Criteria for selecting implementation science theories and frameworks: results from an international survey
Open accessAbstract
BACKGROUND: Theories provide a synthesizing architecture for implementation science. The underuse, superficial use, and misuse of theories pose a substantial scientific challenge for implementation science and may relate to challenges in selecting from the many theories in the field. Implementation scientists may benefit from guidance for selecting a theory for a specific study or project. Understanding how implementation scientists select theories will help inform efforts to develop such guidance. Our objective was to identify which theories implementation scientists use, how they use theories, and the criteria used to select theories. METHODS: We identified initial lists of uses and criteria for selecting implementation theories based on seminal articles and an iterative consensus process. We incorporated these lists into a self-administered survey for completion by self-identified implementation scientists. We recruited potential respondents at the 8th Annual Conference on the Science of Dissemination and Implementation in Health and via several international email lists. We used frequencies and percentages to report results. RESULTS: Two hundred twenty-three implementation scientists from 12 countries responded to the survey. They reported using more than 100 different theories spanning several disciplines. Respondents reported using theories primarily to identify implementation determinants, inform data collection, enhance conceptual clarity, and guide implementation planning. Of the 19 criteria presented in the survey, the criteria used by the most respondents to select theory included analytic level (58%), logical consistency/plausibility (56%), empirical support (53%), and description of a change process (54%). The criteria used by the fewest respondents included fecundity (10%), uniqueness (12%), and falsifiability (15%). CONCLUSIONS: Implementation scientists use a large number of criteria to select theories, but there is little consensus on which are most important. Our results suggest that the selection of implementation theories is often haphazard or driven by convenience or prior exposure. Variation in approaches to selecting theory warn against prescriptive guidance for theory selection. Instead, implementation scientists may benefit from considering the criteria that we propose in this paper and using them to justify their theory selection. Future research should seek to refine the criteria for theory selection to promote more consistent and appropriate use of theory in implementation science.
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Use of frameworks to explicitly guide hypothesis formation is the minority, even within implementation efforts using theory to guide other aspects of the research process.
“Despite its explanatory power, use of frameworks to explicitly guide hypothesis formation are the minority, even within implementation efforts using theory to guide other aspects of the research process [38–40].”
From Ten recommendations for using implementation frameworks in research and practice (2020) · cites this paper as [38]
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- Authors
- Birken, S. A., Powell, B. J., Shea, C. M., Haines, E. R., Alexis Kirk, M., Leeman, J., Rohweder, C., Damschroder, L., & Presseau, J.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- VA Center for Clinical Management Research (US)
- University of Ottawa (CA)
- Corresponding author
- Birken, Sarah A.
- ORCID
- Venue
- Implementation Science
- Published
- 2017-10-30
- Volume
- 12
- Issue
- 1
- Pages
- 124-124
- ISSN
- 1748-5908 (ISSN-L)
- PMC
- PMC5663064
- OpenAlex
- W2765628342
- Cited by
- 471
- References
- 28
- Citations by year
- 2026: 30 · 2025: 52 · 2024: 66 · 2023: 58 · 2022: 55 · 2021: 61 · 2020: 95 · 2019: 32 · 2018: 21 · 2017: 1
- FWCI
- 65.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Implementation Science (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)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health (UL1TR001111, L30MH108060, KL2TR001109)
- National Institute of Mental Health (L30MH108060, R01MH106510, K01MH113806, R25MH080916)
- National Institute of Allergy and Infectious Diseases (P30AI050410)
- National Center for Advancing Translational Sciences
- 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
- theory choice, implementation theory, implementation factors, implementation planning, conceptual clarity, fecundity, falsifiability, consensus building
- MeSH terms
- Female, Health Plan Implementation, Health Services Research, Humans, Male, Health Care Surveys, Internationality
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