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. 2018 Nov 14;18(1):857.
doi: 10.1186/s12913-018-3671-z.

"There is nothing so practical as a good theory": a pragmatic guide for selecting theoretical approaches for implementation projects

Elizabeth A Lynch  1 , Alison Mudge  2 , Sarah Knowles  3 , Alison L Kitson  4 , Sarah C Hunter  4 , Gill Harvey  5
Affiliations

"There is nothing so practical as a good theory": a pragmatic guide for selecting theoretical approaches for implementation projects

Elizabeth A Lynch et al. BMC Health Serv Res. .

Abstract

Background: A multitude of theories, models and frameworks relating to implementing evidence-based practice in health care exist, which can be overwhelming for clinicians and clinical researchers new to the field of implementation science. Clinicians often bear responsibility for implementation, but may be unfamiliar with theoretical approaches designed to inform or understand implementation.

Main text: In this article, a multidisciplinary group of clinicians and health service researchers present a pragmatic guide to help clinicians and clinical researchers understand what implementation theories, models and frameworks are; how a theoretical approach to implementation might be used; and some prompts to consider when selecting a theoretical approach for an implementation project. Ten commonly used and highly cited theoretical approaches are presented, none of which have been utilised to their full potential in the literature to date. Specifically, theoretical approaches tend to be applied retrospectively to evaluate or interpret findings from a completed implementation project, rather than being used to plan and design theory-informed implementation strategies which would intuitively have a greater likelihood of success. We emphasise that there is no right or wrong way of selecting a theoretical approach, but encourage clinicians to carefully consider the project's purpose, scope and available data and resources to allow them to select an approach that is most likely to "value-add" to the implementation project.

Conclusion: By assisting clinicians and clinical researchers to become confident in selecting and applying theoretical approaches to implementation, we anticipate an increase in theory-informed implementation projects. This then will contribute to more nuanced advice on how to address evidence-practice gaps and ultimately to contribute to better health outcomes.

Keywords: Evidence-based practice; Implementation; Knowledge translation; Theory-informed.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

ALK and GH are developers of PARIHS framework and produced the refined version the i-PARIHS framework.

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Figures

Fig. 1
Fig. 1
Five questions to help select a theoretical approach
Fig. 2
Fig. 2
How a theoretical approach can support a project at different stages
See this image and copyright information in PMC

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