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Powell BJ, Waltz TJ, Chinman MJ, Damschroder LJ, Smith JL, Matthieu MM, Proctor EK, Kirchner JE, Janney CA. A refined compilation of implementation strategies. Poster session presented at: National Institutes of Health / AcademyHealth Conference on the Science of Dissemination and Implementation; 2014 Dec 8; Bethesda, MD.
Title: A Refined Compilation of Implementation Strategies: Results from Modified Delphi and Concept Mapping Exercises
Introduction: Efforts to identify, develop, and test implementation strategies have been complicated by the use of inconsistent language and inadequate descriptions of implementation strategies in the scholarly literature. A literature-based compilation of strategies was developed to address this problem (Powell et al., 2012). Using innovative and rigorous methods, the current study further refines and improves that compilation by establishing expert consensus on implementation strategy terms, definitions, and categories that can be used to guide implementation research and practice.
Methods: Purposive sampling was used to recruit a panel of implementation experts and clinical managers. The expert panel was engaged in a three-round modified Delphi process to generate consensus on strategies and definitions. The first and second rounds (36 and 43 participants respectively) involved web-based surveys that prompted comments on implementation strategy terms and definitions. After each round, iterative refinements were made based upon participants' feedback. The third round (32 participants) involved a live, web-based polling and consensus process. Finally, the expert panel completed a concept mapping exercise using Concept Systems Global Max that generated conceptually distinct categories of strategies, and provided a depiction of the relationships between them.
Findings: The modified Delphi process yielded a refined compilation of 73 implementation strategies and definitions that were grouped into nine categories (e.g., utilize financial strategies) based upon the concept mapping exercise. Graphical representations of the interrelationships among the strategies are also provided. This research advances the field by improving the conceptual clarity of implementation strategies that can be used in isolation or combination in implementation research and practice.
Acknowledgments: Primary funding for this research was provided by the U.S. Department of Veterans Affairs Veterans Health Administration's Mental Health Quality Enhancement Research Initiative (QLP 55-025).