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Cited by 180Health Policy Implementation ScienceHealth Sciences Research and EducationClinical practice guidelines implementation

Towards a common terminology: a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies

Open access
Colquhoun, Heather, Leeman, Jennifer, Michie, Susan, Lokker, Cynthia, Bragge, Peter, Hempel, Susanne, McKibbon, K Ann, Peters, Gjalt-Jorn Y +3 more·2014·Implementation Science
DOI 10.1186/1748-5908-9-51PMC PMC4021969
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Abstract

BACKGROUND: A wide range of diverse and inconsistent terminology exists in the field of knowledge translation. This limits the conduct of evidence syntheses, impedes communication and collaboration, and undermines knowledge translation of research findings in diverse settings. Improving uniformity of terminology could help address these challenges. In 2012, we convened an international working group to explore the idea of developing a common terminology and an overarching framework for knowledge translation interventions. FINDINGS: Methods included identifying and summarizing existing frameworks, mapping together a subset of those frameworks, and convening a multi-disciplinary group to begin working toward consensus. The group considered four potential approaches to creating a simplified framework: melding existing taxonomies, creating a framework of intervention mechanisms rather than intervention strategies, using a consensus process to expand one of the existing models/frameworks used by the group, or developing a new consensus framework. CONCLUSIONS: The work group elected to draft a new, simplified consensus framework of interventions to promote and integrate evidence into health practices, systems and policies. The framework will include four key components: strategies and techniques (active ingredients), how they function (causal mechanisms), how they are delivered (mode of delivery), and what they aim to change (intended targets). The draft framework needs to be further developed by feedback and consultation with the research community and tested for usefulness through application and evaluation.

AI snapshot

Written from the paper’s full text.

TL;DR

An international workgroup explored inconsistent knowledge translation terminology and considered four options for a simplified framework. They elected to draft a new consensus framework with four components—active ingredients, causal mechanisms, mode of delivery, and intended targets—to be refined and tested.

Key findings

  • The workgroup considered four approaches: melding existing taxonomies, creating a framework of intervention mechanisms, expanding an existing framework via consensus, or developing a new consensus framework; it elected to develop a new consensus framework.
  • The draft simplified framework categorizes interventions by four elements: intervention strategies and techniques (active ingredients), how they function (causal mechanisms), how they are delivered (mode of delivery), and what they aim to change (intended targets).
  • A mapping exercise of four familiar frameworks/taxonomies—the Behaviour Change Wheel, the Cochrane EPOC framework, the Leeman Taxonomy, and the Behaviour Change Technique Taxonomy v1—did not result in a unified framework but illustrated key challenges.
  • The paper reports that 35 researchers and information specialists were invited and 12 attended the two-day meeting; background cites 100 different KT terms and at least 61 dissemination/implementation models.

Methods

  • An international workgroup was convened; 35 researchers and information specialists from Canada, the UK, USA, the Netherlands, and Australia were invited, and 12 attended a two-day meeting in Ottawa, Canada, in September 2012.
  • Before the meeting, invitees shared frameworks they had developed or used; five attendees mapped four intervention frameworks/taxonomies into a single framework.
  • During the meeting, participants presented their experiences, reviewed the mapping exercise, discussed four potential approaches, and agreed on a shared objective to work towards a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies.

Limitations

  • Stated: the group was limited to 12 participants, and the authors aim to involve a larger group with broader representation in background and geography.
  • Stated: the framework is a draft to encourage debate; it needs further development through feedback and consultation and testing for usefulness through application and evaluation, and whether it will be useful is an empirical question.
  • Evident: the mapping exercise did not produce a unified framework, and the paper reports no validation or testing of the draft framework.

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

Integrity signals

Registry

Crossref · 10.1186/1748-5908-9-51

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 26 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The mapping exercise did not result in a unified framework.

    “Although the mapping exercise did not result in a unified framework, it illustrated the key issues and challenges and served as a starting point for future work”
    Quote in the paperSubstantial claim
  • Findingown data

    Terms within the taxonomies are not consistent in scope, scale or function, with some terms describing broad approaches to implementation and others describing more discrete strategies.

    “terms within the taxonomies are not consistent in scope, scale or function, with some terms describing broad approaches to implementation (e.g., quality improvement) and others describing more discrete strategies (e.g., reminder systems).”
    Quote in the paperSubstantial claim
  • Premisecitation

    Systematic reviews on KT interventions consistently conclude that variability in intervention reporting impeded the synthesis.

    “Systematic reviews on KT interventions consistently conclude that variability in intervention reporting impeded the synthesis [5-7].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [5] Flodgren G, Parmelli E, Doumit G, Gattellari M, O’Brien MA, Grimshaw J, Eccles MP: Local opinion leaders: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2011. CD000125

      Not checked in the free run.

    • cites [6] O’Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard-Jensen J, Kristoffersen DT, Forsetlund L, Bainbridge D, Freemantle N, Davis DA, Haynes RB, Harvey EL: Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2007. CD000409

      Not checked in the free run.

    • cites [7] Grilli R, Ramsay C, Minozzi S: Mass media interventions: effects on health services utilisation. Cochrane Database Syst Rev 2002. CD000389

      Not checked in the free run.

  • Premisecitation

    A recent review of models and frameworks for dissemination and implementation suggests that at least 61 such models exist.

    “A recent review of models and frameworks for dissemination and implementation suggests that at least 61 such models exist [8].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [8] Tabak RG, Khoong EC, Chambers DA, Brownson RC: Bridging research and practice: models for dissemination and implementation research. Am J Prev Med 2012, 43:337–350. source

      Not checked in the free run.

  • Premisecitation

    McKibbon and colleagues attempted unsuccessfully to develop a search filter specific to KT.

    “McKibbon and colleagues attempted unsuccessfully to develop a search filter specific to KT [4]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] McKibbon KA, Lokker C, Wilczynski NL, Haynes RB, Ciliska D, Dobbins M, Davis DA, Straus SE: Search filters can find some but not all knowledge translation articles in MEDLINE: an analytic survey. J Clin Epidemiol 2012, 65:651–659. source

      Not checked in the free run.

  • May combine two claims. 9
  • Classified as probably not a substantial claim. 12

  • May combine two claims.

    Findingown data

    The mapping exercise highlighted that the terms used within taxonomies overlap and the relationships among them are unclear.

    “The mapping exercise highlighted several obstacles to melding existing taxonomies: the terms used within taxonomies overlap and the relationships among them are unclear”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingnone given

    The workgroup agreed on the option of developing a new consensus framework of KT interventions that would guide the development of a standardized vocabulary and the development of common language.

    “The workgroup agreed on the option of developing a new consensus framework of KT interventions that would guide the development of a standardized vocabulary and the development of common language.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In an analysis of titles and abstracts of over 20,000 quality improvement publications, Walshe found that authors used numerous different terms to present an essentially similar set of approaches, with terms changing in frequency of use over time.

    “in an analysis of the titles and abstracts of over 20,000 quality improvement publications, Walshe found that authors used numerous different terms to present an essentially similar set of approaches, with terms changing in frequency of use over time [2].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2] Walshe K: Pseudoinnovation: the development and spread of healthcare quality improvement methodologies. Int J Qual Health Care 2009, 21:153–159. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The KT field is in the early stages of development and lacks shared conceptualizations of problems, potential solutions, and a common language.

    “The KT field is in the early stages of development and as yet lacks shared conceptualizations of problems, potential solutions, and a common language.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] McKibbon KA, Lokker C, Wilczynski NL, Ciliska D, Dobbins M, Davis DE, Haynes RB, Straus S: A cross-sectional study of the number and frequency of terms used to refer to knowledge translation in a body of health literature in 2006: a Tower of Babel? Implement Sci 2010, 5:16. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    McKibbon et al. identified 100 different terms to describe KT research.

    “McKibbon et al. identified 100 different terms to describe KT research [3].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] McKibbon KA, Lokker C, Wilczynski NL, Ciliska D, Dobbins M, Davis DE, Haynes RB, Straus S: A cross-sectional study of the number and frequency of terms used to refer to knowledge translation in a body of health literature in 2006: a Tower of Babel? Implement Sci 2010, 5:16. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The diversity of models reflects their development in different contexts for different purposes, but it potentially limits effective communication between research and implementation groups and risks introducing inefficiencies into efforts to interpret and accumulate evidence and to apply evidence to improvements in practice and policy.

    “Whilst the diversity reflects their development in different contexts for different purposes, it potentially limits effective communication between research and implementation groups and risks introducing inefficiencies into efforts to interpret and accumulate evidence and to apply evidence to improvements in practice and policy.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The first study, using a process of consultation with expert panels, developed a definition of QI but was not successful in applying that definition to synthesize QI literature.

    “The first, using a process of consultation with expert panels, developed a definition of QI but was not successful in applying that definition to synthesize QI literature [27].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [27] Rubenstein LV, Hempel S, Farmer MM, Asch SM, Yano EM, Dougherty D, Shekelle PW: Finding order in heterogeneity: types of quality-improvement intervention publications. Qual Saf Health Care 2008, 17:403–408. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Active ingredients can be categorized broadly, as is done in the interventions and policy levels of the Behavior Change Wheel, or characterized at the level of specific strategies or techniques.

    “Active ingredients can be categorized broadly, as is done in the interventions and policy levels of the Behavior Change Wheel [21], or characterized at the level of specific strategies or techniques [24].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [21] Michie S, van Stralen MM, West R: The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011, 6:42. source

      Not checked in the free run.

    • cites [24] Michie S, Richardson M, Johnston M, Abraham C, Francis JJ, Hardeman W, Eccles MP, Cane J, Wood CE: The Behavior Change Technique Taxonomy (v1) of 93 hierarchically-clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Beh Med 2013, 46:81–95. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The Behavior Change Wheel identifies nine functions by which interventions affect outcomes.

    “This identifies nine functions by which interventions affect outcomes (e.g., education, persuasion, incentivisation).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [21] Michie S, van Stralen MM, West R: The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011, 6:42. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The workgroup was limited to 12 participants.

    “While representation of the participants included QI, patient safety, public health, behaviour change, policy, information retrieval, and taxonomy, the group was limited to 12 participants.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Because active ingredients concern generic psychological, organizational, and regulatory processes, a generically defined active ingredient can be delivered in a variety of applications or media.

    “Because the active ingredients concern generic psychological, organizational, and regulatory processes, a generically defined active ingredient can be delivered in a variety of applications or media.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Testing and refining a taxonomy/model by categorizing interventions is an iterative process whereby items are added or refined to ensure that all interventions can be described.

    “This is an iterative process whereby items are added or refined to ensure that all interventions can be described.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    The relative importance of different causal mechanisms is influenced by a variety of contextual factors.

    “The relative importance of different causal mechanisms is influenced by a variety of contextual factors.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationnone given

    The framework categorizes interventions according to four elements: intervention strategies and techniques (active ingredients), how they function (causal mechanisms), how they are delivered (mode of delivery), and what they aim to change (intended targets).

    “The framework categorizes interventions according to four elements that form the basis of the interventions and the specific terms used to describe them.”
    • Also stated in: § Meeting outcome – draft simplified model · plain
      “The four elements include intervention strategies and techniques (active ingredients), how they function (causal mechanisms), how they are delivered (mode of delivery), and what they aim to change (intended targets).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Only after stakeholders are engaged, the policy or plan is collaboratively formulated, and decision-makers are persuaded to support and enact it can the actual implementation of the policy or plan begin.

    “Only then can the actual implementation of the policy or plan begin [31].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Hendriks AM, Jansen MW, Gubbels JS, De Vries NK, Paulussen T, Kremers SP: Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity - the behavior change ball. Implement Sci 2013, 8:46. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some authors test and refine their taxonomy/model by selecting relevant research studies and categorizing the intervention according to the taxonomy.

    “Some authors test and refine their taxonomy/model by selecting relevant research studies and categorizing the intervention according to the taxonomy (e.g., [33]).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [33] Mazza D, Bairstow P, Buchan H, Chakraborty S, VanHecke O, Grech C, Kunnamo I: Refining a taxonomy for guideline implementation: results of an exercise in abstract classification. Implement Sci 2013, 8:32. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Recommendations for solving issues of terminology have included using expertise from taxonomic fields, standardizing vocabulary and definitions, and advocating the adoption of a small, common set of terms.

    “Recommendations for solving issues of terminology have included using expertise from taxonomic fields, standardizing vocabulary and definitions, and advocating the adoption of a small, common set of terms [3].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] McKibbon KA, Lokker C, Wilczynski NL, Ciliska D, Dobbins M, Davis DE, Haynes RB, Straus S: A cross-sectional study of the number and frequency of terms used to refer to knowledge translation in a body of health literature in 2006: a Tower of Babel? Implement Sci 2010, 5:16. source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Intervention targets have been categorized as: change behavior of individuals; change coordinated behaviors among multiple staff; change policies, procedures, and technologies; increase organizational or system-level capacity or improve infrastructure; create or strengthen collaborative partnerships or coalitions; and change systems.

    “Intervention targets have been categorized as: change behavior of individuals; change coordinated behaviors among multiple staff; change policies, procedures, and technologies; increase organizational or system-level capacity or improve infrastructure; create or strengthen collaborative partnerships or coalitions; and change systems [32].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Scheirer MA: Linking sustainability research to intervention types. Am J Public Health 2013, 103:e73-e80. source

      Not checked in the free run.

18 of 18

Claims other papers make about this one

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Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. Stevens KR: ACE Star Model of EBP: Knowledge Transformation. The University of Texas Health Science Center at San Antonio; 2004:1–3. [Academic Center for Evidence-based Practice] http://www.acestar.uthscsa.edu 2013
  2. Canadian Institutes of Health Research: About knowledge translation & commercialization. 2013. http://www.cihr-irsc.gc.ca/e/29418.html .
  3. McMaster Health Forum: Health Systems Evidence. 2013, 1–3. http://www.healthsystemsevidence.org/open-search.aspx . 2013
  4. Cochrane Effective Practice and Organisation of Care Group: EPOC resources for review authors. 2013, 1–3. http://epoc.cochrane.org/ . 2010
  5. Bartholomew LK, Parcel GS, Kok G, Gottlieb N: Planning Health Promotion Programs: Intervention Mapping. San Francisco: Jossey-Bass; 2011.

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Authors
Colquhoun, H., Leeman, J., Michie, S., Lokker, C., Bragge, P., Hempel, S., McKibbon, K. A., Peters, G.-J. Y., Stevens, K. R., Wilson, M. G., & Grimshaw, J.
Affiliations
  • Ottawa Hospital (CA)
  • University of North Carolina at Chapel Hill (US)
  • University College London (GB)
  • McMaster University (CA)
  • The Alfred Hospital (AU)
  • RAND Corporation (US)
  • Open University of the Netherlands (NL)
  • The University of Texas at San Antonio Health Science Center (US)
  • University of Ottawa (CA)
Corresponding author
Colquhoun, Heather
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2014-05-01
Volume
9
Issue
1
Pages
51-51
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/1748-5908-9-51
PMC
PMC4021969
OpenAlex
W2139297527
Semantic Scholar
06b62b3410e19d220ad4e47ef839ad2bdc707656
Cited by
180
References
31
Citations by year
2026: 6 · 2025: 5 · 2024: 14 · 2023: 21 · 2022: 10 · 2021: 23 · 2020: 17 · 2019: 18 · 2018: 11 · 2017: 19 · 2016: 11 · 2015: 21 · 2014: 4
FWCI
33.11
Type
journal article
Language
en
Update notices
correction (2014-12-21)
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • uO Research (University of Ottawa) (submittedVersion, public-domain)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion, cc-by)
  • UCL Discovery (University College London) (submittedVersion)
  • DSpace (Open University in the Netherlands) (submittedVersion, cc-by)
  • DSpace (Open University in the Netherlands) (submittedVersion, other-oa)
  • UNC Libraries
Funders
  • National Institutes of Health
  • Canadian Institutes of Health Research
  • U.S. National Library of Medicine
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
knowledge translation, terminology standardization, knowledge translation intervention, intervention framework, causal mechanisms, intervention strategies, mode of delivery, consensus framework, evidence integration, health policy, health care system
MeSH terms
Diffusion of Innovation, Humans, Terminology as Topic, Evidence-Based Medicine, Translational Research, Biomedical, Policy

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