Building expert consensus for characterizing implementation strategies

Powell BJ, Waltz TJ, Matthieu MM, Chinman MJ, Smith JL, Damschroder LJ, Kirchner JE, Proctor EK. Building expert consensus for characterizing implementation strategies. Paper presented at: National Institutes of Health / AcademyHealth Conference on the Science of Dissemination and Implementation; 2014 Dec 9; Bethesda, MD.

Abstract: Efforts to identify, develop, and test implementation strategies have been complicated by the use of inconsistent language and inadequate descriptions of strategies in the scholarly literature. A literature based compilation of strategies was developed to address this problem (Powell et al., 2012); however, its development was not informed by the participation of a wide-range of implementation and clinical experts. This presentation describes our effort to further refine that compilation for use in the VA by establishing expert consensus on strategy terms, definitions, and categories that can be used to guide implementation research. Purposive sampling was used to recruit an expert panel comprised of implementation science experts and VA clinical managers. Specifically, a reputation-based snowball sampling approach was used in which an initial list of experts was developed by members of the study team. This list included the editorial board of the journal Implementation Science, Implementation Research Coordinators from the VA QUERI program, and faculty from the NIH-funded Implementation Research Institute. The Expert Panel was engaged in a three-round modified Delphi process to generate consensus on strategies and definitions. The first and second rounds involved web-based surveys that prompted comments on implementation strategy terms and definitions. The initial survey was seeded with strategy terms and definitions from the Powell et al. (2012) compilation. After each round, iterative refinements were made to the compilation based upon participants' feedback. The third round involved a live, web-based polling process and consensus process that yielded a final compilation of 73 strategies and definitions. This presentation highlights the advantages and challenges associated with using asynchronous and live web based methods for obtaining wide participation of experts.