GACD e-Hub Educators' Portal

Introductions

Implementation science is the study of the methods and strategies that enable research uptake into practice and policy by bridging the gap between research findings and their practical application in policies and practice. With the aim to improve population health, implementation science examines what works, for whom, and under what conditions. It also focuses on scaling effective interventions across and within countries, ensuring equitable access regardless of gender, age, and socioeconomic status.

This portal is designed to provide educators with the essential tools required to teach implementation science at undergraduate and postgraduate levels. Although, implementation science is relevant across various domains, this module emphasises its application in addressing complex health challenges associated with non-communicable diseases (NCDs).

The portal offers a comprehensive set of resources including videos delivered by global experts in implementation science, to guide educators through the core concepts of implementation science, including:

  1. The science of implementation
  2. Stakeholder engagement
  3. Understanding theories, models and frameworks
  4. Assessing and understanding context
  5. Designing and testing implementation strategies

Overview of Modules

MODULE 1
The Science of Implementation

In this module you will learn how implementation research has been established as a scientific discipline, its typical aims and focus, and the range of disciplines from which it draws.

MODULE 2
Stakeholder Engagement

In this module, we will explore the central importance of effective, equitable, and meaningful stakeholder engagement at all stages of implementation research.

MODULE 3
Understanding Theories, Models, and Frameworks

This module explores how theories, models, and frameworks can be used to guide the process of implementation research, to understand determinants and mechanisms of change affecting implementation, and to structure robust evaluations of implementation activities.

MODULE 4
Addressing and Understanding Context

The teaching in this module will help you to understand what is meant by ‘context’ in implementation research, and approaches to context assessment.

MODULE 5
Designing and Testing Implementation Strategies

In this module you will explore the concept of implementation strategies, how they differ from evidence-based interventions, different study designs to test them in the real world, and measuring relevant implementation outcomes.

Module 1 (2-3 Hours)

MODULE 1: The Science of Implementation

Scope and Duration: Longer version (2 to 3 hours with additional and optional context)

In this module you will learn how implementation research has been established as a scientific discipline, its typical aims and focus, and the range of disciplines from which it draws.

Learning outcomes:

After engaging in the Fundamentals of Implementation Science Module 1a content, learners will be able to

  • Explain the ‘know-do’ gap in healthcare and appreciate the importance of implementation as a science and how it can help to bridge the ‘know-do’ gap.
  • Differentiate between evidence-based interventions (what is implemented) and implementation strategies (how they are implemented).
  • Define characteristics and core components of implementation research.
  • Compare implementation science with other forms of health research and recognise its transdisciplinary nature in creating a shared language across disciplines.

Teaching approach:

This module consists of:

  • Pre-class reading,
  • Pre-recorded lectures (50 minutes),
  • Classroom or tutorial activity (70 minutes), and
  • Additional (optional) teaching content (60 minutes).

Pre-class reading

  • Lane-Fall MB, Curran GM, & Beidas RS. Scoping implementation science for the beginner: locating yourself on the “subway line” of translational research. BMC Med Res methodol. 2019;19(1):133.org/10.1186/s12874-019-0783-z
  • Brown CH, Curran G, Palinkas LA, Aarons GA, Wells KB, Jones L, ET AL. An Overview of Research and Evaluation Designs for Dissemination and Implementation. Annu Rev Public Health. 2017;38:1–22. org/10.1146/annurev-publhealth-031816-044215
  • Vedanthan R. Global Health Delivery and Implementation Research: A New Frontier for Global Health. Mt Sinai J Med. 2017;78(3):303–5. org/10.1002/msj.20250

Teaching session content

Core content videos

Instructions to educators: Show this video first, accompanied by a class discussion of the key messages immediately thereafter.

Lecture 1A (pre-recorded video – 20 minutes):

Topic: Implementation as a science: key concepts, ideas, and issues

Lecturer: Brian Oldenburg

Slides available: Colour (pdf) | Black and white (pdf)

Lecture 1B (pre-recorded video – 6 minutes):

Topic: Evidence-based intervention or implementation strategy?

Lecturer: Leslie Johnson

Slides available: Colour (pdf) | Black and white (pdf)

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Lecture 1C (pre-recorded video – 24 minutes):

Topic: Approaches and disciplines for implementation research

Lecturer: Rajesh Vedanthan

Slides available: Colour (pdf) | Black and white (pdf)

Class/tutorial activities (70 minutes)

Discussion of key messages (15 minutes)

Lecture 1A

  1. Evidence alone is insufficient to combat NCDs, a significant gap exists between knowledge and action in healthcare.
  2. Implementation science focuses on how to apply evidence-based interventions.
  3. Implementation science actively considers the real-world environment when introducing new interventions and practices.

Lecture 1B

  1. Implementation strategies support implementation of evidence-based interventions (EBIs).
  2. It is important to first establish the difference between “what” you are implementing and “how” you plan to implement.
  3. You need more than an EBI to achieve impact.

Lecture 1C

  1. Implementation research is transdisciplinary.
  2. We as researchers are trying to achieve a common language among multiple disciplines to address a common issue.
  3. There are multiple steps in an implementation research project. Each step can be transdisciplinary and the entirety of the project is transdisciplinary.

Activity – Individual reflection or small group discussion (30 minutes) 

In small groups, discuss your responses to the following questions:

  1. How can we effectively bridge the gap between research findings and real-world practice? What factors hinder the translation of knowledge into action?
  1. Can you think of a health-related program or project you’ve come across (in your work, studies, or community)? What kinds of actions or strategies helped it:
    1. Get started (adoption)?
    2. Run smoothly (implementation)?
    3. Keep going over time (sustainability)

TIPS for educators to help guided discussion

Prompt students to consider system-level barriers: e.g., funding limitations, policy misalignment, organisational inertia.

Highlight the role of context: Cultural, social, and resource-related factors all affect how evidence is applied.

Guide students to pick a specific intervention or program, even something informal or local (e.g., a vaccination drive, smoking cessation program, mental health initiative).

– For adoption, ask about champions, readiness, and initial motivation, who said yes, and why?

– For implementation, encourage discussion around training, communication, support structures, and fidelity.

– For sustainability, prompt them to consider leadership support, ongoing resources, integration into routine practice, and long-term relevance.

Invite reflections on failure or adaptation, as these are also rich learning points.

Class discussion (20 minutes)

A representative from each small group (or individual, if working alone) will report back to the broader class with a brief summary of their discussion.

Final reflections/conclusion (5 minutes)

Educator to sum up the learning through emphasising key messages.

Further learning

Additional Reading (optional)

Powell BJ, McMillen JC, Proctor EK, Carpenter CR, Griffey RT, Bunger AC, et al. A compilation of strategies for implementing clinical innovations in health and mental health. Med Care Res Rev. 2012;69(2):123–57. org/10.1177/1077558711430690

Grading of Recommendations, Assessment, Development and Evaluations (GRADE) website. [Internet]. Available from: https://www.gradeworkinggroup.org/

Chunara R, Gjonaj J, Immaculate E, Wanga I, Alaro J, Scott-Sheldon LAJ, et al. Social determinants of health: the need for data science methods and capacity. Lancet Digit Health. 2024;6(4):e235–7. org/10.1016/S2589-7500(24)00022-0

Chay J, Su RJ, Kamano JH, Andama B, Bloomfield GS, Delong AK, et al. Cost-effectiveness of group medical visits and microfinance interventions versus usual care to manage hypertension in Kenya: a secondary modelling analysis of data from the Bridging Income Generation with Group Integrated Care (BIGPIC) trial. Lancet Glob Health. 2024;12(8):e1331–42. org/10.1016/S2214-109X(24)00188-8

Additional Teaching Content (60 minutes) – Optional

Case Studies: (30 minutes): Select 2–3 case studies from the GACD implementation science e-hub that align with your course content. Divide the class into 2–3 groups, assigning one case study to each group. Each group will read and discuss their case study in a small group, focusing on the key elements of implementation research as discussed in lectures 1A, 1B and 1C, and prepare a brief summary to present to the class.

Group Presentation and discussion (25 minutes):

Each group will present their assigned case study, covering the following points:

  • Context of the case
  • Key stakeholders involved
  • Main implementation challenges
  • Adaptation and application of implementation strategies
  • Evaluation methods and key findings
  • Success factors and lessons learned
  • Strengths and limitations

After each presentation, allow time for questions and brief discussion.

Final reflections and conclusion (5 minutes):

Educators to summarise key learning from the activity, reinforcing the core messages and insights from the case studies.

Instructions on adapting this material:

Please ensure this source is properly acknowledged when using any part of the lesson plan or associated materials in teaching or training.

Citation: Global Alliance for Chronic Diseases (GACD). (n.d.). Implementation Science e-Hub. Retrieved from https://implementationscience-gacd.org/

Module 2 (2-3 Hours)

MODULE 2: Stakeholder Engagement

Scope and Duration: Shorter version (2 to 3 hours with additional and optional context)

In this module, we will explore the central importance of effective, equitable, and meaningful stakeholder engagement at all stages of implementation research.

Learning outcomes:

After engaging in the Fundamentals of Implementation Science Module 1a content, learners will be able to

  • Explain why stakeholder engagement and community participation are critical for achieving health equity.
  • Identify and classify stakeholders using the 7 Ps framework and differentiate levels of engagement.
  • Discuss building stakeholder engagement by fostering trust and creating supportive social networks that enable change.
  • Reflect on the principles of collaborative, respectful, and enduring partnerships.

Teaching approach:

This module consists of:

  • Pre-class reading,
  • A pre-recorded lecture (50 minutes),
  • Classroom or tutorial activity (70 minutes), and
  • Additional (optional) teaching content (60 minutes).

Pre-class reading

Pellecchia M, Arnold KT, Tomczuk L, Beidas RS. Engaging stakeholders. In: Weiner BJ, Lewis CC, Sherr K, editors. New York: Springer Publishing Company; p. 133–54. https://doi.org/10.1891/9780826186935.0006

Concannon TW, Meissner P, Grunbaum JA, McElwee N, Guise JM, Santa J, et al. A new taxonomy for stakeholder engagement in patient-centered outcomes research. J Gen Intern Med. 2012;27(8):985–91. https://doi.org/10.1007/s11606-012-2037-1

Ramanadhan S, Alemán R, Bradley CD, Cruz JL, Safaeinili N, Simond, V, et al. Using participatory implementation science to advance health equity. Annu Rev Public Health. 2024;45(1):47–67. org/10.1146/annurev-publhealth-060722-024251

Collins SE, Clifasefi SL, Stanton J, The Leap Advisory Board, Straits KJE, Gil-Kashiwabara E, et al. Community-based participatory research (CBPR): towards equitable involvement of community in psychology research. Am Psychol. 2018;73(7):884–98. org/10.1037/amp0000167

Teaching session content

Core content videos

Instructions to educators: Show this video first, accompanied by a class discussion of the key messages immediately thereafter.

Lecture 2A (pre-recorded video – 30 minutes):

Topic: Who, what, when, and why: the importance of stakeholders

Lecturer: Lijing Yan

Slides available: Colour (pdf) | Black and white (pdf)

Lecture 2B (pre-recorded video – 20 minutes):

Topic: Community participatory action research

Lecturer: Ruth Verhey

Slides available: Colour (pdf) | Black and white (pdf)

Class/tutorial activities (70 minutes)

Discussion of key messages (15 minutes)

Lecture 2A

  1. Stakeholder engagement is critically important for implementation research in improving processes, outcomes, and sustainability.
  2. The 7 Ps framework of classifying stakeholders.
  3. Three levels of stakeholder engagement: non-participation, symbolic participation, and engaged participation.
  4. Identifying stakeholders through a stakeholder analysis.
  5. Stakeholder engagement is needed from onset to finish throughout the entire process.

 

Lecture 2B

  1. The goal of community participatory action research is better health equity, driven by communities with a bottom-up approach.
  2. It is vital to create long-standing engagement by showing up and building social networks, supporting and accepting change, and allowing respect and recognition for frustration.
  3. Importantly, you must: (i) listen; (ii) invite all to mutually learn; and (iii) stay and keep listening.
  4. If you want to walk fast, go alone; if you want to walk far, walk with others.

Activity – Individual reflection or small group discussion (30 minutes) 

In small groups, discuss your responses to the following questions:

  1. Value and risks of engagement: What are the benefits of involving stakeholders in decision-making and implementation What are the benefits of involving stakeholders in decision-making and implementation processes, and what might be the consequences if engagement is inadequate or ineffective?
  2. Identifying and engaging stakeholders: Who are the key stakeholders in a project that you have been involved in (use the 7 Ps framework), and how can researchers effectively identify and engage them at different stages of the research process?
  3. Community participation and trust: How does community participatory action research (CPAR) differ from traditional research approaches, and what strategies can researchers use to build trust, foster partnerships, and address challenges when involving diverse community members?

Class discussion (20 minutes)

A representative from each small group (or individual, if working alone) will report back to the broader class with a brief summary of their discussion.

Final reflections and conclusion (5 minutes)

Educator to sum up the learning through emphasising key messages.

Further learning

Additional Reading (optional)

Goodman MS, Sanders Thompson VL. The science of stakeholder engagement in research: classification, implementation, and evaluation. Transl Behav Med. 2017;7(3):486–91. https://doi.org/10.1007/s13142-017-0495-z

Additional Teaching Content (60 minutes) – Optional

Case Studies: (30 minutes): Select 2–3 case studies from the GACD implementation science e-hub that align with your course content. Divide the class into 2–3 groups, assigning one case study to each group. Each group will read and discuss their case study in a small group, focusing on the key elements of implementation research as discussed in lectures 2A and 2B, and prepare a brief summary to present to the class.

Group Presentation and discussion (25 minutes):

Each group will present their assigned case study, covering the following points:

  • Context of the case
  • Key stakeholders involved
  • Roles and levels of stakeholder engagement
  • Approaches used to build trust, long-term relationships, and community participation
  • Challenges in engaging diverse stakeholders and how they were addressed
  • Success factors and lessons learned for sustaining engagement and partnerships

After each presentation, allow time for questions and brief discussion.

Final reflections and conclusion (5 minutes):

Educator to summarise key learning from the activity, reinforcing the core messages and insights from the case studies.

Instructions on adapting this material:

Please ensure this source is properly acknowledged when using any part of the lesson plan or associated materials in teaching or training.

Citation: Global Alliance for Chronic Diseases (GACD). (n.d.). Implementation Science e-Hub. Retrieved from https://implementationscience-gacd.org/

Module 3 (3 Hours)

MODULE 3: Understanding Theories, Models, and Frameworks

Scope and Duration: Longer version (3 hours)

This module explores how theories, models, and frameworks can be used to guide the process of implementation research, to understand determinants and mechanisms of change affecting implementation, and to structure robust evaluations of implementation activities.

Learning outcomes:

After engaging in this module content, learners will be able to:

  • Explain the key functions and purposes of theories, models, and frameworks (TMFs) in guiding implementation research.
  • Compare and contrast commonly used TMFs, identifying their main similarities, differences, and areas of application across diverse contexts.
  • Apply guiding principles for aligning TMF choice with research questions, context, and intended outcomes.
  • Describe the role of mechanisms of change, including capabilities, opportunities, and motivation, in shaping behaviour and influencing implementation outcomes.
  • Apply the Consolidated Framework for Implementation Research (CFIR) and the RE-AIM framework to design, implement, and evaluate evidence-based interventions in real-world settings.

Teaching approach:

This module consists of:

  • Pre-class reading,
  • A pre-recorded lecture (approximately 1.5 hours), and
  • Classroom or tutorial activity (1.5 hours).

Pre-class reading

Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci. 2015;10:53. Published 2015 Apr 21. doi:10.1186/s13012-015-0242-0  

Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42. Published 2011 Apr 23. doi:10.1186/1748-5908-6-42

Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42. Published 2011 Apr 23. doi:10.1186/1748-5908-6-42

Holtrop JS, Estabrooks PA, Gaglio B, et al. Understanding and applying the RE-AIM framework: Clarifications and resources. J Clin Transl Sci. 2021;5(1):e126. Published 2021 May 14. doi:10.1017/cts.2021.789

Consolidated Framework for Implementation Research (CFIR) website – click here

D&I Models in Health Web Tool website – click here

RE-AIM website – click here

Teaching session content

Core content videos

Instructions to educators: Show this video first, accompanied by a class discussion of the key messages immediately thereafter.

Lecture 3A (pre-recorded video – 28:44 minutes): 

Topic: Theories, models, and frameworks for implementation research

Lecturer: Pilvikki Absetz

Slides available: Colour (pdf) | Black and white (pdf)

Lecture 3B (pre-recorded video – 22:19 minutes): 

Topic: Mechanisms of change

Lecturer: Pilvikki Absetz

Slides available: Colour (pdf) | Black and white (pdf)

Lecture 3C (pre-recorded video – 13:00 minutes): 

Topic: Practical application – the Consolidated Framework for Implementation Research (CFIR)

Lecturer: Kavita Singh

Slides available: Colour (pdf) | Black and white (pdf)

Lecture 3D (pre-recorded video – 22:52 minutes): 

Topic: Practical application – the RE-AIM Framework

Lecturer: Jaap Koot

Slides available: Colour (pdf) | Black and white (pdf)

Class/tutorial activities (1.5 hours)

Discussion of key messages (25 minutes)

Lecture 3A

  1. When conducting implementation research, any one TMF will not be sufficient – TMFs are needed to cover several functions and different levels.
  2. No single TMF is perfect, nor the only right one to use.
  3. Findings from your needs assessment and earlier literature are your best guides.
  4. Good resources exist to help you identify and select TMFs.

Lecture 3B

  1. Capabilities, opportunities and motivation are necessary preconditions of behaviour; other theories specify how these operate.
  2. Many of the same theories could be applied to implementer behaviours.
  3. More research developing, applying, and testing theories in LMIC settings is needed.

Lecture 3C

  1. The Consolidated Framework for Implementation Research (CFIR) is a useful tool to guide the development and evaluation of evidence-based interventions (EBIs).
  2. CFIR-based process evaluation can answer the fidelity, adaptions, and contextual factors influencing the implementation and effectiveness of EBIs.
  3. Updated CFIR 2.0 address critiques of the CFIR by focusing on “innovation recipients” and “equity in implementation”.

Lecture 3D

  1. The RE-AIM framework can be used for simple or for complex topics.
  2. The indicators should be formulated well ahead of the evaluation, to enable data collection during implementation.
  3. The mixed method approach of both quantitative and qualitative data requires a multidisciplinary team to perform the research.

Activity – Individual reflection or small group discussion (40 minutes) 

In small groups, identify a health problem that you want to address (e.g., diabetes prevention, cancer screening, tobacco cessation, etc.).

  • Click on the “Plan” section of the tool and use this section to create a logic model for your chosen health problem.
  • As you build the logic model, identify key constructs for your project.
  • Constructs are the main concepts or elements from your D&I framework, intervention, implementation strategies, or hypothesised outcomes. These constructs will guide your selection of potential D&I models.
  • Discuss in your group
    • Which constructs did you include and why?
    • Which D&I models did the tool suggest for your project?
    • How could these models guide the implementation of your chosen health problem?

Class discussion (25 minutes)

Each group to share a brief summary of your group’s logic model and key insights (2-3 minutes per group).

 

Instructions on adapting this material:

Please ensure this source is properly acknowledged when using any part of the lesson plan or associated materials in teaching or training.

Citation: Global Alliance for Chronic Diseases (GACD). (n.d.). Implementation Science e-Hub. Retrieved from https://implementationscience-gacd.org/

Module 4 (1.5 Hours)

MODULE 4: Addressing and Understanding Context

Duration: 1.5 hours

The teaching in this module will help you to understand what is meant by ‘context’ in implementation research, and approaches to context assessment.

Learning outcomes:

After engaging with this module, learners will be able to

  • Explain what is meant by ‘context’ in implementation research and why it is critical to implementation success
  • Describe different methods and frameworks used to assess context, including the value of mixed-method approaches.
  • Discuss how understanding and working with context can guide adaptation of interventions and implementation strategies to local needs.
  • Apply practical tools and techniques to assess contextual factors that influence implementation

 Teaching approach:

This module consists of:

  • Pre-class reading,
  • A pre-recorded lecture (30 minutes), and
  • Classroom or tutorial activity (60 minutes).

Pre-class reading

Pfadenhauer LM, Gerhardus A, Mozygemba K, et al. Making sense of complexity in context and implementation: the Context and Implementation of Complex Interventions (CICI) framework. Implement Sci. 2017;12(1):21. Published 2017 Feb 15. doi:10.1186/s13012-017-0552-5

Daivadanam M, Ingram M, Sidney Annerstedt K, et al. The role of context in implementation research for non-communicable diseases: Answering the ‘how-to’ dilemma. PLoS One. 2019;14(4):e0214454. Published 2019 Apr 8. doi:10.1371/journal.pone.0214454

Improving access to cancer care among rural populations in India: Development of a validated tool for health system capacity assessment (Mallafré-Larrosa M et al. 2024. Cancer Med. 13(14):e7343) – click here

Working with context to implement NCD programmes – GACD thematic workshop (2023) – click here

Access Cancer Care India project website – click here

Teaching session content

Core content videos

Instructions to educators: Show this video first, accompanied by a class discussion of the key messages immediately thereafter.

Lecture 4A (pre-recorded video – 20 minutes): 

Topic: Context in implementation research

Lecturer: Zahra Aziz

Slides available: Colour (pdf) | Black and white (pdf)

Lecture 4C (pre-recorded video – 10 minutes): 

Topic: Practical application – Context in the Access Cancer Care India project

Lecturer: Arunah Chandran

Slides available: Colour (pdf) | Black and white (pdf)

Class/tutorial activities (60 minutes)

Discussion of key messages (10 minutes)

  1. However you define context, it is crucial to implementation success.
  2. Frameworks can be helpful to structure or inform your approach to context assessment, and applying mixed methods will provide a richer understanding.
  3. Working with (rather than against) context allows researchers to adapt intervention components and implementation strategies to local needs.
  4. Leveraging meaningful stakeholder engagement is the backbone of assessing context.
  5. Surveys, focus groups, in-depth interviews, and policy analyses can contribute to understanding context at different levels.
  6. Assessing and understanding context has been crucial to the success of the Access Cancer Care India project.
  7. A validated tool with a three-step method has been developed to assess health system capacity, intended for use in lower resourced settings.

Activity – Individual reflection or small group discussion (30 minutes) 

In small groups, identify a health problem to address (e.g., diabetes prevention, cancer screening, tobacco cessation) and choose a setting.

Discuss in your group:

  • What defines the boundaries of your implementation context?
  • Which methods (e.g., surveys, interviews, policy analysis) would best assess your context – and why?
  • How might you use stakeholder engagement to deepen your understanding of context?
  • What tools or frameworks from the literature could support your context assessment?

Class discussion (20 minutes)

Each group to share a brief summary of your chosen project and key insights.

Instructions on adapting this material:

Please ensure this source is properly acknowledged when using any part of the lesson plan or associated materials in teaching or training.

Citation: Global Alliance for Chronic Diseases (GACD). (n.d.). Implementation Science e-Hub. Retrieved from https://implementationscience-gacd.org/

Module 5 (2 Hours)

MODULE 5: Designing and Testing Implementation Strategies

Duration: 2 hours

In this module you will explore the concept of implementation strategies, how they differ from evidence-based interventions, different study designs to test them in the real world, and measuring relevant implementation outcomes..

Learning outcomes:

After engaging with this module, learners will be able to

  • Differentiate implementation strategies from evidence-based interventions and explain why creating a shared language enhances comparability and replication in implementation research.
  • Describe the range of study designs used to test implementation strategies, including quantitative, qualitative, mixed-method, and hybrid designs (Types 1–3).
  • Identify relevant implementation outcomes (e.g., adoption, feasibility, fidelity) and explain how these differ from clinical or health outcomes.
  • Apply appropriate criteria for choosing, measuring, and reporting implementation outcomes based on project stage, barriers, and theoretical foundations.

 Teaching approach:

This module consists of:

  • Pre-class reading,
  • A pre-recorded lecture (50 minutes), and
  • Classroom or tutorial activity (70 minutes).

Pre-class reading

Powell, B.J., Waltz, T.J., Chinman, M.J. et al.A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Sci 10, 21 (2015). https://doi.org/10.1186/s13012-015-0209-1

Leeman, J., Birken, S., Powell, B.J. et al.Beyond “implementation strategies”: classifying the full range of strategies used in implementation science and practice. Implementation Sci 12, 125 (2017). https://doi.org/10.1186/s13012-017-0657-x

Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012;50(3):217-226. doi:10.1097/MLR.0b013e3182408812

Brown CH, Curran G, Palinkas LA, et al. An Overview of Research and Evaluation Designs for Dissemination and Implementation. Annu Rev Public Health. 2017;38:1-22. doi:10.1146/annurev-publhealth-031816-044215

Proctor E, Silmere H, Raghavan R, et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):65-76. doi:10.1007/s10488-010-0319-7

Allen P, Pilar M, Walsh-Bailey C, et al. Quantitative measures of health policy implementation determinants and outcomes: a systematic review. Implement Sci. 2020;15(1):47. Published 2020 Jun 19. doi:10.1186/s13012-020-01007-w

Teaching session content

Core content videos

Instructions to educators: Show this video first, accompanied by a class discussion of the key messages immediately thereafter.

Lecture 5A (pre-recorded video – 10 minutes): 

Topic: Implementation strategies

Lecturer: Laslie Johnson

Slides available: Colour (pdf) | Black and white (pdf)

Lecture 5B (pre-recorded video – 20 minutes): 

Topic: Study designs for implementation research

Lecturer: Vilma Irazola

Slides available: Colour (pdf) | Black and white (pdf)

Lecture 5D (pre-recorded video – 20 minutes):

Topic: Choosing and using implementation outcomes

Lecturer: Enola Proctor

Slides available: Colour (pdf) | Black and white (pdf)

Class/tutorial activities (70 minutes)

Discussion of key messages (10 minutes)

  1. The creation of a shared language for implementation strategies helps compare research findings.
  2. Defining the specifics of implementation strategies increases transparency and enables replication.
  3. Local context will influence which strategies are needed and the tailoring required.
  4. In implementation science, we use a broad range of study designs, both quantitative and qualitative, and most often, mixed-method approaches.
  5. Hybrid studies have a dual focus on implementation evaluation and clinical/health outcome effectiveness.
  6. There are three types of hybrid studies (1, 2 and 3).
  7. The difference between them relies on the hierarchy of clinical/health versus implementation outcomes.
  8. Implementation outcomes – such as adoption and feasibility – need to be measured distinct from intervention outcomes.
  9. Choosing which implementation outcomes to use in your research should be informed by the barriers of implementation adoption, the stage of implementation, and relevant theories.
  10. When reporting implementation outcomes, report the data source and the measurement.

Activity – Individual reflection or small group discussion (40 minutes) 

  • In small groups, identify a health problem to address (e.g., diabetes prevention, hypertension control, cancer screening) and choose a setting.
  • Discuss in your group:
    • What implementation barriers exist and which strategies could address your “know–do” gap?
    • Which study design (quantitative, qualitative, mixed-methods, or hybrid) would best suit your research question, and why?
    • What trade-offs might exist between methodological rigor and real-world relevance?
    • Which implementation outcomes (e.g., adoption, feasibility, fidelity) would you measure, and how could you ensure their reliability and sustainability over time?

Class discussion (20 minutes)

Each group to share a brief summary of your chosen project and key insights.

Instructions on adapting this material:

Please ensure this source is properly acknowledged when using any part of the lesson plan or associated materials in teaching or training.

Citation: Global Alliance for Chronic Diseases (GACD). (n.d.). Implementation Science e-Hub. Retrieved from https://implementationscience-gacd.org/

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