Abstract
Abstract
Background
Implementation science aims to accelerate the public health impact of evidence-based interventions. However, implementation science has had too little focus on the role of health policy — and its inseparable politics, polity structures, and policymakers — in the implementation and sustainment of evidence-based healthcare. Policies can serve as determinants, implementation strategies, the evidence-based “thing” to be implemented, or another variable in the causal pathway to healthcare access, quality, and patient outcomes. Research describing the roles of policy in dissemination and implementation (D&I) efforts is needed to resolve persistent knowledge gaps about policymakers’ evidence use, how evidence-based policies are implemented and sustained, and methods to de-implement policies that are ineffective or cause harm. Few D&I theories, models, or frameworks (TMF) explicitly guide researchers in conceptualizing where, how, and when policy should be empirically investigated. We conducted and reflected on the results of a scoping review to identify gaps of existing Exploration, Preparation, Implementation, and Sustainment (EPIS) framework-guided policy D&I studies. We argue that rather than creating new TMF, researchers should optimize existing TMF to examine policy’s role in D&I. We describe six recommendations to help researchers optimize existing D&I TMF. Recommendations are applied to EPIS, as one example for advancing TMF for policy D&I.
Recommendations
(1) Specify dimensions of a policy’s function (policy goals, type, contexts, capital exchanged).
(2) Specify dimensions of a policy’s form (origin, structure, dynamism, outcomes).
(3) Identify and define the nonlinear phases of policy D&I across outer and inner contexts.
(4) Describe the temporal roles that stakeholders play in policy D&I over time.
(5) Consider policy-relevant outer and inner context adaptations.
(6) Identify and describe bridging factors necessary for policy D&I success.
Conclusion
Researchers should use TMF to meaningfully conceptualize policy’s role in D&I efforts to accelerate the public health impact of evidence-based policies or practices and de-implement ineffective and harmful policies. Applying these six recommendations to existing D&I TMF advances existing theoretical knowledge, especially EPIS application, rather than introducing new models. Using these recommendations will sensitize researchers to help them investigate the multifaceted roles policy can play within a causal pathway leading to D&I success.
Funder
National Institute on Drug Abuse
Medical Research Future Fund
National Institute of Mental Health
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Health Informatics,Health Policy,General Medicine
Cited by
24 articles.
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