma Irazola explores the balance between fidelity and adaptation in scale up research. She discusses how researchers can distinguish between the ‘core’ and ‘peripheral’ elements of an intervention and its associated strategies, and how to manage adaptation without compromising effectiveness or programme logic.

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In the At scale in the real world session, Tilahun Haregu shares practical examples of applying scale up methods in varied global contexts. They reflect on challenges and enablers of scaling interventions, the critical role of context in shaping outcomes, and lessons learned from real-world implementation.

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For more information and to access the full Advanced Programme, click here.

From our Resources and toolkit library

In this section, we provide a selection of practical resources focused on designing appropriate implementation strategies. These tools and publications are designed to help you plan, select, and tailor implementation approaches effectively, ensuring that evidence-based interventions are integrated into practice with rigour and sustainability.

WHO TDR Implementation Toolkit
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A comprehensive toolkit providing step-by-step guidance on conducting implementation research and selecting strategies appropriate to local contexts, particularly in low- and middle-income settings.

D&I Models Webtool
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An interactive online resource that helps researchers and practitioners identify and apply dissemination and implementation models, supporting the systematic design and evaluation of implementation strategies.

ExpandNet resources
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A practical framework and set of tools for developing and scaling up implementation strategies. These resources guide users through participatory planning, contextual analysis, and documentation to ensure sustainability.

Implementation Science Journal
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An open-access, peer-reviewed journal publishing empirical research and methodological papers on the development, testing, and reporting of implementation strategies.

WHO (2016) A Guide to Implementation Research in the Prevention and Control of NCDs
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This guide provides practical direction for designing and adapting implementation strategies to strengthen NCD prevention and control programmes in real-world contexts.

To access our curated implementation science resources, click here.

From our case studies

In this section, you will explore real-world examples that demonstrate how implementation strategies are designed, adapted, and tested in diverse health system contexts. These case studies show how evidence-based interventions are successfully integrated into practice through context-sensitive strategies, stakeholder engagement, and iterative refinement. Together, they illustrate how rigorous design and adaptation underpin effective implementation.

SINEMA Initiative: mHealth Intervention for Secondary Stroke Prevention in Rural China

This case study demonstrates the design and delivery of a multifaceted mHealth implementation strategy in rural China. The SINEMA initiative combined digital tools for healthcare providers with patient-facing communication to enhance medication adherence and physical activity. The project highlights the importance of contextually adapting technology-based strategies to improve cardiovascular outcomes in resource-limited settings.

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PT4A Initiative and Community-Based Medication Delivery in Western Kenya

The PT4A initiative developed an innovative, community-based implementation strategy combining peer-delivered medication distribution and digital monitoring systems to improve hypertension management. The case illustrates the role of co-designed strategies and rapid adaptation—particularly during the COVID-19 pandemic—in maintaining continuity of care and improving adherence outcomes.

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Adapting Hypertension Interventions to New Contexts in Mongolia

This case focuses on tailoring evidence-based salt reduction interventions to the Mongolian context. It showcases how systematic adaptation—guided by local data, stakeholder input, and pilot testing—can optimise strategy relevance and feasibility in new sociocultural environments.

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To access our full range of case studies, click here.

From GACD's impact case studies

GACD impact case studies demonstrate how well-designed implementation strategies can bridge the gap between evidence and practice. Below is an examples that showcases how context-specific strategies were developed, adapted, and scaled to strengthen health systems and improve outcomes.

Empowering people with diabetes in South Africa through the GREAT project

The GREAT programme improved diabetes care by embedding group education sessions within primary care clinics. Co-developed with health authorities, the strategy focused on patient empowerment, facilitator training, and integration into clinic operations. Results showed better self-management, improved clinical outcomes, and sustained adoption across several provinces.

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To access GACD’s growing number of impact case studies, click here.

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