Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 27;19(11):e0310117.
doi: 10.1371/journal.pone.0310117. eCollection 2024.

Proposal of the Implementation Theory Selection Model and exemplar application in fall injury prevention

Alexandra M B Korall  1   2 , Helen Chong  3 , Vicki Komisar  3   4 , Dawn C Mackey  3 , Masood Khan  2 , Femke Hoekstra  5 , Susan G Brown  6 , Pauli Gardner  7 , Christine Hames  8 , Andrew C Laing  6   9 , Kathryn M Sibley  1   2
Affiliations

Proposal of the Implementation Theory Selection Model and exemplar application in fall injury prevention

Alexandra M B Korall et al. PLoS One. .

Abstract

Introduction: The use of theories, models and/or frameworks (TMFs) in implementation research and practice is essential for developing useful and testable implementation strategies. Recommendations and tools exist to aid implementation groups in selecting TMFs, but they do not explicitly outline a systematic method for identifying and selecting TMFs. This paper aimed to (1) propose a systematic consensus-based method to select TMFs to support implementation processes, and to (2) demonstrate the use of this novel method in the context of researching the implementation of hip protectors for fracture prevention in long-term care (LTC).

Materials & methods: We developed a systematic, consensus-based method for selecting TMFs, referred to as the Implementation Theory Selection Model (ITSM). The ITSM comprises five steps: (1) identify potentially relevant TMFs; (2) narrow the pool of TMFs; (3) appraise the relevance of eligible TMFs; (4) prioritize a short-list of TMFs for further, in-depth consideration; and (5) select TMFs through consensus with investigators and research user partners. We operationalized each step of the ITSM through a project investigating determinants of hip protector use and organizational readiness for implementation in a LTC organization in Ontario, Canada.

Results: Using the ITSM in our case example, we identified 66 TMFs (Step 1). Of these, 23 met our eligibility criteria (Step 2) and were appraised twice, by five appraisers (Step 3). Six TMFs (Step 4) advanced to the consensus meeting, which was attended by nine investigators and three research users, including two organizational partners and one older adult. Three rounds of voting yielded a tie between the TMFs the group felt would be most appropriate. Research users from our partner LTC organization made the final selection preferring the combination of the Practical, Robust Implementation and Sustainability Model and Consolidated Framework for Implementation Research (Step 5).

Conclusions: The ITSM offers a step-by-step guide for implementation groups to adopt a rigorous, transparent and reproducible method for TMF selection. Although we have demonstrated the feasibility of operationalizing each step of the ITSM in our case example, continued research is needed to evaluate and refine the ITSM to ensure it is appropriate for a wide variety of implementation contexts.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig 1
Fig 1. Illustration of the Implementation Theory Selection Model (ITSM).
TMF = Theory, Model and/or Framework.
Fig 2
Fig 2. Elimination process for the first two parallel rounds of consensus in our case example.
TMF = Theory, Model and/or Framework.
Fig 3
Fig 3. Flow of TMFs through the Implementation Theory Selection Model (ITSM) in our case example.
TMF = Theory, Model and/or Framework.
See this image and copyright information in PMC

References

    1. Proctor EK, Powell BJ, Baumann AA, Hamilton AM, Santens RL. Writing implementation research grant proposals: ten key ingredients. Implement Sci. 2012;7(1):96. doi: 10.1186/1748-5908-7-96 - DOI - PMC - PubMed
    1. Estabrooks CA, Thompson DS, Lovely JJE, Hofmeyer A. A guide to knowledge translation theory. J Contin Educ Health Prof. 2006;26(1):25–36. doi: 10.1002/chp.48 - DOI - PubMed
    1. Foy R, Ovretveit J, Shekelle PG, Pronovost PJ, Taylor SL, Dy S, et al.. The role of theory in research to develop and evaluate the implementation of patient safety practices. BMJ Quality & Safety. 2011;20(5):453. doi: 10.1136/bmjqs.2010.047993 - DOI - PubMed
    1. Moullin JC, Dickson KS, Stadnick NA, Albers B, Nilsen P, Broder-Fingert S, et al.. Ten recommendations for using implementation frameworks in research and practice. Implement Sci Commun. 2020;1(1):42. doi: 10.1186/s43058-020-00023-7 - DOI - PMC - PubMed
    1. Tinkle M, Kimball R, Haozous EA, Shuster G, Meize-Grochowski R. Dissemination and implementation research funded by the US national institutes of health, 2005–2012. Nurs Res Pract. 2013;2013:909606. doi: 10.1155/2013/909606 - DOI - PMC - PubMed