Adaptive Designs in Implementation Science and Practice: Their Promise and the Need for Greater Understanding and Improved Communication

Author:

Kilbourne Amy12,Chinman Matthew345,Rogal Shari46,Almirall Daniel7

Affiliation:

1. Quality Enhancement Research Initiative, U.S. Department of Veterans Affairs, Washington, District of Columbia, USA

2. Department of Learning Health Science, University of Michigan Medical School, Ann Arbor, Michigan, USA;

3. RAND Corporation, Pittsburgh, Pennsylvania, USA

4. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA

5. Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA

6. Departments of Medicine and Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

7. Institute for Social Research and Department of Statistics, University of Michigan, Ann Arbor, Michigan, USA

Abstract

The promise of adaptation and adaptive designs in implementation science has been hindered by the lack of clarity and precision in defining what it means to adapt, especially regarding the distinction between adaptive study designs and adaptive implementation strategies. To ensure a common language for science and practice, authors reviewed the implementation science literature and found that the term adaptive was used to describe interventions, implementation strategies, and trial designs. To provide clarity and offer recommendations for reporting and strengthening study design, we propose a taxonomy that describes fixed versus adaptive implementation strategies and implementation trial designs. To improve impact, ( a) future implementation studies should prespecify implementation strategy core functions that in turn can be taught to and replicated by health system/community partners, ( b) funders should support exploratory studies that refine and specify implementation strategies, and ( c) investigators should systematically address design requirements and ethical considerations (e.g., randomization, blinding/masking) with health system/community partners. Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Publisher

Annual Reviews

Subject

Public Health, Environmental and Occupational Health,General Medicine

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