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Review
. 2020 Aug 27;15(1):68.
doi: 10.1186/s13012-020-01003-0.

The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature

Anna Bergström  1   2 , Anna Ehrenberg  3   4 , Ann Catrine Eldh  5   6 , Ian D Graham  7   8 , Kazuko Gustafsson  3   9 , Gillian Harvey  4 , Sarah Hunter  10 , Alison Kitson  10   11 , Jo Rycroft-Malone  12 , Lars Wallin  3   13
Affiliations
Review

The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature

Anna Bergström et al. Implement Sci. .

Abstract

Background: The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework.

Methods: This citation analysis commenced from four core articles representing the key stages of the framework's development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail.

Results: The citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated.

Conclusions: In line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.

Keywords: Citation analysis; Implementation science; Knowledge translation; PARIHS framework.

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Conflict of interest statement

We acknowledge that GH, AK, and JRM were all involved in the development of the PARIHS framework. Further, IDG, JRM, and LW are all members of the BMC Implementation Science Editorial Board.

Figures

Fig. 1
Fig. 1
Adapted PRISMA flow diagram
Fig. 2
Fig. 2
Types of articles published before December 31 using the PARIHS framework
Fig. 3
Fig. 3
Use of the PARIHS framework by type of article
See this image and copyright information in PMC

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