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Article
Advancing Evidence Synthesis from Effectiveness to Implementation: Integration of Implementation Measures into Evidence Reviews
Journal of General Internal Medicine (2020)
  • Aaron A. Tierney, Stanford University School of Medicine
  • Marie C. Haverfield, San Jose State University
  • Mark P. McGovern, VA Health Care System
  • Donna M. Zulman, Stanford University School of Medicine
Abstract
Background
In order to close the gap between discoveries that could improve health, and widespread impact on routine health care practice, there is a need for greater attention to the factors that influence dissemination and implementation of evidence-based practices. Evidence synthesis projects (e.g., systematic reviews) could contribute to this effort by collecting and synthesizing data relevant to dissemination and implementation. Such an advance would facilitate the spread of high-value, effective, and sustainable interventions.

Objective
The objective of this paper is to evaluate the feasibility of extracting factors related to implementation during evidence synthesis in order to enhance the replicability of successes of studies of interventions in health care settings.

Design
Drawing on the implementation science literature, we suggest 10 established implementation measures that should be considered when conducting evidence synthesis projects. We describe opportunities to assess these constructs in current literature and illustrate these methods through an example of a systematic review.

Subjects
Twenty-nine studies of interventions aimed at improving clinician-patient communication in clinical settings.

Key Results
We identified acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, intervention complexity, penetration, reach, and sustainability as factors that are feasible and appropriate to extract during an evidence synthesis project.

Conclusions
To fully understand the potential value of a health care innovation, it is important to consider not only its effectiveness, but also the process, demands, and resource requirements involved in downstream implementation. While there is variation in the degree to which intervention studies currently report implementation factors, there is a growing demand for this information. Abstracting information about these factors may enhance the value of systematic reviews and other evidence synthesis efforts, improving the dissemination and adoption of interventions that are effective, feasible, and sustainable across different contexts.
Keywords
  • implementation science,
  • evidence synthesis,
  • systematic reviews,
  • data extraction
Publication Date
April, 2020
DOI
10.1007/s11606-019-05586-3
Publisher Statement
This is the Version of Record. SJSU users: You can also use the following link to login and access the article via SJSU databases.
Citation Information
Aaron A. Tierney, Marie C. Haverfield, Mark P. McGovern and Donna M. Zulman. "Advancing Evidence Synthesis from Effectiveness to Implementation: Integration of Implementation Measures into Evidence Reviews" Journal of General Internal Medicine Vol. 35 Iss. 4 (2020) p. 1219 - 1226
Available at: http://works.bepress.com/marie-haverfield/20/