Cited by 2,585Health Policy Implementation ScienceClinical practice guidelines implementationHealth Sciences Research and Education

The DOI matches its Crossref record; 102 of the 102 references it cites were found in a registry or an index; 2 of the 49 sources its claims cite were checked for support.

Implementation strategies: recommendations for specifying and reporting

Open access
Proctor, Enola K, Powell, Byron J, McMillen, J Curtis·2013·Implementation Science

Abstract

Implementation strategies have unparalleled importance in implementation science, as they constitute the 'how to' component of changing healthcare practice. Yet, implementation researchers and other stakeholders are not able to fully utilize the findings of studies focusing on implementation strategies because they are often inconsistently labelled and poorly described, are rarely justified theoretically, lack operational definitions or manuals to guide their use, and are part of 'packaged' approaches whose specific elements are poorly understood. We address the challenges of specifying and reporting implementation strategies encountered by researchers who design, conduct, and report research on implementation strategies. Specifically, we propose guidelines for naming, defining, and operationalizing implementation strategies in terms of seven dimensions: actor, the action, action targets, temporality, dose, implementation outcomes addressed, and theoretical justification. Ultimately, implementation strategies cannot be used in practice or tested in research without a full description of their components and how they should be used. As with all intervention research, their descriptions must be precise enough to enable measurement and 'reproducibility.' We propose these recommendations to improve the reporting of implementation strategies in research studies and to stimulate further identification of elements pertinent to implementation strategies that should be included in reporting guidelines for implementation strategies.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This paper argues that implementation strategies are inconsistently labelled and poorly described, limiting replication, meta-analysis, and practice use. It proposes reporting standards for naming, defining, and operationalizing strategies across seven dimensions: actor, action, action targets, temporality, dose, implementation outcomes addressed, and theoretical justification.

Key findings

  • Implementation strategies often lack consistent labels, theoretical justification, operational definitions or manuals, and are part of packaged approaches whose specific elements are poorly understood; this impedes searching, meta-analysis, and replication.
  • The authors propose seven dimensions for specification: actor, action, action targets, temporality, dose, implementation outcomes affected, and justification (theoretical, empirical, or pragmatic).
  • They recommend two standards: all implementation studies should name and define strategies using existing literature/taxonomies, and specify/operationalize them across the seven dimensions, ideally with manuals or protocols.
  • Examples cited include Powell et al.’s menu of 68 implementation strategies grouped by six processes, Michie et al.’s taxonomy of 93 behavior change techniques, Eccles et al.’s five modifiable audit-and-feedback elements producing 288 potential forms, and a review of 61 conceptual models finding 98% addressed more than one of five socioecological levels.

Methods

  • Design: conceptual/recommendation paper, not an empirical study; the authors synthesize prior literature and existing reporting guidelines such as WIDER, SQUIRE, and the Equator Network.
  • Data or sample: no study sample or dataset; illustrative examples and tables are used, including Table 1 prerequisites and Table 2 specification of “clinical supervision” and “clinician implementation team.”
  • Main analysis: narrative argument and proposed extension of reporting guidelines; no statistical analysis is reported.

Limitations

  • The paper does not report a formal limitations section; the authors acknowledge room for national or international consensus processes to formalize and extend the proposed guidelines.
  • Evident from the text: the recommendations are not empirically tested here, and no data are presented on whether adopting them improves reproducibility, meta-analysis, or implementation outcomes.
  • Evident from the text: the scope is limited to specification and reporting of implementation strategies, not a comprehensive reporting guideline for all implementation research designs.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/1748-5908-8-139

Cites

102 of 102 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

22 Not checked yet · 14 Own interpretation · 2 No basis given · 1 Partly supported · accuracy not yet measured

Verify all 47 references — free account

Show all 14 claims

  • Probably not a substantial claim. 22
  • It may state two separate claims as one. 7
25 of 25
  • The paper relies on this without support.

    Implementation strategies often lack operational definitions or manuals to guide their use.

    “lack operational definitions or manuals to guide their use”
  • The paper relies on this without support.

    Too rarely are the specific targets of implementation strategies clearly stated.

    “Yet too rarely are the specific targets of implementation strategies clearly stated.”
  • The paper relies on this without support.

    Most often a number of implementation strategies are combined to form a multifaceted strategy.

    “Most often a number of strategies are combined to form a multifaceted strategy such as training, consultation, and audit and feedback.”
  • The paper relies on this without support.

    Implementation strategies can vary tremendously in dosage or intensity.

    “implementation strategies also can vary tremendously in dosage or intensity.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

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

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

Cites

Show all 102 references

Research works printed but not linked: 4

  1. Cochrane Effective Practice and Organisation of Care Group: Data Collection Checklist. 2002, 1-30. http://epoc.cochrane.org/sites/epoc.cochrane.org/files/uploads/datacollectionchecklist.pdf ,
  2. Institute for Healthcare Improvement: The breakthrough series: IHI’s colaborative model for achieving breakthrough improvement. 2003, Cambridge, Massachusetts: Institute for Healthcare Improvement
  3. Massoud MR, Nielsen GA, Nolan K, Nolan T, Schall MW, Sevin CA: A framework for spread: from local improvements to system-wide change. 2006, Institute for Healthcare Improvement: Cambridge, Massachusetts
  4. Proctor EK, Powell BJ, Feely M: Measurement issues in dissemination and implementation science. Child and adolescent therapy: dissemination and implementation of empirically supported treatments. Edited by: Beidas RS, Kendall PC. New York: Oxford University Press, In Press

Cited by

Sorted by citations

Items 401–500 of 1,003

Metadata

Authors
Proctor, E. K., Powell, B. J., & McMillen, J. C.
Affiliations
  • Washington University in St. Louis (US)
  • University of Chicago (US)
Corresponding author
Proctor, Enola K
Venue
Implementation Science
Published
2013-12
Volume
8
Issue
1
Pages
139-139
ISSN
1748-5908 (ISSN-L)
OpenAlex
W2126340581
Cited by
2,585
References
102
Citations by year
2026: 258 · 2025: 328 · 2024: 464 · 2023: 330 · 2022: 318 · 2021: 277 · 2020: 219 · 2019: 140 · 2018: 91 · 2017: 70 · 2016: 25 · 2015: 48 · 2014: 15
FWCI
53.13
Type
journal article
Language
en
Open access
Locations
  • Implementation Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • Washington University in St. Louis
  • Institute of Clinical and Translational Sciences
  • National Institutes of Health (UL1TR000448, TL1TR000449, 5p30mh068579-05)
  • National Institute of Mental Health (P30-MH-068579, F31MH098478, R25MH080916, T32MH019960)
  • National Cancer Institute (U54CA155496)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092950)
  • National Center for Research Resources (RR-024992, UL1RR024992)
  • National Center for Advancing Translational Sciences
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
implementation strategies, reporting guidelines, operationalization, theoretical justification, implementation outcomes, reproducibility, intervention research
MeSH terms
Delivery of Health Care, Diffusion of Innovation, Research, Program Development

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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.

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