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      Differing conceptual maps of skills for implementing evidence-based interventions held by community-based organization practitioners and academics: A multidimensional scaling comparison

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          Abstract

          Community-based organizations (CBOs) are critical for delivering evidence-based interventions (EBIs) to address cancer inequities. However, a lack of consensus on the core skills needed for this work often hinders capacity-building strategies to support EBI implementation. The disconnect is partly due to differing views of EBIs and related skills held by those typically receiving versus developing capacity-building interventions (here, practitioners and academics, respectively). Our team of implementation scientists and practice-based advisors used group concept mapping to engage 34 CBO practitioners and 30 academics with experience addressing cervical cancer inequities implementing EBIs. We created group-specific maps of skills using multidimensional scaling and hierarchical cluster analysis, then compared them using Procrustes comparison permutations. The 98 skills were sorted into six clusters by CBO practitioners and five by academics. The groups generated maps with statistically comparable underlying structures but also statistically significant divergence. Some skill clusters had high concordance across the two maps, e.g. “managing funding and external resources.” Other skill clusters, e.g. “adapting EBIs” from the CBO practitioner map and “selecting and adapting EBIs” from the academic map, did not overlap as much. Across groups, key clusters of skills included connecting with community members, understanding the selected EBI and community context, adapting EBIs, building diverse and equitable partnerships, using data and evaluation, and managing funding and external resources. There is a significant opportunity to combine CBO practitioners’ systems/community frames with the EBI-focused frame of academics to promote EBI utilization and address cancer and other health inequities.

          Abstract

          This group concept mapping study draws on the expertise of 34 community-based organizations (CBO) practitioners and 30 academics addressing cervical cancer inequities to explore important differences in conceptualizing core skills needed to implement evidence-based interventions. Convergence and divergence between group-specific skills maps suggest that capacity-building interventions must integrate differing perspectives held by practitioners and academics.

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          Systematic review of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework

          Background Effective implementation of evidence-based practices (EBPs) remains a significant challenge. Numerous existing models and frameworks identify key factors and processes to facilitate implementation. However, there is a need to better understand how individual models and frameworks are applied in research projects, how they can support the implementation process, and how they might advance implementation science. This systematic review examines and describes the research application of a widely used implementation framework, the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Methods A systematic literature review was performed to identify and evaluate the use of the EPIS framework in implementation efforts. Citation searches in PubMed, Scopus, PsycINFO, ERIC, Web of Science, Social Sciences Index, and Google Scholar databases were undertaken. Data extraction included the objective, language, country, setting, sector, EBP, study design, methodology, level(s) of data collection, unit(s) of analysis, use of EPIS (i.e., purpose), implementation factors and processes, EPIS stages, implementation strategy, implementation outcomes, and overall depth of EPIS use (rated on a 1–5 scale). Results In total, 762 full-text articles were screened by four reviewers, resulting in inclusion of 67 articles, representing 49 unique research projects. All included projects were conducted in public sector settings. The majority of projects (73%) investigated the implementation of a specific EBP. The majority of projects (90%) examined inner context factors, 57% examined outer context factors, 37% examined innovation factors, and 31% bridging factors (i.e., factors that cross or link the outer system and inner organizational context). On average, projects measured EPIS factors across two of the EPIS phases (M = 2.02), with the most frequent phase being Implementation (73%). On average, the overall depth of EPIS inclusion was moderate (2.8 out of 5). Conclusion This systematic review enumerated multiple settings and ways the EPIS framework has been applied in implementation research projects, and summarized promising characteristics and strengths of the framework, illustrated with examples. Recommendations for future use include more precise operationalization of factors, increased depth and breadth of application, development of aligned measures, and broadening of user networks. Additional resources supporting the operationalization of EPIS are available. Electronic supplementary material The online version of this article (10.1186/s13012-018-0842-6) contains supplementary material, which is available to authorized users.
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            Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study

            Background Poor terminological consistency for core concepts in implementation science has been widely noted as an obstacle to effective meta-analyses. This inconsistency is also a barrier for those seeking guidance from the research literature when developing and planning implementation initiatives. The Expert Recommendations for Implementing Change (ERIC) study aims to address one area of terminological inconsistency: discrete implementation strategies involving one process or action used to support a practice change. The present report is on the second stage of the ERIC project that focuses on providing initial validation of the compilation of 73 implementation strategies that were identified in the first phase. Findings Purposive sampling was used to recruit a panel of experts in implementation science and clinical practice (N = 35). These key stakeholders used concept mapping sorting and rating activities to place the 73 implementation strategies into similar groups and to rate each strategy’s relative importance and feasibility. Multidimensional scaling analysis provided a quantitative representation of the relationships among the strategies, all but one of which were found to be conceptually distinct from the others. Hierarchical cluster analysis supported organizing the 73 strategies into 9 categories. The ratings data reflect those strategies identified as the most important and feasible. Conclusions This study provides initial validation of the implementation strategies within the ERIC compilation as being conceptually distinct. The categorization and strategy ratings of importance and feasibility may facilitate the search for, and selection of, strategies that are best suited for implementation efforts in a particular setting. Electronic supplementary material The online version of this article (doi:10.1186/s13012-015-0295-0) contains supplementary material, which is available to authorized users.
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              Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation.

              If we keep on doing what we have been doing, we are going to keep on getting what we have been getting. Concerns about the gap between science and practice are longstanding. There is a need for new approaches to supplement the existing approaches of research to practice models and the evolving community-centered models for bridging this gap. In this article, we present the Interactive Systems Framework for Dissemination and Implementation (ISF) that uses aspects of research to practice models and of community-centered models. The framework presents three systems: the Prevention Synthesis and Translation System (which distills information about innovations and translates it into user-friendly formats); the Prevention Support System (which provides training, technical assistance or other support to users in the field); and the Prevention Delivery System (which implements innovations in the world of practice). The framework is intended to be used by different types of stakeholders (e.g., funders, practitioners, researchers) who can use it to see prevention not only through the lens of their own needs and perspectives, but also as a way to better understand the needs of other stakeholders and systems. It provides a heuristic for understanding the needs, barriers, and resources of the different systems, as well as a structure for summarizing existing research and for illuminating priority areas for new research and action.
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                Author and article information

                Contributors
                Journal
                Transl Behav Med
                Transl Behav Med
                tbm
                Translational Behavioral Medicine
                Oxford University Press (US )
                1869-6716
                1613-9860
                January 2025
                20 November 2024
                20 November 2024
                : 15
                : 1
                : ibae051
                Affiliations
                Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health , Boston, MA 02115, USA
                Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health , Boston, MA 02115, USA
                Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health , Boston, MA 02115, USA
                Conservation Law Foundation , Boston, MA 02110, USA
                Rhode Island Department of Health , Providence, RI 02908, USA
                Curriculum & Instruction, University of Massachusetts Boston , Boston, MA 02125, USA
                Community Benefits, Tufts Medicine , Burlington, MA 01803, USA
                Boys and Girls Club of Worcester , Worcester, MA 01610, USA
                American Heart Association , Waltham, MA 02451, USA
                St. Mark Congregational Church , Boston, MA 02121, USA
                Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health , Boston, MA 02115, USA
                Concept Systems, Inc. , Ithaca, NY, USA
                Public Health and Preventive Medicine, SUNY Upstate Medical University , Syracuse, NY, USA
                Author notes
                Correspondence address. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston MA 02115, USA. Tel: 617-432-1872; E-mail: sramanadhan@ 123456hsph.harvard.edu
                Author information
                https://orcid.org/0000-0003-0650-9433
                Article
                ibae051
                10.1093/tbm/ibae051
                11756311
                39566021
                cca7edc4-e30c-4d74-977c-678d2433c62b
                © The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Pages: 11
                Categories
                Original Research
                AcademicSubjects/MED00860
                AcademicSubjects/SCI02170

                Neurology
                evidence-based interventions,implementation science,community-based organizations,capacity-building,group concept mapping,health inequities

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