A Method for Tracking Implementation Strategies: An Exemplar Implementing Measurement-Based Care in Community Behavioral Health Clinics
Open accessAbstract
Implementation experts suggest tailoring strategies to the intended context may enhance outcomes. However, it remains unclear which strategies are best suited to address specific barriers to implementation, in part because few measurement methods exist that adhere to recommendations for reporting. In the context of a dynamic cluster randomized trial comparing a standardized to tailored approach to implementing measurement-based care (MBC), this study aimed to (a) describe a method for tracking implementation strategies, (b) demonstrate the method by tracking strategies generated by teams tasked with implementing MBC at their clinics in the tailored condition, and (c) conduct preliminary examinations of the relation between strategy use and implementation outcomes (i.e., self-reported fidelity to MBC). The method consisted of a coding form based on Proctor, Powell, and McMillen (2013) implementation strategy reporting guidelines and Powell et al.'s (2012) taxonomy to facilitate specification of the strategies. A trained research specialist coded digitally recorded implementation team meetings. The method allowed for the following characterization of strategy use. Each site generated 39 unique strategies across an average of six meetings in five months. There was little variability in the use of types of implementation strategies across sites with the following order of prevalence: quality management (50.00%), restructuring (16.53%), communication (15.68%), education (8.90%), planning (7.20%), and financing (1.69%). We identified a new category of strategies not captured by the existing taxonomy, labeled "communication." There was no evidence that number of implementation strategies enacted was statistically significantly associated with changes in self-reported fidelity to MBC-however, financing strategies were associated with increased fidelity. This method has the capacity to yield rich data that will inform investigations into tailored implementation approaches.
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Changes to implementation strategies are likely to occur within and between implementing sites in research studies and applied efforts.
“These changes are likely to occur within and between implementing sites in research studies and applied efforts (50, 51), and without rigorous methods for tracking implementation strategy use, efforts to understand what strategies were used and whether or not they were effective are stymied.”
From Enhancing the Impact of Implementation Strategies in Healthcare: A Research Agenda (2019) · cites this paper as [51]
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Sacca, L., Shegog, R., Hernandez, B., Peskin, M. F., Rushing, S. C., Jessen, C. M., Lane, T. L., & Markham, C. M. (2022) · Implementation Science · doi:10.1186/s13012-022-01190-y · Cited by 39 · see citing works
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Factors Associated with Effective Implementation: Research and Practical Implications
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Self-citationAdvancing Implementation Science Measurement
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Fridberg, H., Wallin, L., & Tistad, M. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08846-x · Cited by 20 · see citing works
Lewis, C. C., Marti, C. N., Scott, K., Walker, M. R., Boyd, M. R., Puspitasari, A. J., Mendel, P. J., & Kroenke, K. (2022) · Psychiatric Services · doi:10.1176/appi.ps.202100284 · Cited by 18 · see citing works
Self-citationAllen, C. G., Judge, D. P., Levin, E., Sterba, K. R., Hunt, K. J., Ramos, P. S., Melvin, C. L., Wager, K. A., Catchpole, K. C., Clinton, C., et al. (2022) · Implementation Science Communications · doi:10.1186/s43058-022-00286-2 · Cited by 18 · see citing works
Metz, A. J. R., Boaz, A., & Powell, B. J. (2019) · Evidence & Policy · doi:10.1332/174426419x15579811791990 · Cited by 16 · see citing works
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Douglas, S., Bovendeerd, B., van Sonsbeek, M., Manns, M., Milling, X. P., Tyler, K., Bala, N., Satterthwaite, T., Hovland, R. T., Amble, I., et al. (2023) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-023-01314-6 · Cited by 9 · see citing works
En Route to Implementation Science 3.0
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Danish, A., Chouinard, M., Aubrey‐Bassler, K., Burge, F., Doucet, S. A., Ramsden, V. R., Bisson, M., Cassidy, M., Condran, B. R., Lambert, M., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-038241 · Cited by 15 · see citing works
Justice community opioid innovation network (JCOIN): The TCU research hub
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Self-citationHyzak, K. A., Bunger, A. C., Herrmann, S. A., Kerlek, A. J., Lauden, S. M., Dudley, S., Underwood, A. L., & Berlan, E. D. (2023) · Global Implementation Research and Applications · doi:10.1007/s43477-023-00082-7 · Cited by 13 · see citing works
Zulkiewicz, B. A., Burrus, O., Harshbarger, C. L., Ortiz, A., Garner, B. R., & Lewis, M. A. (2020) · AIDS and Behavior · doi:10.1007/s10461-020-02944-9 · Cited by 12 · see citing works
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Czosnek, L., Rankin, N. M., Cormie, P., Murnane, A., Turner, J., Richards, J. A., Rosenbaum, S., & Zopf, E. M. (2023) · Supportive Care in Cancer · doi:10.1007/s00520-023-07844-x · Cited by 10 · see citing works
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A typology of useful evidence: approaches to increase the practical value of intervention research
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Vax, S., Gidugu, V., Farkas, M. D., & Drainoni, M. (2021) · Implementation Research and Practice · doi:10.1177/2633489520988254 · Cited by 16 · see citing works
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Ko, H., Gatto, A. J., Jones, S. B., O’Brien, V. C., McNamara, R. S., Tenzer, M. M., Sharp, H. D., Kablinger, A. S., & Cooper, L. D. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-09202-3 · Cited by 8 · see citing works
Allen, C. G., Judge, D. P., Nietert, P. J., Hunt, K. J., Jackson, A., Gallegos, S., Sterba, K. R., Ramos, P. S., Melvin, C. L., Wager, K. A., et al. (2023) · Translational Behavioral Medicine · doi:10.1093/tbm/ibad006 · Cited by 6 · see citing works
van Engen, V., Bonfrer, I., Ahaus, K., Hollander-Ardon, M. D., Peters, I. A., & Buljac‐Samardžić, M. (2024) · Journal of Medical Internet Research · doi:10.2196/60306 · Cited by 5 · see citing works
Reisinger, H. S., Barron, S., Balkenende, E., Steffen, M. J. A., Steffensmeier, K. S., Richards, C., Ball, D. D., Chasco, E. E., Tiem, J. M. V., Johnson, N. L., et al. (2024) · Health Services Research · doi:10.1111/1475-6773.14377 · Cited by 5 · see citing works
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Venâncio, S. I., Relvas, G. R. B., Melo, D. S., de Souza, C. B., Moreira, H. D. O. M., Veras, J. J. P., Veiga, M. M. L., Ramos, M. K. P., Ferreira, R. A. B., Alves, V. H., et al. (2023) · Global Implementation Research and Applications · doi:10.1007/s43477-023-00098-z · Cited by 4 · see citing works
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Zulu, J. M., Maritim, P., Halwiindi, H., Chavula, M. P., Munakampe, M. N., Matenga, T. F. L., Mweemba, C., Sinyangwe, N. N., Habib, B., Musukuma, M., et al. (2024) · Archives of Public Health · doi:10.1186/s13690-024-01384-4 · Cited by 3 · see citing works
Nguyen, M. X., Bartels, S. M., Akiba, C. F., Sripaipan, T., Nong, H. T. T., Dang, L. T., Hà, T. V., Hoang, V. T., Giang, L. M., Go, V. F.-L., et al. (2024) · BMC Medical Research Methodology · doi:10.1186/s12874-024-02367-3 · Cited by 2 · see citing works
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Implementation of the Wolverine Mental Health Program, Part 3: Sustainment Phase
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Connors, E. H., Selino, S., Almirall, D., Fusco, N., & Tebes, J. K. (2025) · Implementation Research and Practice · doi:10.1177/26334895251363416 · Cited by 2 · see citing works
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Self-citationA Pilot Study Comparing Tools for Tracking Implementation Strategies and Treatment AdaptationsPreprint
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Self-citationSiegle, A., zu Sayn-Wittgenstein-Hohenstein, F., & Roes, M. (2020) · Implementation Science · doi:10.1186/s13012-020-01033-8 · Cited by 2 · see citing works
Multi Methods Assessment of Technical Assistance for Community-Based Food Access Organizations
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Evaluating Implementation Strategies
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- Authors
- Boyd, M. R., Powell, B. J., Endicott, D., & Lewis, C. C.
- Affiliations
- Indiana University (US)
- University of North Carolina at Chapel Hill (US)
- Kaiser Permanente Washington Health Research Institute (US)
- Corresponding author
- Boyd, Meredith R.
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 49
- Issue
- 4
- Pages
- 525-537
- ISSN
- 0005-7894 (ISSN-L)
- PMC
- PMC6020155
- OpenAlex
- W2772841284
- Cited by
- 137
- References
- 62
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 14 · 2023: 25 · 2022: 23 · 2021: 20 · 2020: 29 · 2019: 11 · 2018: 3
- FWCI
- 18.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Behavior Therapy (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- National Institute of Mental Health of the National Institutes of Health (R01MH103310)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- measurement-based care, implementation strategies, implementation fidelity, tailored implementation, implementation outcomes, financing strategy, quality management, communication strategies, implementation barriers
- MeSH terms
- Adult, Community Mental Health Centers, Female, Patient Care, Health Plan Implementation, Humans, Male, Middle Aged, Psychiatry, Cluster Analysis
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