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 accessAbstract
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.
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Cites
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Nilsen, P., & Bernhardsson, S. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4015-3 · Cited by 1,014
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“formalises how change needs to be executed in order for the implementation effort to be successful [70, 82, 83] and underpins both the implementation process and implementation strategies [37].”
BackgroundMethodInfluentialSelf-citationSkivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K., Craig, N. J., French, D., McIntosh, E., et al. (2021) · Health Technology Assessment · doi:10.3310/hta25570 · Cited by 585
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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)
- 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
- bronze
- doi.org
- 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
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