Cited by 278Health Policy Implementation ScienceHealth Sciences Research and EducationClinical practice guidelines implementation

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Developing Robust, Sustainable, Implementation Systems Using Rigorous, Rapid and Relevant Science

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Glasgow, Russell E., Chambers, David·2012·Clinical and Translational Science

DOI 10.1111/j.1752-8062.2011.00383.xPMC PMC5439908

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Abstract

Background: Current approaches to medical science generally have not resulted in rapid, robust integration into feasible, sustainable real world healthcare programs and policies. Implementation science risks falling short of expectations if it aligns with historical norms. Fundamentally different scientific approaches are needed to accelerate such integration. Methods: We propose that the key goal of implementation science should be to study the development, spread and sustainability of broadly applicable and practical programs, treatments, guidelines, and policies that are contextually relevant and robust across diverse settings, delivery staff, and subgroups. We recommend key conceptual and methodological characteristics needed to accomplish these goals. Results: The methods to produce such advances should be rapid, rigorous, transparent, and contextually relevant. We recommend approaches that incorporate a systems perspective, investigate generalizability, are transparent, and employ practical measures and participatory approaches. Conclusions: To produce different outcomes, we need to think and act differently. Implications of such an implementation science approach include fundamental changes that should be relevant to Clinical Translational Science Award investigators, comparative effectiveness researchers, those interested in pragmatic trials, grant funders, and community partners. Clin Trans Sci 2012; Volume #: 1–8

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“Nearly half measured sustainability through self-reports or interviews, suggesting that more comprehensive and rigorous methods are needed (Glasgow & Chambers, 2012; Stirman et al., 2012).”
Method
M.I.C.A.H. Project HEAL: Sustainability of a Faith-Based Community Health Advisor Training Program in Urban Underserved Communities in the USA
Marin, D. B., Karol, A. B., Sharma, V., Wetmore, J. B., Costello, Z., Henry, B., Robinson, M., Thompson, L. B., Peña, I., & Jandorf, L. H. (2021) · Journal of Religion and Health · doi:10.1007/s10943-021-01453-w · Cited by 9
“Key to the success of any health promotion program is proof of its sustainability (Glasgow & Chambers, 2012; Scheirer et al., 2017; Shelton et al., 2018).”
Background
Collaborating on Data, Science, and Infrastructure: The 20-Year Journey of the Cancer Research Network
Doria-Rose, V. P., Greenlee, R. T., Buist, D. S. M., Miglioretti, D. L., Corley, D. A., Brown, J. S., Clancy, H., Tuzzio, L., Moy, L. M., Hornbrook, M. C., et al. (2019) · eGEMs (Generating Evidence & Methods to improve patient outcomes) · doi:10.5334/egems.273 · Cited by 9
Dissemination of quality improvement innovations by multisector health care alliances
Hearld, L. R., Alexander, J. A., Wolf, L. J., & Shi, Y. (2019) · Journal of Health Organization and Management · doi:10.1108/jhom-08-2017-0195 · Cited by 10
Systematic Review of Research on Co-Location Models for Serving Intimate Partner and Sexual Violence Survivors
Rizo, C. F., Deinse, T. B. V., Durant, S., Lopez, Q. S., Mason, A., & Ryan, P. H. (2021) · Journal of Family Violence · doi:10.1007/s10896-021-00257-6 · Cited by 8
Improving Health for Older Adults With Pain Through Engagement: Protocol for Tailoring and Open Pilot Testing of a Mind-Body Activity Program Delivered Within Shared Medical Visits in an Underserved Community Clinic
McDermott, K. A., Levey, N., Brewer, J. R., Ehmann, M., Hooker, J. E., Pasinski, R., Yousif, N., Raju, V., Gholston, M., Greenberg, J., et al. (2023) · JMIR Research Protocols · doi:10.2196/52117 · Cited by 8
“RDA is a valid and reliable qualitative data analysis method that is recommended in studies where there is a need for real-time data to inform intervention adaptation and implementation [54-56].”
Method
Real-world public health interventions demonstrate how research evidence informs program scale-up
Crane, M. A., Lee, K., Wolfenden, L., Phongsavan, P., & Bauman, A. E. (2024) · Health Promotion International · doi:10.1093/heapro/daae111 · Cited by 8
“The extent (years) the intervention has been delivered as evidence of ongoing dissemination sustainment. to be effective when embedded into the often complex multi-level implementation context in which population health programs are delivered (Glasgow and Chambers, 2012).”
Background
Next Steps in Designing for Diffusion of Pre-Exposure Prophylaxis
Dearing, J. W., Norton, W. E., & Larson, R. S. (2012) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.09.028 · Cited by 8
Pragmatic research in sport: coaching philosophies in action - a values chain to inform practice
Grečić, D., & Grundy, A. (2016) · CLOK (University of Central Lancashire) · Cited by 8
Exploring the potential roles of community-university partnerships in northern suicide prevention implementation research
Fraser, S. L., Plourde-Léveillé, L., & Kirmayer, L. J. (2020) · International Journal of Circumpolar Health · doi:10.1080/22423982.2020.1835271 · Cited by 8
“science are interested in how the local context and its specificities, including end-user engagement, influence the ability to implement a programme or policy, and the ways in which these programmes or policies must be adapted to ensure their uptake within a given setting [26].”
Background
Context Matters, So How Do We Get Better at Working With Context in Implementation Research and Practice? Comment on "Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-country Analysis"
Harvey, G. (2022) · International Journal of Health Policy and Management · doi:10.34172/ijhpm.2022.7088 · Cited by 8
Tackling the social and structural drivers of HIV in Canada
Rourke, S., Bacon, J., McGee, F., & Gilbert, M. (2015) · Canada Communicable Disease Report · doi:10.14745/ccdr.v41i12a03 · Cited by 8
Community capacity coach: Embedded support to implement evidenced‐based prevention
Strompolis, M., Cain, J. M., Wilson, A., Aldridge, W. A., Armstrong, J. M., & Srivastav, A. (2020) · Journal of Community Psychology · doi:10.1002/jcop.22375 · Cited by 8
How Are Community Health Workers Trained to Deliver Physical Activity to Adults? A Scoping Review
Ramalingam, N., Strayer, T. E., Breig, S. A., & Harden, S. M. (2019) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000081 · Cited by 9
The measurement-based care to opioid treatment programs project (MBC2OTP): a study protocol using rapid assessment procedure informed clinical ethnography
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“The final step of the RAPICE methodology will be the selection of OTPs for the Phase 2 pilot MBC trial [57].”
BackgroundMethod
A comparison of how behavioral health organizations utilize training to prepare for health care reform
Stanhope, V., Choy-Brown, M., Barrenger, S. L., Manuel, J. I., Mercado, M., McKay, M. M., & Marcus, S. C. (2017) · Implementation Science · doi:10.1186/s13012-017-0549-0 · Cited by 7
“In addition to organizational characteristics, dissemination and implementation research has increasingly called for attention to the outer context, which includes social, policy, and financial environments [23], and a system’s perspective that takes into account the interrelationships among system elements and rules…”
Background
Practical partnered research to improve weight loss among overweight/obese veterans: lessons from the trenches
AuYoung, M., Damschroder, L. J., Kinsinger, L., Moin, T., & Richardson, C. R. (2017) · BMC Medical Research Methodology · doi:10.1186/s12874-017-0321-9 · Cited by 7
“The authors would also like to thank all of the leadership, coaches, and staff members within the multiple organizations who were Table 2 Examining rigor and relevance of the VA-DPP implementation study [3]”
BackgroundMethodInfluential
Barriers and facilitators to high-volume evidence-based innovation and implementation in a large, community-based learning health system
Durojaiye, C., Prausnitz, S. R., Schneider, J. L., Lieu, T. A., Schmittdiel, J. A., Rouillard, S., Chen, Y., Lee, K., & Corley, D. A. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11803-5 · Cited by 6
“While useful for the question of interest, single-topic studies may not identify systemic issues [11].”
A food synergy approach in a national program to improve the micronutrient status of preschoolers: a randomized control trial protocol
Roychoudhury, D., Nair, K. M., Balakrishna, N., Radhakrishna, K. V., Ghosh, S., & Rao, S. F. (2018) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13953 · Cited by 6
Tools for Evaluating the Implementation of Complex Education Interventions
Kainz, K., Metz, A. J. R., & Yazejian, N. (2021) · American Journal of Evaluation · doi:10.1177/1098214020958490 · Cited by 6
“An agile research agenda responds to calls for rigorous and relevant science that can guide implementation and adaptation in complex settings (Chambers et al., 2013; Ghate, 2015; Glasgow and Chambers, 2012).”
Background
Role of Context, Resources, and Target Population in the Fidelity of Critical Time Intervention
Barrenger, S. L., Kriegel, L. S., Angell, B., & Draine, J. (2015) · Psychiatric Services · doi:10.1176/appi.ps.201400108 · Cited by 6
“As CTI is applied to a wider array of populations, corresponding research practices need to take into account both the context and complexity of systems in which the intervention will operate (14).”
Background
Factors associated with the implementation of a vegetable and fruit program in a population of Australian elementary schools
Nathan, N., Wiggers, J. H., Wyse, R., Williams, C. M., Sutherland, R., Yoong, S. L., Lecathelinais, C., & Wolfenden, L. (2017) · Health Education Research · doi:10.1093/her/cyx038 · Cited by 6
“The inconsistency of the findings across studies may reflect differing jurisdictional, setting or program contextual issues, which have been suggested to influence program implementation [35].”
Background
Community-Based Efforts to Reduce Violence: A Scoping Review on the Implementation of Cure Violence
Solomon, S. R., Roman, C. G., Davey-Rothwell, M. A., Abaya, R., Webster, D. W., & Frattorolli, S. (2025) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/00469580251360956 · Cited by 5
“13 IS encompasses research that evaluates the process of implementing evidence-based interventions, 14,15 as well as hybrid designs that examine both the effectiveness of a promising intervention and its implementation.”
Strengthening breast surgery workforce capacity: implementation of competency-based training programme
Aponte‐Rueda, M. E., & Nieves, M. (2021) · ecancermedicalscience · doi:10.3332/ecancer.2021.1203 · Cited by 5
“The programme aims to improve the workforce capacity using an implementation framework that allows for its adoption and adaptation in a complex environment [39, 40].”
Sustainability Management Status of Agro-Ecosystems: A Case Study of Sugarcane Farmers in Shevgaon and Paithan (Sub-Districts) of Maharashtra, India
Wadghane, R. H. (2022) · Agricultural Research · doi:10.1007/s40003-022-00617-8 · Cited by 5
“To asses sustainability more robust, applicable, flexible methods are needed in response to current global challenges [17].”
Method
The Promise and Challenges of Dissemination and Implementation Research
Silver, M. I., Colditz, G. A., & Emmons, K. M. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197660690.003.0001 · Cited by 5
Multidisciplinary Prerounding Meeting as a Continuous Quality Improvement Tool: Leveraging to Reduce Continuous Benzodiazepine Use at an Academic Medical Center
Flannery, A. H., Bastin, M. L. T., Montgomery-Yates, A. A., Hook, C., Cassity, E. P., Eaton, P. M., & Morris, P. E. (2018) · Journal of Intensive Care Medicine · doi:10.1177/0885066618769015 · Cited by 5
Dissemination and Implementation Science
Morrato, E. H., & Smith, M. Y. (2020) · Springer eBooks · doi:10.1007/978-981-15-3013-5_13 · Cited by 5
Putting Antibiotic Prescribing for Children Into Context
Finkelstein, J. A. (2013) · JAMA · doi:10.1001/jama.2013.6288 · Cited by 5
COVID-19 research response to immediate demands: setting priorities with key stakeholders to enable health services research in NSW, Australia
Rankin, N. M., Nutbeam, D., Lévesque, J., Ko, H., Jennings, G., Walczak, A., & Jorm, C. M. (2024) · Journal of Health Organization and Management · doi:10.1108/jhom-03-2023-0059 · Cited by 4
Bleeding Disorders Research Collaborative: an opportunity for impact
Santaella, M. E. E., Valadez, S., Vázquez, E., Benasutti, H., Carlson, S. A., DiMichele, D., Norris, K. L., Robinson, F., Valentino, L. A., Witkop, M., et al. (2026) · Expert Review of Hematology · doi:10.1080/17474086.2026.2688871 · Cited by 4
“Implementation realities are rarely considered in study designs, contributing to this low conversion rate [21].”
Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 states
Hunt, T., Oser, C. B., Friedmann, P. D., Mack, N. A., Balvanz, P., Freisthler, B., Chandler, R. K., Hochstatter, K. R., Harris, D. R., Glasgow, L., et al. (2025) · Health & Justice · doi:10.1186/s40352-025-00353-5 · Cited by 4
“Guided by the Practical, Robust Implementation and Sustainability Model (PRISM) framework (Glasgow & Chambers, 2012), multilevel contextual factors impacting implementation are also assessed, including perspectives on the intervention, characteristics of implementers and setting, external…”
Academic health science networks' experiences with rapid implementation practice during the COVID-19 pandemic in England
Ziemann, A., Sibley, A., Scarbrough, H., Tuvey, S., & Robens, S. (2022) · Frontiers in Health Services · doi:10.3389/frhs.2022.943527 · Cited by 4
“AHSNs have achieved rapid implementation through: (1) An agile and adaptive implementation approach; (2) Accelerating existing innovations and building on existing relationships and networks; (3) Remote stakeholder engagement; and (4) Ensuring quality, safety,”
BackgroundMethodInfluential
Evaluating professionals’ adaptations before and after a decision support intervention “the Adaptation and Fidelity Tool” (A-FiT)—A longitudinal within-person intervention design
Zetterlund, J., Hasson, H., Schwarz, U. V. T., Neher, M., & Wahlström, E. (2025) · Implementation Research and Practice · doi:10.1177/26334895251334552 · Cited by 4
“To facilitate the maintenance of EBIs and generate better outcomes there is a need to understand and develop knowledge about the sustainment phase further (Fleiszer et al., 2015; Glasgow & Chambers, 2012; Hailemariam et al., 2019; Shelton et al., 2018).”
The Kidney Score Platform for Patient and Clinician Awareness, Communication, and Management of Kidney Disease: Protocol for a Mixed Methods Study
Tuot, D. S., Crowley, S. T., Katz, L. A., Leung, J., Alcantara-Cadillo, D. K., Ruser, C. B., Talbot-Montgomery, E., & Vassalotti, J. A. (2020) · JMIR Research Protocols · doi:10.2196/22024 · Cited by 4
“Implementation science frameworks, which take into account multiple interacting domains and processes that factor into successful program implementation, can help assure that the aforementioned gaps in chronic kidney disease awareness and education are addressed with interventions that are feasible and generalizable i…”
Background
Study Protocol: Multi-Level Determinants of Implementation and Sustainment in the Education Sector
McLeod, B. D., Sutherland, K. S., Conroy, M. A., Lyon, A. R., Chapman, J. E., Granger, K. L., & Saldana, L. (2022) · Journal of Emotional and Behavioral Disorders · doi:10.1177/10634266221090160 · Cited by 6
“Experts have highlighted sustainment as an understudied area (Chambers et al., 2013; Glasgow & Chambers, 2012).”
Background
The ART of Readiness: A Practical Tool for Implementation Tailoring at the Activity Level
Scott, V. C., LaMarca, T. K., Hamm, D. W., Tolley, A. J., Rachel, S. A., & Wandersman, A. (2024) · Global Implementation Research and Applications · doi:10.1007/s43477-023-00115-1 · Cited by 5
“…assortment of implementation resources is highly valuable, there is a growing demand for practical, easy-to-use tools, and rapid methods to adapt and optimize interventions (Glasgow & Chambers, 2012; Glasgow et al., 2014; Robinson & Damschroder, 2023; Stanick et al., 2019; Valenta et al., 2023).”
Enhancing Physical Activity as Lifestyle Behavior in Older Persons: The Rome Statement
Freiberger, E., Rydwik, E., Chorus, A. M. J., Tak, E. C. P. M., Delecluse, C., Schena, F. F., Waaler, N., Laventure, B., & van Meeteren, N. L. U. (2017) · Journal of Aging and Physical Activity · doi:10.1123/japa.2017-0001 · Cited by 4
Advancing Research Practice Partnerships to Achieve Population-Level Mental Health Outcomes
Adsul, P., & Chambers, D. (2018) · Global Social Welfare · doi:10.1007/s40609-018-0130-z · Cited by 4
Self-citation
Looking beyond the Lamppost: Population-Level Primary Prevention of Breast Cancer
McLoughlin, G. M., Wiedenman, E. M., Gehlert, S. J., & Brownson, R. C. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17238720 · Cited by 4
“Such practitioner-focused research has been recommended by D&I scholars as a way to enhance external validity and translatability of findings so they can be rapidly put in to practice [62,66].”
Background
‘Every Touch Point Is an Opportunity’: Tobacco Control Experts' Views on How to Implement Smoking Cessation Interventions Within an Australian Lung Cancer Screening Program
Harrison, N. J., Riddiford‐Harland, D. L., York, S. H., Marshall, H., Rhee, J., Stone, E. C. A., Yap, M. L., Sharman, A. R., Weber, M. F., McCullough, S., et al. (2025) · Cancer Medicine · doi:10.1002/cam4.70963 · Cited by 3
“We document a range of expert-identified implementation strategies to support intervention delivery during LCS; our mapping of key implementation determinant topics, across all CFIR domains, can enhance generalisability in other areas [68].”
A Scoping Review of Implementation Science in Planning and Delivering Tobacco Control Interventions in the United States from 2000 to 2020: Frameworks, Intervention Characteristics, and Health Equity Considerations
Selove, R., Combs, T., Heckman, C. J., Neil‐Sztramko, S., Scheuermann, T. S., Ginossar, T., Leng, J. C. F., Walker, P. D., Sidani, J. E., & Salloum, R. G. (2025) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntaf155 · Cited by 3
Professionals’ Fidelity-Adaptation Attitudes: Relation to Implementation Determinants and Work-Life Consequences – A Cluster Analysis
Zetterlund, J., Hasson, H., Neher, M., & Schwarz, U. V. T. (2024) · Global Implementation Research and Applications · doi:10.1007/s43477-024-00120-y · Cited by 3
“Yet despite frequent calls for increased focus on the sustainment phase of implementation (Durlak & DuPre, 2008; Glasgow & Chambers, 2012) and particularly on the professionals’ views, attitudes, and practices in relation to EBIs (Scurlock-Evans & Upton, 2015), such studies are lacking.”

Authors: Glasgow, R. E., & Chambers, D.
Affiliations: National Institutes of Health (US)
National Institute of Mental Health (US)
Corresponding author: Glasgow, Russell E.
ORCID: Glasgow, Russell E.
Venue: Clinical and Translational Science
Publisher: Wiley
Published: 2012-02
Volume: 5
Issue: 1
Pages: 48-55
ISSN: 1752-8054 (ISSN-L)
1752-8062
DOI: 10.1111/j.1752-8062.2011.00383.x
PMC: PMC5439908
OpenAlex: W1980568269
Cited by: 278
References: 42
Citations by year: 2026: 12 · 2025: 18 · 2024: 18 · 2023: 17 · 2022: 30 · 2021: 41 · 2020: 20 · 2019: 19 · 2018: 18 · 2017: 14 · 2016: 12 · 2015: 23 · 2014: 14 · 2013: 15 · 2012: 7
FWCI: 33.55
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 22 d)
Locations: Clinical and Translational Science (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
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: implementation science, generalizability, systems approach, participatory approach, translational research, pragmatic trials, comparative effectiveness research, research transparency
MeSH terms: Cooperative Behavior, Health Policy, Health Services Research, Humans, Organizational Objectives, Research Design, Research Support as Topic, Practice Guidelines as Topic, Community Networks, Evidence-Based Medicine, Translational Research, Biomedical, Comparative Effectiveness Research

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Developing Robust, Sustainable, Implementation Systems Using Rigorous, Rapid and Relevant Science

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