*IMPLEMENTATION SCIENCE > *Implementation Frameworks — What’s in the Box? > Flashcards

*Implementation Frameworks — What’s in the Box? Flashcards

(75 cards)

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1
Q

CFIR — what are the main domains?

A

Intervention Characteristics, Outer Setting, Inner Setting, Characteristics of Individuals, and Process. Orienting cue: CFIR describes multilevel determinants of implementation.

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2
Q

CFIR — what sits under Intervention Characteristics?

A

Evidence strength and quality, relative advantage, adaptability, trialability, complexity, design quality and packaging, and cost.

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3
Q

CFIR — what sits under Inner Setting?

A

Structural characteristics, networks and communications, culture, implementation climate, and readiness for implementation.

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4
Q

CFIR — what sits under Process?

A

Planning, engaging, executing, and reflecting and evaluating.

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5
Q

EPIS — what are the phases?

A

Exploration, Preparation, Implementation, and Sustainment. Orienting cue: EPIS provides a time-ordered view of change.

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6
Q

EPIS — what are the cross-cutting contexts?

A

Inner context, outer context, and bridging factors. Orienting cue: EPIS explicitly links phases and context.

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7
Q

RE-AIM — what does each letter stand for?

A

Reach, Effectiveness, Adoption, Implementation, and Maintenance. Orienting cue: RE-AIM describes real-world impact dimensions.

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8
Q

RE-AIM — which levels does it span?

A

Individual level, organisational or setting level, and system level over time.

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9
Q

Proctor implementation outcomes — what are they?

A

Acceptability, adoption, appropriateness, feasibility, fidelity, penetration, sustainability, and cost.

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10
Q

Proctor outcomes — what are they for?

A

To distinguish implementation success from clinical or service outcomes.

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11
Q

ERIC — what is it?

A

A taxonomy of implementation strategies consisting of 73 clustered strategies.

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12
Q

ERIC — what are example strategy clusters?

A

Training and educating stakeholders, adapting and tailoring to context, providing interactive assistance, changing infrastructure, and using evaluative strategies.

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13
Q

TDF — what does it stand for?

A

Theoretical Domains Framework. Purpose: synthesis of behaviour change theories.

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14
Q

TDF — what are the core domains?

A

Knowledge, skills, social or professional role, beliefs about capabilities, beliefs about consequences, environmental context and resources, and social influences.

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15
Q

COM-B — what are the components?

A

Capability, Opportunity, and Motivation. Orienting cue: behaviour occurs when all three are present.

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16
Q

COM-B — what sits under Capability?

A

Physical capability and psychological capability.

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17
Q

COM-B — what sits under Opportunity?

A

Physical opportunity and social opportunity.

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18
Q

COM-B — what sits under Motivation?

A

Reflective motivation and automatic motivation.

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19
Q

Behaviour Change Wheel — what are its layers?

A

COM-B at the centre, surrounded by intervention functions and policy categories.

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20
Q

Behaviour Change Wheel — what are intervention functions?

A

Education, persuasion, incentivisation, training, enablement, and environmental restructuring.

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21
Q

Normalisation Process Theory — what are the constructs?

A

Coherence, cognitive participation, collective action, and reflexive monitoring.

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22
Q

NPT — what does it focus on?

A

How practices become routinely embedded in everyday work.

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23
Q

RE-AIM versus Proctor outcomes — what’s the difference?

A

RE-AIM focuses on impact and reach; Proctor outcomes focus on implementation quality.

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24
Q

CFIR versus TDF — what’s the distinction?

A

CFIR addresses system-level determinants; TDF focuses on individual behaviour determinants.

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25
Logic model — what are the core components?
Inputs, activities, outputs, outcomes, and impact.
26
Theory of Change — what distinguishes it from a logic model?
Explicit articulation of causal assumptions and mechanisms.
27
RE-AIM plus EPIS — how do they complement?
EPIS explains when change occurs; RE-AIM clarifies what matters at scale.
28
CFIR plus ERIC — how are they paired?
CFIR identifies determinants; ERIC provides strategy options.
29
Which frameworks answer why versus how versus how well?
Why: CFIR and TDF. How: ERIC. How well: Proctor outcomes and RE-AIM.
30
In one line, what is this deck for?
Fast structural recall of major implementation frameworks without rereading the literature.
31
i-PARIHS — what are the core elements?
Innovation, Recipients, Context, and Facilitation. Orienting cue: PARIHS with facilitation made explicit.
32
i-PARIHS — what does it emphasise compared to CFIR?
Active facilitation and human support for change. Shortcut: CFIR explains what matters; i-PARIHS foregrounds who helps.
33
PARIHS (classic) — what are the elements?
Evidence, Context, and Facilitation. Orienting cue: Early implementation triad; less granular than CFIR.
34
CFIR 2.0 — what changed from original CFIR?
Streamlined constructs, clearer definitions, and an explicit equity orientation. Orienting cue: Evolution, not replacement.
35
Dynamic Sustainability Framework — core idea?
Interventions, context, and outcomes co-evolve over time. Orienting cue: Sustainment requires ongoing adaptation.
36
ExpandNet — what is it for?
Planning and managing scale-up, with focus on horizontal versus vertical scale and system readiness.
37
ExpandNet — what does it add beyond EPIS?
Explicit scale strategies and system alignment. Shortcut: EPIS defines phases; ExpandNet provides scaling logic.
38
PRISM — what does it extend?
Extends RE-AIM by adding contextual determinants and implementation infrastructure.
39
PRISM — why does it exist?
To explain why RE-AIM outcomes look the way they do. Shortcut: RE-AIM plus CFIR-lite.
40
NASSS — what does it stand for?
Non-adoption, Abandonment, Scale-up, Spread, and Sustainability. Originally developed for digital health.
41
NASSS — what does it focus on?
Why technologies fail to embed in complex systems. Shortcut: Digital implementation failure lens.
42
StaRI — what is it?
A reporting standard for implementation studies designed to improve clarity and transparency.
43
StaRI — when does it matter to practitioners?
When writing protocols, reviewing manuscripts, or teaching research literacy.
44
How do these Tier 2A frameworks relate to Tier 1?
CFIR provides determinant backbone, EPIS provides temporal structure, and RE-AIM frames outcomes. Tier 2A are variants, extensions, or emphases.
45
In one line, what is Tier 2A for?
Fast recognition of commonly cited frameworks without relearning the field.
46
Hybrid effectiveness–implementation designs — what are the types?
Type 1, Type 2, and Type 3. Orienting cue: Hybrid designs study effectiveness and implementation together.
47
Hybrid Type 1 — what is emphasised?
Clinical effectiveness is primary; implementation is secondary. Shortcut: Effectiveness trial with an implementation add-on.
48
Hybrid Type 2 — what is emphasised?
Effectiveness and implementation are equally emphasised. Shortcut: True dual-focus design.
49
Hybrid Type 3 — what is emphasised?
Implementation is primary; effectiveness is secondary. Shortcut: Implementation trial that still tracks outcomes.
50
Realist evaluation — what is the core logic?
Context–Mechanism–Outcome (CMO). Orienting cue: What works, for whom, in what circumstances?
51
Realist evaluation — what does “mechanism” mean?
How people respond to resources or opportunities. Shortcut: Not the intervention itself, but the response it triggers.
52
Process evaluation — what is it for?
To understand how an intervention was delivered and received, focusing on fidelity, reach, dose, and context.
53
MRC Process Evaluation — what are its components?
Implementation, mechanisms of impact, and context. Orienting cue: Structured unpacking of what happened.
54
Effectiveness vs implementation vs service outcomes — what’s the distinction?
Effectiveness: patient or population outcomes. Implementation: uptake, fidelity, sustainment. Service: efficiency, access, cost.
55
Fidelity — what does it mean formally?
The degree to which an intervention is delivered as intended. Note: distinct from quality or outcomes.
56
Adaptation — how is it treated in evaluation?
Intentional modification to improve fit. Orienting cue: Adaptation is not failure of fidelity.
57
Fidelity–adaptation tension — what is the core issue?
Preserving core mechanisms while allowing contextual fit. Shortcut: Protect the why, flex the how.
58
Pragmatic vs explanatory trials — what’s the difference?
Explanatory trials test under ideal conditions; pragmatic trials test under real-world conditions. Orienting cue: Pragmatic aligns better with implementation science.
59
PRECIS-2 — what is it?
A tool to rate how pragmatic a trial is across domains such as eligibility, setting, flexibility, and follow-up.
60
In one line, what is Tier 2B for?
Instant recognition of evaluation and study design terms used in implementation research.
61
SEIPS — what does it stand for?
System Engineering Initiative for Patient Safety. Orienting cue: Human factors model linking work system to processes and outcomes.
62
SEIPS — what are the main work system components?
Person, Tasks, Tools and technology, Physical environment, and Organisation.
63
Work-as-imagined vs work-as-done — what’s the distinction?
Work-as-imagined is how work is supposed to happen; work-as-done is how work actually happens. Orienting cue: The gap explains most implementation failures.
64
Why is work-as-imagined versus work-as-done important in implementation?
Because implementation plans often describe work-as-imagined only. Shortcut: Design must target work-as-done.
65
Complex Adaptive Systems (CAS) — what does this mean?
Systems with interacting agents, feedback loops, and non-linear effects. Orienting cue: Healthcare is not mechanically predictable.
66
CAS — what does it challenge in implementation thinking?
Linear cause–effect assumptions and one-size-fits-all solutions. Shortcut: Small changes can have large effects.
67
Resilience engineering — core focus?
How systems adapt and succeed under varying conditions. Orienting cue: Success and failure arise from the same adaptations.
68
Safety-I vs Safety-II — what’s the difference?
Safety-I focuses on preventing things going wrong; Safety-II focuses on understanding how things go right. Orienting cue: Safety-II aligns with implementation learning.
69
Why is Safety-II relevant to implementation?
Because implementation relies on everyday adaptations rather than perfect compliance. Shortcut: Learn from success, not just failure.
70
Burden — how is it framed in implementation?
Cognitive, temporal, and emotional load imposed by change. Orienting cue: Burden predicts abandonment.
71
Moral injury — how does it appear in implementation?
When staff are asked to deliver care they believe is compromised by system constraints. Shortcut: Poor implementation can cause moral harm.
72
Equity-focused implementation — what does it emphasise?
Differential access, burden, and benefit across populations. Orienting cue: Implementation can widen or narrow inequities.
73
Why is equity a design issue in implementation?
Because uniform interventions affect unequal systems differently. Shortcut: Fair is not the same as equal.
74
How do these boundary frameworks support OHFE credibility?
They legitimise human factors insights and bridge safety, equity, and implementation. Orienting cue: Shared language enables influence.
75
In one line, what is Tier 2C for?
Recognising and using boundary frameworks that connect implementation science to human factors, safety, and equity.
*IMPLEMENTATION SCIENCE
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