The DOI matches its Crossref record; 48 of the 49 references it cites were found in a registry or an index; 5 of the 43 sources its claims cite were checked for support.
The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework
Open accessAbstract
BACKGROUND: The case has been made for more and better theory-informed process evaluations within trials in an effort to facilitate insightful understandings of how interventions work. In this paper, we provide an explanation of implementation processes from one of the first national implementation research randomized controlled trials with embedded process evaluation conducted within acute care, and a proposed extension to the Promoting Action on Research Implementation in Health Services (PARIHS) framework. METHODS: The PARIHS framework was prospectively applied to guide decisions about intervention design, data collection, and analysis processes in a trial focussed on reducing peri-operative fasting times. In order to capture a holistic picture of implementation processes, the same data were collected across 19 participating hospitals irrespective of allocation to intervention. This paper reports on findings from data collected from a purposive sample of 151 staff and patients pre- and post-intervention. Data were analysed using content analysis within, and then across data sets. RESULTS: A robust and uncontested evidence base was a necessary, but not sufficient condition for practice change, in that individual staff and patient responses such as caution influenced decision making. The implementation context was challenging, in which individuals and teams were bounded by professional issues, communication challenges, power and a lack of clarity for the authority and responsibility for practice change. Progress was made in sites where processes were aligned with existing initiatives. Additionally, facilitators reported engaging in many intervention implementation activities, some of which result in practice changes, but not significant improvements to outcomes. CONCLUSIONS: This study provided an opportunity for reflection on the comprehensiveness of the PARIHS framework. Consistent with the underlying tenant of PARIHS, a multi-faceted and dynamic story of implementation was evident. However, the prominent role that individuals played as part of the interaction between evidence and context is not currently explicit within the framework. We propose that successful implementation of evidence into practice is a planned facilitated process involving an interplay between individuals, evidence, and context to promote evidence-informed practice. This proposal will enhance the potential of the PARIHS framework for explanation, and ensure theoretical development both informs and responds to the evidence base for implementation.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This embedded process evaluation of a national implementation RCT found that robust evidence was necessary but not sufficient for practice change, with context, inter-professional issues, and individual caution mediating implementation. The authors propose extending PARIHS by making individuals an explicit element alongside evidence, context, and facilitation.
Key findings
- The trial showed no significant effect of the interventions on the primary outcome of fluid fasting time; the process evaluation drew on 151 staff and patients across 19 participating hospitals.
- The evidence base for shortening fasting times was robust and relatively uncontested, but it was mediated by practitioner and patient caution, perceived risk, and staff fear of adverse consequences; in most sites it was unclear whether the evidence reached potential users.
- Implementation context was challenging across micro, meso, and macro levels, including emotional responses, inter-professional issues, unclear ownership and decision-making authority, communication problems, variable organizational buy-in, and different starting points; average fluid fasting times ranged from 12.9 hours to 5.8 hours, one standard dissemination site decreased from 12.5 to 7.7 hours, and another site started at 5.8 hours and continued lower at 4.2 hours but not statistically significantly lower.
- Facilitators reported many activities, but their relative and direct impact on policy and practice changes was difficult to judge, and there appeared to be no distinguishing features between the activities, skills, and attributes of an opinion leader and a PDSA facilitator despite the interventions being conceptually different.
Methods
- Design: PARIHS was prospectively applied to guide intervention design, data collection, and analysis within a process evaluation embedded in a pragmatic randomized controlled trial; three interventions were randomly allocated across 19 hospitals in England, Scotland, Wales, and Northern Ireland: standard dissemination, a web-based resource championed by opinion leader(s), and a Plan-Do-Study-Act (PDSA) intervention, each over six months.
- Data: pre- and post-intervention data were collected between November 2006 and February 2009 from a purposive sample of 151 staff and patients, including key contact interviews (28 total), change agent interviews (21 total), patient interviews (70 total), and five focus groups with 32 participants.
- Analysis: qualitative data were transcribed and managed in N*DIST 5 and NVIVO 7; inductive and deductive content analysis was undertaken informed by Ritchie and Spencer’s approach, first within data sets and then mapped across the core PARIHS elements of evidence, context, and facilitation, with cross-checking by three researchers.
Limitations
- The paper states that the process evaluation was designed to capture data across intervention sites rather than conduct in-depth case studies or ethnographies in a few sites, and that in-depth data collection in purposively sampled sites may have provided more illuminating evidence about intervention implementation, particularly fidelity.
- The paper states that the study had no capacity for observational work and therefore relied on self-reported data, that some voices were missing (surgeons who did not consent and senior operational managers not included in sampling), and that although the study design and interventions were prospectively designed based on PARIHS, the evaluation of the framework was retrospective; the addition of the concept of the individual needs further consideration, elaboration, and clarification.
- Evident from the text: because there was no significant effect on the primary outcome, the relative and direct impact of facilitator activities on policy and practice changes was difficult to judge, and no distinguishing features were found between opinion leader and PDSA facilitator activities, skills, and attributes despite the interventions being conceptually different.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
47 Own result · 38 Own interpretation · 22 Not checked yet · 16 No basis given · 4 Own method · 1 Supported so far · 1 Not supported · accuracy not yet measured
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Findings from this study and evidence from others' research and conceptualisations of evidence-based change and theory show the crucial role that individuals plays in the relative success of evidence-based change [6,7,27,37-39].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
What the sources say
- Supportedcites [6] Damschroder LJ, Aaron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009, 4: 50-10.1186/1748-5908-4-50. source
In Results (Overview of the CFIR; page not supplied), the paper says individuals make choices and can influence implementation outcomes. Results (Characteristics of individuals) adds that organizational change starts with individual behavior change. Together, these support the attributed point about individuals' importance to the success of evidence-based change. (LLM, conf=0.92)
- Supportedcites [7] Michie S, van Stralen MV, West R: The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Sci. 2011, 6: 42-10.1186/1748-5908-6-42. source
The Background states that improving implementation of evidence-based practice depends on behaviour change. The Methods section explains how individuals’ capability and motivation, together with their opportunities, generate behaviour. These passages support the attributed point that individuals play a crucial role in the success of evidence-based change; page numbers were not supplied. (LLM, conf=0.87)
- Supportedcites [27] Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82 (4): 581-629. 10.1111/j.0887-378X.2004.00325.x. source
The review identifies champions as a key determinant of organizational innovation (passage 6, labeled Abstract). It also describes implementation of evidence-based clinical guidelines as requiring individual as well as organizational change (passage 1, labeled Abstract). Together, these support the claim that individuals play an important role in the success of evidence-based change. (LLM, conf=0.88)
- Not checked yetcites [37] Wenger E: Communities of Practice. 1998, Cambridge: Cambridge University Press source
- Supportedcites [38] Gabbay J, le May A: Evidence based guidelines or collectively constructed ‘mindlines?’ ethnographic study of knowledge management in primary care. BMJ. 2004, 329 (7473): 1013-1018. 10.1136/bmj.329.7473.1013. source
The Implications section says opinion leaders shape the knowledge practitioners use and that each practitioner can strengthen colleagues’ evidence-based understanding. The Introduction also links individual clinicians and collective sense-making to the implementation of research evidence. Together, these passages support the broad claim that individuals play a crucial role in evidence-based change. (LLM, conf=0.86)
- Not checked yetcites [39] Estabrooks CA, Rutakumwa W, O’Leary KA, Profetto-McGrath J, Milner M, Levers MJ, Scott-Findlay S: Sources of practice knowledge among nurses. Qual Health Res. 2005, 15 (4): 460-476. 10.1177/1049732304273702. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Progress was made in sites where processes were aligned with existing initiatives.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The implementation context was challenging, in which individuals and teams were bounded by professional issues, communication challenges, power and a lack of clarity for the authority and responsibility for practice change.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were also reports of ward-based team communication problems, which had led to prolonged delays or fasting times for patients.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Communication
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In interviews, opinion leaders and PDSA facilitators reported engaging in many activities including: amendment of information; dissemination of information; awareness raising; individual review of patient fast; educational meetings; policy development; promotion of guidance; teaching/training (formal and informal); and using role models of good practice.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Activities and impact
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The process evaluation's self-reported data (interviews) provide a sufficient and accurate account of the implementation activities and their impact.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Within two of the interventions there was the potential to work with individuals and teams to attempt to overcome some of the challenges, but this was not translated to reductions in fasting times in most sites.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Summary
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The guideline recommendations were mainly localized through local policies rather than, for example, consensus processes.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Localizing evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Data shows examples of some challenges with communication, which meant that individualising patients’ fasting times in line with recommendations would be difficult, if not impossible to achieve:”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Communication
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In another site (web resource and opinion leader), they used learning and awareness from a patient safety initiative to implement individual review of fasting practice.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Integration with existing initiatives
plaindirectSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Apart from some wanting clarity about how to interpret recommendations, for example, how much water patients could drink pre-operatively; the evidence base was relatively uncontested by those involved in the study.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Uncontested evidence mediated by caution
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 39
- Probably not a substantial claim. 59
- The quote only partly states this claim. 1
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“While this showed the evidence was used locally, it did not impact on practice [12].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Localizing evidence
What the sources say
- Disputedcites [12] Rycroft-Malone J, Seers K, Crichton N, Chandler J, Hawkes C, Allen C, Bullock I, Strunin L: A pragmatic randomised controlled trial evaluating three implementation interventions. Implement Sci. 2012, 7: 80-10.1186/1748-5908-7-80. sourceExperimental — accuracy not yet measured
The Discussion says the project raised local awareness and that some trusts developed new policies and changed fasting practice. It found no significant improvement in the primary outcome—duration of fluid fasting—but that does not mean there was no impact on practice. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Disputed
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally, facilitators reported engaging in many intervention implementation activities, some of which result in practice changes, but not significant improvements to outcomes.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One of the challenges encountered concerned the ‘ownership’ of fasting practice.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Ownership and decision-making authority
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Some hospitals did not have a written fasting policy and had to develop one during the intervention phase, which left limited time to implement it.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Different starting points
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Some patients also expressed a cautious attitude towards the advice they had been given because they did not want to jeopardize their treatment:”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Uncontested evidence mediated by caution
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While hospitals had signed up to being involved in the project, the managerial support for it was variable, and consequently so were the commitment and resources dedicated to it.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Macro
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This was tempered by a concern expressed by some nurses about getting into trouble if patients were not fasted long enough, with which some anaesthetists sympathized:”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Ownership and decision-making authority
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At some sites existing policy was in line with the guideline evidence, and in others it was similar (e.g., three hours fluid fast).”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Localizing evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The enactment of these roles varied and was linked to activities rather than the prescribed intervention strategy.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Facilitation
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Data from interviews with change agents and key contacts who were either senior nursing or anaesthetic staff showed that most respondents believed the evidence base for shortening fasting times to be robust:”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Uncontested evidence mediated by caution
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This hospital started with the lowest pre-intervention fluid fast time (5.8 hours), which continued to get lower (4.2), but not statistically significantly lower.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Integration with existing initiatives
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Staff reported feeling overwhelmed by competing priorities, and that this project came ‘at a bad time.’”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Macro
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, we did record changes to policy and practice, which did not translate into changes to patient outcomes.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Activities and impact
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Opinion leaders and PDSA facilitators reported operationalising these activities in the following ways:”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Activities and impact
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
- Rests on an assumption: The process evaluation's self-reported data (interviews) provide a sufficient and accurate account of the implementation activities and their impact.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The need for managing operating lists meant that individual staff reportedly took a cautionary approach to fasting practice:”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Uncontested evidence mediated by caution
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A need was expressed for establishing clarity about roles and responsibilities and for all team members to take ownership:”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Ownership and decision-making authority
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A number of resource issues hindered implementation effort such as time (specifically for opinion leaders and PDSA facilitators to enact their roles, and for education sessions and team meetings), turnover of staff, and lack of permanent staff.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Macro
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For some, the fasting policy needed updating and two sites did not have a policy.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Localizing evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These are consistent with findings in the current study where individual's risk taking behavior, emotional response, skills and experience, enthusiasm, commitment, and decision-making authority were important factors in the intervention's implementation and impact.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The process evaluation's self-reported data (interviews) provide a sufficient and accurate account of the implementation activities and their impact.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The findings from this study re-emphasize the multiple and complex deliberative processes involved in implementation work.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In this study, the presence of good quality evidence was a constant, however it proved to be a necessary (for example, to guide the development of new local policy/guidance), but not a sufficient condition for changing current practice and routines.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this study, we had difficulty mapping the findings onto the high-low continua, which could be illustrative of two things.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The interventions, including facilitation components, did not overcome the challenges presented by these factors to a sufficient level to affect fasting outcomes even though facilitators reported working with individuals and teams on a variety of activities.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The lack of effect on duration of fasting in the PoISE trial is a valid indicator of implementation failure rather than of the ineffectiveness of the evidence or of the outcome measure.
None of the sources cited for this claim have been checked yet.
In the paper
“Findings from this study show that some factors were more important than others in providing the conditions for, and influencing the effect of implementation interventions, which included inter-professional team working (including communication), decision-making authority (mediated by inter-professional tensions), and organizational buy-in, issues evident in others' work [e.g., [34,35].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
What the sources say
- Not checked yetcites [34] Brown D, McCormack B: Developing the practice context to enable more effective pain management with older people: an action research study. Implement Sci. 2011, 6: 9-10.1186/1748-5908-6-9. source
- Not checked yetcites [35] Kavanagh T, Stevens B, Seers K, Sidani S, Watt-Watson J: Process evaluation of appreciate inquiry to translate pain management evidence into pediatric nursing practice. Implement Sci. 2010, 5: 90-10.1186/1748-5908-5-90. source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In this study, the evidence for shortening fasting times is scientifically robust and was generally acceptable, but these qualities were not sufficient to outweigh other factors.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A robust and uncontested evidence base was a necessary, but not sufficient condition for practice change, in that individual staff and patient responses such as caution influenced decision making.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Abstract > Results
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Facilitation is concerned with enabling and making things easier [30].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Facilitation
What the sources say
- Not checked yetcites [30] Harvey G, Loftus-Hills A, Rycroft-Malone J, Titchen A, Kitson A, McCormack B, Seers K: Getting evidence into practice: the role and function of facilitation. J Adv Nurs. 2002, 37 (6): 577-588. 10.1046/j.1365-2648.2002.02126.x. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These themes interact with each other such that, for example, emotional reactions may be a function of inter-professional issues, and a product of individual, team and organizational communication.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Context
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The process evaluation data provides a rich picture of implementation processes that offers an explanation for the trial findings, and about how the implementation of interventions played out within the practice context.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Different starting points present challenges to implementation researchers, particularly within the relative confines of a trial design and the implementation of complex interventions.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Different starting points
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“PARIHS represents the complexity of implementation by considering the three core elements and their sub-elements to be dynamic and interrelated.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Background
What the sources say
- Not checked yetcites [13] Rycroft-Malone J, Kitson A, Harvey G, McCormack B, Seers K, Titchen A, Estabrooks CA: Ingredients for change: Revisiting a conceptual framework. Qual Saf Health Care. 2002, 11: 174-180. 10.1136/qhc.11.2.174. source
- Not checked yetcites [14] Rycroft-Malone J, Harvey G, Seers K, Kitson A, McCormack B, Titchen A: An exploration of the factors that influence the implementation of evidence into practice. J Clin Nurs. 2004, 13: 913-924. 10.1111/j.1365-2702.2004.01007.x. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“The ability to learn from implementation studies would be improved by greater attention on theoretically driven formative and/or process evaluations to help determine how interventions work in different contexts, and to promote the transferability of findings to other settings [10,26].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Background
What the sources say
- Not checked yetcites [10] Stetler CB, Legro MW, Wallace CM, Bowman C, Guihan M, Hagedorn H, Kimmel B, Sharp ND, Smith JL: The role of formative evaluation in implementation research and the QUERI experience. J Gen Intern Med. 2006, 21 (Suppl 2): S1-S8. source
- Not checked yetcites [26] Lewin S, Glenton C, Oxman A: Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ. 2009, 339: b3496-10.1136/bmj.b3496. http://www.bmj.com/content/339/bmj.b3496 , source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Potentially successful strategies included using existing structures or initiatives already in place to review fasting times and practice, aligning with organizational strategies, working with those in pivotal roles, and the initiation of awareness raising activities.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Summary
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, because there has been a lack of attention to implementation processes within studies such as those included in these reviews, it is difficult to determine why and how interventions may have worked or not, or how to tailor interventions.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Background
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“PARIHS is an example of the development of a middle range explanation or theory about implementation [16].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Background
What the sources say
- Not checked yetcites [16] Merton R: On Theoretical Sociology: Five essays old and new. 1967, New York: Free Press
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Specifically, the working proposition is that the most successful implementation will occur when evidence is robust and practitioners ‘agree’ with it, the context is receptive, and where implementation processes are appropriately facilitated by internal and/or external facilitators [13,14].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Background
What the sources say
- Not checked yetcites [13] Rycroft-Malone J, Kitson A, Harvey G, McCormack B, Seers K, Titchen A, Estabrooks CA: Ingredients for change: Revisiting a conceptual framework. Qual Saf Health Care. 2002, 11: 174-180. 10.1136/qhc.11.2.174. source
- Not checked yetcites [14] Rycroft-Malone J, Harvey G, Seers K, Kitson A, McCormack B, Titchen A: An exploration of the factors that influence the implementation of evidence into practice. J Clin Nurs. 2004, 13: 913-924. 10.1111/j.1365-2702.2004.01007.x. source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Generally, this evidence base indicates that there may be more promise in the use of interventions that are theoretically based, interactive, and tailored to barriers [25].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Background
What the sources say
- Not checked yetcites [25] Baker R, Camosso-Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, Robertson N: Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2010, 10.1002/14651858.CD005470.pub2/abstract;jsessionid=86C5FC23066D86044C938F0C6B589926.d03t03. http://onlinelibrary.wiley.com/ [Art. No.: CD005470.], Issue 3
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We propose that successful implementation of evidence into practice is a planned facilitated process involving an interplay between individuals, evidence, and context to promote evidence-informed practice.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Abstract > Conclusions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Consistent with the underlying tenant of PARIHS, a multi-faceted and dynamic story of implementation was evident.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Abstract > Conclusions
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
In the paper
“However, in their review of the use of PARIHS, Helfrich et al. [17] found that others had tended to use the framework retrospectively.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Background
What the sources say
- Not checked yetcites [17] Helfrich C, Damschroder L, Hagedorn H, Daggett G, Sahay A, Ritchie M, Damush T, Guihan M, Ullrich P, Stetler C: A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Implement Sci. 2010, 5: 82-10.1186/1748-5908-5-82. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In theory, the PDSA intervention had the potential to work with these complexities, however, the delivery of this strategy was itself compromised by the challenging environment, including lack of time and opportunity to bring people together to problem solve.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Integration with existing initiatives
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“the three opportunities to refine the PARIHS framework they identify: being clearer about the interrelationships and dynamics between elements/sub elements would eventually help to identify more generalisable patterns; the need for a more explicit definition for successful implementation; and drawing on other conceptual frameworks and models to further elaborate on core PARIHS elements.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion
What the sources say
- Not checked yetcites [17] Helfrich C, Damschroder L, Hagedorn H, Daggett G, Sahay A, Ritchie M, Damush T, Guihan M, Ullrich P, Stetler C: A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Implement Sci. 2010, 5: 82-10.1186/1748-5908-5-82. source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“The recommendations include that patients could have water up to two hours and food up to six hours before induction of anaesthesia, with resumption of fluids when fully awake [28].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Methods > Interventions
What the sources say
- Not checked yetcites [28] RCN/RCoA: Perioperative fasting in adults and children. Clinical Practice guidelines. 2005, London: Royal College of Nursing
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Bringing fasting practice more in line with the guideline recommendations requires a multi-disciplinary team approach and communication within and across teams and departments.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Communication
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The analysis process was carried out by three members of the research team, which included cross-checking coding and themes. Emerging themes were also shared periodically with the whole research team as an additional check on credibility.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Methods > Data analysis and integration
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“PARIHS appears to have good face validity in that it has been often used in implementation activity and is widely cited in the international literature.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Background
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This finding is likely to be fairly typical of many clinical issues underpinned by national guidelines and a function of how organizations set their priorities.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Macro
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Apart from revision of information, these activities are more active than passive.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Activities and impact
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the prominent role that individuals played as part of the interaction between evidence and context is not currently explicit within the framework.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Abstract > Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Consistent with the underlying tenant of PARIHS, the findings present a multi-faceted and dynamic story of implementation.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Some sites had been championing evidence-based fasting practice for some years which could explain lower baseline times.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Results > Different starting points
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“To date, the role, behavior and attributes of individuals have been implicit within the PARIHS framework.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The strength of the framework is in representing the elements' interconnectivity, which should be preserved in this new representation.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“The additional element has the potential to strengthen the framework's usefulness for planning and evaluating implementation efforts and is a reflection of current evidence and theory, particularly discussions about the social processes involved in knowledge mobilisation work [43].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
What the sources say
- Not checked yetcites [43] Crilly T, Jashapara A, Ferlie E: Research utilisation and knowledge mobilisation: a scoping review of the literature. 2010, NETSCC, [ http://www.netscc.ac.uk/hsdr/files/project/SDO_ES_08-1801-220_V01.pdf ]
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We also did not have the capacity to undertake any observational work, and therefore have been reliant on self-reported data to reach the conclusions reported in this paper.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Limitations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In other theories (e.g., Rogers Diffusions) and frameworks (e.g., [6,8,27], the individual is acknowledged as a core component.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
What the sources say
- Not checked yetcites [6] Damschroder LJ, Aaron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009, 4: 50-10.1186/1748-5908-4-50. source
- Not checked yetcites [8] Aarons GA, Hurlburt M, McCue Horwitz S: Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011, 38: 4-23. 10.1007/s10488-010-0327-7. source
- Not checked yetcites [27] Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82 (4): 581-629. 10.1111/j.0887-378X.2004.00325.x. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Helfrich et al. encourage better elaboration of PARIHS' core elements.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
What the sources say
- Not checked yetcites [17] Helfrich C, Damschroder L, Hagedorn H, Daggett G, Sahay A, Ritchie M, Damush T, Guihan M, Ullrich P, Stetler C: A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Implement Sci. 2010, 5: 82-10.1186/1748-5908-5-82. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally, there are some voices missing from this account, including those of surgeons (who could have participated, but did not consent to) and senior operational managers (who were not included in our sampling strategy).”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“These authors suggest that breaking 'bad' habits could be achieved by changing something in the context or by removing a person from that context.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
What the sources say
- Not checked yetcites [32] Nilsen P, Roback K, Broström A, Ellström P-E: Creatures of habit: accounting for the role of habit in implementation research on clinical behaviour change. Implement Sci. 2012, 7: 53-10.1186/1748-5908-7-53. source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The successful implementation of evidence into practice is a planned facilitated process involving an interplay between individuals, evidence, and context to promote evidence-informed practice.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In-depth data collection within purposively sampled sites may have provided more illuminating evidence about intervention implementation, particularly fidelity.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Limitations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The findings from this evaluation lead us to proposing an extension to the PARIHS framework to enhance its usefulness as a conceptual framework that can be applied in practice.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Conclusions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is important to state that making individuals more explicit within the PARIHS framework does not mean they should be separated from the other elements, particularly context.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
None of the sources cited for this claim have been checked yet.
In the paper
“we propose that the concept of the individual might incorporate: capability, capacity, motivation (including recognising a need for change), resilience, acceptability, feelings, knowledge and beliefs (including self efficacy) about the intervention/evidence, position and fit within the organization/social system, and approach to decision-making (e.g., experimentation, use of information).”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
What the sources say
- Not checked yetcites [6] Damschroder LJ, Aaron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009, 4: 50-10.1186/1748-5908-4-50. source
- Not checked yetcites [7] Michie S, van Stralen MV, West R: The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Sci. 2011, 6: 42-10.1186/1748-5908-6-42. source
- Not checked yetcites [8] Aarons GA, Hurlburt M, McCue Horwitz S: Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011, 38: 4-23. 10.1007/s10488-010-0327-7. source
- Not checked yetcites [27] Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82 (4): 581-629. 10.1111/j.0887-378X.2004.00325.x. source
- Not checked yetcites [37] Wenger E: Communities of Practice. 1998, Cambridge: Cambridge University Press source
- Not checked yetcites [40] Squires JE, Estabrooks CA, Gustavsson P, Wallin L: Individual determinants of research utilization by nurses: a systematic review update. Implement Sci. 2011, 6: 1-10.1186/1748-5908-6-1. source
- Not checked yetcites [41] Meijers JMM, Janssen MAP, Cummings G, Wallin L, Estabrooks CA, Halfens R: Assessing the relationships between contextual factors and research utilization in nursing: systematic literature review. J Adv Nurs. 2006, 55 (5): 622-635. 10.1111/j.1365-2648.2006.03954.x. source
- Not checked yetcites [42] Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A: Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005, 14 (1): 26-33. 10.1136/qshc.2004.011155. source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this paper, we propose that the PARIHS framework should be enhanced to ensure theoretical development keeps a pace with the current evidence base for implementation.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
In the paper
“Helfrich et al. [17] suggest that successful implementation should take a logic model approach to linking the implementation strategy to outcomes, including the realization of an implementation plan, the achievement and maintenance of the targeted evidence-based practice, and the achievement and maintenance of patient or organizational outcomes.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Successful implementation
What the sources say
- Not checked yetcites [17] Helfrich C, Damschroder L, Hagedorn H, Daggett G, Sahay A, Ritchie M, Damush T, Guihan M, Ullrich P, Stetler C: A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Implement Sci. 2010, 5: 82-10.1186/1748-5908-5-82. source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the study design and interventions were prospectively designed based on the core elements of PARIHS, our evaluation of the framework has been retrospective.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The link between behavior and context is made explicit by habit theory, and fits well with the relationship between evidence and context in PARIHS.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this study, the information in recommendations would not have been new to most practitioners; however, one explanation is that their practices were habituated towards maintaining traditional (non evidence-informed) ways of working, which then becomes their stable (and familiar) context.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“This is similar to the idea of creating a dissonance or awakening that current practice is not necessarily appropriate practice, which is a feature of other literatures including practice development [33].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
What the sources say
- Not checked yetcites [33] McCormack B, Dewing J, McCance T: Developing person-centred care: addressing contextual challenges through practice development. Online J Issues Nursing. 2011, 16: 3-
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“They suggest that those who develop habitual behaviors are less likely to act on, or may avoid new information that challenges current practice—particularly in contexts that remain stable.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
What the sources say
- Not checked yetcites [32] Nilsen P, Roback K, Broström A, Ellström P-E: Creatures of habit: accounting for the role of habit in implementation research on clinical behaviour change. Implement Sci. 2012, 7: 53-10.1186/1748-5908-7-53. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Helrich et al. [17] suggest that the high-low continua within PARIHS could encourage a tendency towards linear relationships between elements.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
What the sources say
- Not checked yetcites [17] Helfrich C, Damschroder L, Hagedorn H, Daggett G, Sahay A, Ritchie M, Damush T, Guihan M, Ullrich P, Stetler C: A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Implement Sci. 2010, 5: 82-10.1186/1748-5908-5-82. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Equally, it could be suggested that organizations and systems become habituated, such that in the case of fasting for example, 12-hour fasts become so embedded and institutionalized that this standard becomes the acceptable norm.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Currently individuals are not explicitly part of the PARIHS framework but are embedded implicitly within evidence (individuals interact with evidence), context (individuals are part of context), and facilitation (facilitators work with individuals and teams).”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Over the last decade or so there has been a shift away from a focus on individuals (in the context of the evidence-based practice movements) to one that recognizes the role that context plays in implementation.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Using the high-low continuum may be more helpful in providing a visual representation at diagnosis (i.e., a snapshot), but less useful in evaluating the process of implementation because this does not capture dynamism and patterns of interactions over time.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Interrelationships and dynamics
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Successful Implementation (SI) has not been explicitly defined in previous PARIHS publications.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Successful implementation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“A logic model can (although does not have to) encourage a linear and deductive approach to the identification of inputs, processes and outcomes, which does not fit well with the underlying premise of PARIHS, which acknowledges dynamism and the potential for inductive explanation [36].”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Successful implementation
What the sources say
- Not checked yetcites [36] Kitson A, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A: Evaluating the successful implementation of evidence into practice using the PARIHS framework: theoretical and practical challenges. Implement Sci. 2008, 3 (1): 1-10.1186/1748-5908-3-1. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Individuals are currently implicitly embedded within PARIHS in that facilitators work with individuals, contexts include individuals, and individuals interact with evidence, however, the significance of individuals within implementation is perhaps currently under-represented.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This definition includes the need to pay attention to planning, the process, and evaluation of implementation activity in an iterative rather than staged approach.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Successful implementation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The framework has been developed and refined over time, therefore the addition of 'individuals' to the conceptualisation of successful implementation is timely, particularly in the context of a growing emphasis in the empirical and theoretical literature on behavior and social processes.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Arguably this shift has resulted in an inattention to the study of individual factors, specifically the interplay between actors and the contexts in which they work and how that interplay influences change processes and impacts.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, it could be argued that individual's behavior, intentions and actions should be part of a framework that seeks to explain successful implementation.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Elaborating on PARIHS elements
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A more helpful definition, which acknowledges implementation as a process might be: an orchestrated (active, planned) effort to make evidence-based changes by organizations, teams, and individuals that result in sustained improvements to care, patient outcomes, and service delivery, which are driven by and embedded in organizational strategy.”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Discussion > Successful implementation
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
The paper relies on this without support.
The study was conducted during a period of major NHS changes that impacted staff turnover, workforce reviews, and reorganizations.
“This study was conducted at a time of major NHS changes, including reconfigurations, changes to junior medical staff training grades, and a re-focus on financial deficits impacting on staff turnover, workforce reviews, and reorganizations.”
The paper relies on this without support.
The PARIHS framework is a useful heuristic for guiding the development and evaluation of implementation processes.
“PARIHS was embedded within our evaluation framework because it provided a potentially useful heuristic to guide the development of the study and evaluate the process of implementation.”
The paper relies on this without support.
The process evaluation's self-reported data (interviews) provide a sufficient and accurate account of the implementation activities and their impact.
“We also did not have the capacity to undertake any observational work, and therefore have been reliant on self-reported data to reach the conclusions reported in this paper.”
The paper relies on this without support.
The lack of effect on duration of fasting in the PoISE trial is a valid indicator of implementation failure rather than of the ineffectiveness of the evidence or of the outcome measure.
“Given the lack of effect on duration of fasting as a primary outcome, it is difficult to judge the relative impact of the activities of opinion leaders and PDSA facilitators.”
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?
In the citing paper
“This extension enables the i-PARIHS framework to consider the impact individuals and teams have in supporting or resisting an innovation.”
From PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice (2015) · cites this paper as [12]
In the citing paper
“Growing evidence on the key role individuals play in the implementation process [12]”
From PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice (2015) · cites this paper as [12]
In the citing paper
“Context often plays a subordinate role; where it is considered explicitly, it is usually restricted to an organisational context [27, 44, 91].”
From Making sense of complexity in context and implementation: the Context and Implementation of Complex Interventions (CICI) framework (2017) · cites this paper as [91]
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.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“| Change Agent Interviews | 12 | 12 | 21 |”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Methods > Data collection
Reported 21 · recomputed 24
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Methods > Data collection
“| Key Contact Interviews | 16 | 12 | 28 |”
§ The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework > Methods > Data collection
“| 19 Key contacts | 6 PDSA facilitators | 12** interviews from a possible 19 |”
Citations
Cites
Communities of Practice: Learning, Meaning, and Identity
Wenger, E. (1998) · doi:10.1017/cbo9780511803932 · Cited by 23,500
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009) · Implementation Science · doi:10.1186/1748-5908-4-50 · Cited by 14,496 · cited 3×
“Additionally, the study’s framework incorporates the idea that there are influential factors at micro, meso, and macro organizational layers of context [6,27].”
BackgroundMethodMichie, S., van Stralen, M. M., & West, R. (2011) · Implementation Science · doi:10.1186/1748-5908-6-42 · Cited by 13,697 · cited 3×
“Theory is relevant and applicable to implementation research in a number of ways [3,7,9-11], including in the choice and development of interventions, for identifying appropriate outcomes, measures, and variables of interest, and in guiding the evaluation of implementation processes and outcomes.”
BackgroundMethodQualitative research in health care: Analysing qualitative data
Pope, C. (2000) · BMJ · doi:10.1136/bmj.320.7227.114 · Cited by 8,131
Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations
GREENHALGH, T., ROBERT, G., MACFARLANE, F., BATE, P., & KYRIAKIDOU, O. (2004) · The Milbank Quarterly · doi:10.1111/j.0887-378x.2004.00325.x · Cited by 7,448 · cited 2×
“Additionally, the study’s framework incorporates the idea that there are influential factors at micro, meso, and macro organizational layers of context [6,27].”
BackgroundMethodQualitative data analysis for applied policy research
(2002) · Analyzing Qualitative Data · doi:10.4324/9780203413081-14 · Cited by 4,964 · cited 1×
“A process of inductive and deductive analysis was undertaken informed by Ritchie and Spencer’s [29] approach to analysis, specifically, their approach to concept identification and thematic framework development.”
MethodMaking psychological theory useful for implementing evidence based practice: a consensus approach
Michie, S. (2005) · Quality and Safety in Health Care · doi:10.1136/qshc.2004.011155 · Cited by 3,440
Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors
Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-010-0327-7 · Cited by 3,240 · cited 1×
“Historically, there had been a lack of attention to theory in implementation research, however in recent years there has been a growing interest in its development and use [2-8].”
BackgroundEffectiveness and efficiency of guideline dissemination and implementation strategies
Grimshaw, J., Thomas, R., MacLennan, G., Fraser, C., Ramsay, C., Vale, L., Whitty, P., Eccles, M., Matowe, L., Shirran, L., et al. (2004) · Health Technology Assessment · doi:10.3310/hta8060 · Cited by 3,044 · cited 2×
“Drawing on a variable evidence base about the relative effectiveness of implementation interventions [18-24], three trial interventions were developed and randomly allocated to 19 participating hospitals in England, Scotland, Wales, and Northern Ireland: standard dissemination, a web-based resource championed by an op…”
BackgroundMethodBero, L. A., Grilli, R., Grimshaw, J. M., Harvey, E., Oxman, A. D., & Thomson, M. A. (1998) · BMJ · doi:10.1136/bmj.317.7156.465 · Cited by 2,396
Research works printed but not linked: 2
- Rycroft-Malone J, Bucknall T: Theory, models and frameworks. Models and Frameworks for Implementing Evidence-Based Practice. Edited by: Rycroft-Malone J, Bucknall T. 2010, Oxford: Wiley-Blackwell, 23-47.
- RCN/RCoA: Perioperative fasting in adults and children. Clinical Practice guidelines. 2005, London: Royal College of Nursing
Cited by
Sorted by citations
Standards for Reporting Implementation Studies (StaRI) Statement
Pinnock, H., Barwick, M., Carpenter, C. R., Eldridge, S., Grandes, G., Griffiths, C. J., Rycroft-Malone, J., Meissner, P., Murray, E., Patel, A., et al. (2017) · BMJ · doi:10.1136/bmj.i6795 · Cited by 1,446
Self-citationHarvey, G., & Kitson, A. (2015) · Implementation Science · doi:10.1186/s13012-016-0398-2 · Cited by 1,271
Pfadenhauer, L. M., Gerhardus, A., Mozygemba, K., Lysdahl, K. B., Booth, A., Hofmann, B., Wahlster, P., Polus, S., Burns, J., Brereton, L., et al. (2017) · Implementation Science · doi:10.1186/s13012-017-0552-5 · Cited by 1,016
“ordinate role; where it is considered explicitly, it is usually restricted to an organisational context [27, 44, 91].”
BackgroundThe dark side of coproduction: do the costs outweigh the benefits for health research?
Oliver, K., Kothari, A., & Mays, N. (2019) · Health Research Policy and Systems · doi:10.1186/s12961-019-0432-3 · Cited by 754
Moullin, J. C., Sabater-Hernández, D., Fernandez-Llimos, F., & Benrimoj, S. I. (2015) · Health Research Policy and Systems · doi:10.1186/s12961-015-0005-z · Cited by 392
“Innovations were classified into groups: interventions (including those termed interventions, programs, innovations, complex interventions/innovations, shared-decision making, technologies, evidence-based practices, and telehealth; n = 22) [13,15,16,29,33-37,39-56], guidelines (including clinical-practice, best-practi…”
Background
Metadata
- Authors
- Rycroft-Malone, J., Seers, K., Chandler, J., Hawkes, C. A., Crichton, N., Allen, C., Bullock, I., & Strunin, L.
- Affiliations
- University of Warwick (GB)
- Cochrane (GB)
- Bangor University (GB)
- London South Bank University (GB)
- Royal College of Physicians (GB)
- Royal College of Anaesthetists (GB)
- Venue
- Implementation Science
- Published
- 2013-03-09
- Volume
- 8
- Issue
- 1
- Pages
- 28-28
- ISSN
- 1748-5908 (ISSN-L)
- PMC
- PMC3636004
- OpenAlex
- W2141566744
- Semantic Scholar
- 1cb0304c547f34bf0151e51718de128e00ab9f4a
- Cited by
- 303
- References
- 49
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 13 · 2023: 18 · 2022: 25 · 2021: 35 · 2020: 26 · 2019: 27 · 2018: 30 · 2017: 29 · 2016: 31 · 2015: 31 · 2014: 20 · 2013: 5
- FWCI
- 52.53
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Implementation Science (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- 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
- PARIHS framework, implementation research, implementation process evaluation, evidence-informed practice, implementation context, facilitators, evidence base, practice change, acute care
- MeSH terms
- Attitude of Health Personnel, Data Collection, Decision Making, Diffusion of Innovation, Fasting, Health Services Research, Humans, Interprofessional Relations, Intraoperative Care, Professional Practice, Program Development, Focus Groups, Evidence-Based Practice, Translational Research, Biomedical
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.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
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 ›
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