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Cited by 24Health Policy Implementation ScienceHealth Sciences Research and EducationClinical practice guidelines implementation

Measuring implementation: development of the implementation process assessment tool (IPAT)

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Hartveit, M., Hovlid, E., Nordin, M. H. A., Øvretveit, J., Bond, G. R., Biringer, E., Assmus, J., Mariniusson, G. H. +1 more·2019·BMC Health Services Research
DOI 10.1186/s12913-019-4496-0PMC PMC6805659
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Abstract

Background: Implementation science comprises a large set of theories suggesting interacting factors at different organisational levels. Development of literature syntheses and frameworks for implementation have contributed to comprehensive descriptions of implementation. However, corresponding instruments for measuring these comprehensive descriptions are currently lacking. The present study aimed to develop an instrument measuring care providers’ perceptions of an implementation effort, and to explore the instrument’s psychometric properties. Methods: Based on existing implementation literature, a questionnaire was designed with items on individual and team factors and on stages of change in an implementation process. The instrument was tested in a Norwegian study on implementation of evidence based practices for psychosis. Item analysis, factor structure, and internal consistency at baseline were examined. Results: The 27-item Implementation Process Assessment Tool (IPAT) revealed large variation between mean score of the items. The total scale scores were widely dispersed across respondents. Internal consistency for the total scale was high (Cronbach’s alpha: .962), and all but one item contributed positively to the construct. The results indicated four underlying constructs: individual stages for behavioural change, individual activities and perceived support, collective readiness and support, and individual perceptions of the intervention. Conclusions: The IPAT appears to be a feasible instrument for investigating the implementation process from the perspective of those making the change. It can enable examination of the relative importance of factors thought to be essential for implementation outcomes. It may also provide ongoing feedback for leaders tailoring support for teams to improve implementation. However, further research is needed to detect the instrument’s properties later in the implementation process and in different contexts. Trial registration: ClinicalTrials.gov code NCT03271242 (retrospective registered September 5, 2017).

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Authors
Hartveit, M., Hovlid, E., Nordin, M. H. A., Øvretveit, J., Bond, G. R., Biringer, E., Assmus, J., Mariniusson, G. H., & Ruud, T.
Affiliations
  • Fonna Hospital Trust (NO)
  • Western Norway University of Applied Sciences (NO)
  • Stavanger University Hospital (NO)
  • Karolinska Institutet (SE)
  • Westat (United States) (US)
  • Haukeland University Hospital (NO)
  • Akershus University Hospital (NO)
  • University of Oslo (NO)
Corresponding author
Hartveit, M.
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2019-10-21
Volume
19
Issue
1
Pages
721-721
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/s12913-019-4496-0
PMC
PMC6805659
OpenAlex
W2982088682
Cited by
24
References
41
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 2
FWCI
4.42
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Helse Fonna HF
  • Helse Sør-Øst RHF
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords
implementation science, psychometric properties, stages of change, behavior change, team readiness, perceived support, evidence-based practice implementation, psychosis care, questionnaire development
MeSH terms
Implementation Science, Female, Health Services Research, Humans, Male, Psychometrics, Surveys and Questionnaires, Process Assessment, Health Care

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