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All about Implementation Research (IR)

A manual from MEASURE Evaluation : Fundamentals of Implementation Research. It written on What’s IR (defined what’s IR, implementation research), How it works (the framework of IR) and why we need IR (the application and questions of IR).

The function of IR includes

  • Identifying implementation problems that hinder access to interventions, and delivery of services, as well as usability of evidence-based interventions, and their main determinants  认识实施中的问题
  • Developing and testing practical solutions to these problems that are specific to particular health systems and environments or that address a problem common to a region 开发和测试实际解决方案
  • Identifying how evidence-based interventions, tools, and services should be modified to achieve sustained health impacts in real-world settings, including low- and middle-income countries  识别出项目中的工具、方法和服务等是如何起作用的
  • Determining the best way to introduce practical solutions into health systems and facilitating their full-scale implementation, evaluation and modification  制定最佳的实践方案

Characteristic:

Systematic, Multidisciplinary (Not only one area, but also many relevant things), Contextual and Complex.

How it works?

you should answer following questions:

Scale up: How can a program be scaled up to broader regions or populations?

Sustainability: How can sustainability  be achieved?

Replication and robustness: How can implementation be improved to assure replicability? Can you copy this program to another place?

Program integration : How your program combined with another resources/programs ?

Equitability: Is it equal for everyone who involved ?

Real-life effectivenes : Does the program achieve the intended  impact?

The questions and application

Identifying IR Constraints(约束)

1.Systematic analysis to identify IR constraints

2.Discussion with all concerned stakeholders

3.Routine monitoring of program activities.

4. Annual review meeting

Formulating IR questions

Try to answer following questions when you design questionnaire.

•  How could it best be answered?
•  How could it feasibly be answered?
•  What data is available? What data is needed?
•  What is there control over?

Your approach for formulating an IR question depends on context and availability of information.  Remember that IR problems are program embedded – they begin and end in programs.  So, engage program stakeholders early to formulate IR questions.  The way youformulate your question will drive your research methods.  These are helpful sources forformulating IR questions:
•  Program progress or evaluation reports from monitoring and evaluation activities 项目监测评估报告
•  Medical literature, meta-analyses, and literature reviews 相关的项目评估/回顾(本手册以健康项目为例,是以会出现Medical、Health等字眼)
•  Scientific meetings and conferences 学术报告和会议
•  New ideas from previous research or formative qualitative studies (e.g., interviews) 之前的相关研究
•  Funding agencies’ annual reports 筹资部门店年度报告
•  Questions asked by program staff and students 项目工作人员所提出的问题
•  Local documents – project progress reports, theses, dissertations, seminar proceedings 本地文档——项目进展报告、季度报告等等
•  Analyzing GIS data to identify geographic location and distribution of problems 国家级的数据系统信息等等

Prioritizing IR Questions

  • Relevance 相关性
  • Avoidance of duplication 避免重复
  • Urgency of need 紧急程度如何
  • Political acceptability 政治上的可接受程度
  • Feasibility 可行性,这个研究有多复杂?
  • Applicability of results or recommendation 研究结果的可用性
  • Ethical acceptability 是否符合伦理

Engaging Stakeholders in IR

A good rule of thumb to engage stakeholders from the very beginning is ‘Begin with the end inmind.’  IR relies on many perspectives, so it helps to get a lot of people involved.  Some usefulprinciples for engaging stakeholders include:

•  Engage early and often
•  Engage underrepresented groups and multiple perspectives
•  Frame issues in ways that are congruent with the mission and values of stakeholders
•  Stakeholders are valuable sources of information, and they can link you to other stakeholders

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