CoChat
Sign Up
Cited by 197Health Policy Implementation ScienceClinical practice guidelines implementationHealth Sciences Research and Education

The DOI matches its Crossref record; 87 of the 88 references it cites were found in a registry or an index.

Context and implementation: A concept analysis towards conceptual maturity

Open access
Pfadenhauer, Lisa Maria, Mozygemba, Kati, Gerhardus, Ansgar, Hofmann, Bjørn, Booth, Andrew, Lysdahl, Kristin Bakke, Tummers, Marcia, Burns, Jacob, Rehfuess, Eva Annette·2015·Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
DOI 10.1016/j.zefq.2015.01.004
Open this paper in CoChat — free accountOpen PDF

Abstract

Context and implementation of health interventions have received increasing attention over the past decade, in particular with respect to their influence on the effectiveness and reach of complex interventions. The underlying concepts are both considered partially mature, limiting their operationalization in research and practice. We conducted systematic literature searches and pragmatic utility (PU) concept analyses to provide a state-of-the-art assessment of the concepts of "context" and "implementation" in the health sciences to create a common understanding for their use within systematic reviews and HTA. We performed two separate searches, one for context (EMBASE, MEDLINE) and the other for implementation (Google Scholar) to identify relevant models, theories and frameworks. 17 publications on context and 35 articles on implementation met our inclusion criteria. PU concept analysis comprises three guiding principles: selection of the literature, organization and structuring of the literature, and asking analytic questions of the literature. Both concepts were analyzed according to four features of conceptual maturity, i.e., consensual definitions, clear characteristics, fully described preconditions and outcomes, and delineated boundaries. Context and implementation are highly intertwined, with both concepts influencing and interacting with each other. Context is defined as a set of characteristics and circumstances that surround the implementation effort. Implementation is conceptualized as a planned and deliberately initiated effort with the intention to put an intervention into practice. The concept of implementation presents largely consensual definitions and relatively well-defined boundaries, while distinguishing features, preconditions and outcomes are not yet fully articulated. In contrast, definitions of context vary widely, and boundaries with neighbouring concepts, such as setting and environment, are blurred; characteristics, preconditions and outcomes are ill-defined. Therefore, the maturity of both concepts should be further improved to facilitate operationalization in systematic reviews and HTAs.

Overview

Integrity signals

Registry

Crossref · 10.1016/j.zefq.2015.01.004

Cites

87 of 87 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

The text we found for this paper looks like another document, so its claims and self-check weren’t run. The registry and citation checks still apply.

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The text we found for this paper looks like another document, so the self-check wasn’t run.

Citations

Cites

Research works printed but not linked: 1

  1. Metz, 2012, Active Implementation Frameworks for Program Success, Zero to One, 32, 11

Cited by

Sorted by citations

See all 197

Related

See all

Metadata

Authors
Pfadenhauer, L. M., Mozygemba, K., Gerhardus, A., Hofmann, B., Booth, A., Lysdahl, K. B., Tummers, M., Burns, J., & Rehfuess, E. A.
Affiliations
  • Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (DE)
  • University of Bremen (DE)
  • University of Oslo (NO)
  • University of Sheffield (GB)
  • Radboud University Medical Center (NL)
Corresponding author
Pfadenhauer, Lisa Maria
ORCID
Venue
Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
Publisher
Elsevier BV
Published
2015
Volume
109
Issue
2
Pages
103-114
ISSN
1865-9217 (ISSN-L)
DOI
10.1016/j.zefq.2015.01.004
OpenAlex
W1998641377
Semantic Scholar
93ddce6a560b6dc55062e4dc9a2f4794ee4d6531
Cited by
189
References
88
Citations by year
2026: 7 · 2025: 11 · 2024: 29 · 2023: 18 · 2022: 29 · 2021: 28 · 2020: 23 · 2019: 13 · 2018: 17 · 2017: 9 · 2016: 3 · 2015: 2
FWCI
19.00
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Keywords
context, implementation, health interventions, complex interventions, conceptual analysis, health technology assessment, operationalization
MeSH terms
Delivery of Health Care, Germany, Health Plan Implementation, Humans, Technology Assessment, Biomedical, Evidence-Based Medicine, Guideline Adherence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review