Provide Interactive Assistance and Site Support

These interactive support strategies vary by function and target (e.g., individuals, inner organization setting, outer setting, implementation processes). Strategies focused on the local delivery system such as clinicians or clinics emphasize the execution of implementation processes and integration of the evidence-based practice (EBP) into a setting (e.g., academic detailing, internal facilitation) whereas support system strategies tend to be more centralized and aim to assist the delivery system by building capacity to deliver the practice and scale it to other settings (e.g., centralized technical assistance). Strategies may also serve in a dissemination role to increase awareness, attitude, knowledge, or intention to adopt (eg, learning collaborative or sharing local knowledge). We include evidence related to ten strategies under this category. Select any of the strategies in the box below to learn more.

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Provide External Implementation Facilitation

This strategy involves a change agent who works from outside the local intervention setting. The change agent might be a centralized member of a health system’s administrative core or interorganizational agency. In implementation research, external facilitators are often research team members or clinical partners with expertise in the relevant evidence base for the EBP, implementation methods, and/or project and change management. Blended facilitation refers to specific use of a team-based approach to implementing an EBP for QI or research studies that combine the complementary skills and expertise of both external and internal facilitators.

Strength of Evidence Supporting Its Effectiveness: Supportive

Based on direct and indirect evidence from included studies and contextual systematic review evidence identified outside of this review, we judged evidence to be either supportive, moderate supportive, limited supportive, indirect supportive only, or inconclusive. We determined the strength of evidence supporting the contribution of this strategy to successful implementations was supportive.

Health Care Areas Where the Provide External Implementation Facilitation Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Provide External Implementation Facilitation Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Provide External Implementation Facilitation" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting.

Studies That Used Provide External Implementation Facilitation and Their Outcomes, by Setting

Primary care

Specialty care

Mental health

Public Health

Multiple

Other

References

Dickinson WP, Dickinson LM, Jortberg BT, et al. A Cluster Randomized Trial Comparing Strategies for Translating Self-Management Support into Primary Care Practices. J Am Board Fam Med JABFM. 2019;32(3):341-352. doi:10.3122/jabfm.2019.03.180254

Bravata D. Assessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack: A Nonrandomized Cluster Trial. Published online 2020.

Lowery J, Fagerlin A, Larkin AR, Wiener RS, Skurla SE, Caverly TJ. Implementation of a Web-Based Tool for Shared Decision-making in Lung Cancer Screening: Mixed Methods Quality Improvement Evaluation. JMIR Hum Factors. 2022;9(2):e32399. doi:10.2196/32399

Chinman M, Goldberg R, Daniels K, et al. Implementation of peer specialist services in VA primary care: a cluster randomized trial on the impact of external facilitation. Implement Sci. 2021;16(1):60. doi:10.1186/s13012-021-01130-2

Gold R, Bunce A, Cowburn S, et al. Does increased implementation support improve community clinics’ guideline-concordant care? Results of a mixed methods, pragmatic comparative effectiveness trial. Implement Sci. 2019;14(1):100. doi:10.1186/s13012-019-0948-5

Quanbeck A, Brown RT, Zgierska AE, et al. A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care. Implement Sci. 2018;13(1):21. doi:10.1186/s13012-018-0713-1

Parchman ML, Noel PH, Culler SD, et al. A randomized trial of practice facilitation to improve the delivery of chronic illness care in primary care: initial and sustained effects. Implement Sci IS. 2013;8:93. doi:10.1186/1748-5908-8-93

Hagedorn HJ, Gustavson AM, Ackland PE, et al. Advancing Pharmacological Treatments for Opioid Use Disorder (ADaPT-OUD): an Implementation Trial in Eight Veterans Health Administration Facilities. J Gen Intern Med. Published online January 3, 2022:1-9. doi:10.1007/s11606-021-07274-7

Hahn EE, Munoz-Plaza CE, Pounds D, et al. Effect of a Community-Based Medical Oncology Depression Screening Program on Behavioral Health Referrals Among Patients With Breast Cancer: A Randomized Clinical Trial. JAMA. 2022;327(1):41-49. doi:10.1001/jama.2021.22596

Williams L, Daggett V, Slaven JE, et al. A cluster-randomised quality improvement study to improve two inpatient stroke quality indicators. BMJ Qual Saf. 2016;25(4). doi:10.1136/bmjqs-2015-004188

Kauth MR, Sullivan G, Blevins D, et al. Employing external facilitation to implement cognitive behavioral therapy in VA clinics: a pilot study. Implement Sci. 2010;5:75. doi:10.1186/1748-5908-5-75

Grigoryan L, Naik AD, Lichtenberger P, et al. Analysis of an Antibiotic Stewardship Program for Asymptomatic Bacteriuria in the Veterans Affairs Health Care System. JAMA Netw Open. 2022;5(7):e2222530-e2222530. doi:10.1001/jamanetworkopen.2022.22530

Naar S, MacDonell K, Chapman J, et al. Tailored Motivational Interviewing in Adolescent HIV Clinics: Primary Outcome Analysis of a Stepped Wedge Implementation Trial. J Acquir Immune Defic Syndr. 2022;90(S1):S74-s83. doi:10.1097/qai.0000000000002967

Bauer MS, Miller CJ, Kim B, et al. Effectiveness of Implementing a Collaborative Chronic Care Model for Clinician Teams on Patient Outcomes and Health Status in Mental Health: A Randomized Clinical Trial. JAMA Netw Open. 2019;2(3):e190230. doi:10.1001/jamanetworkopen.2019.0230

Chinman M, McCarthy S, Hannah G, Byrne TH, Smelson DA. Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy. Implement Sci. 2017;12(1):34. doi:10.1186/s13012-017-0565-0

Chokron Garneau H, Assefa MT, Jo B, Ford JH, Saldana L, McGovern MP. Sustainment of Integrated Care in Addiction Treatment Settings: Primary Outcomes From a Cluster-Randomized Controlled Trial. Psychiatr Serv. 2022;73(3):280-286. doi:10.1176/appi.ps.202000293

Williams, N.J., et al., Mechanisms of Change in the ARC Organizational Strategy: Increasing Mental Health Clinicians' EBP Adoption Through Improved Organizational Culture and Capacity. Adm Policy Ment Health, 2017. 44(2): p. 269-283.

Belenko S, Dembo R, Knight DK, et al. Using structured implementation interventions to improve referral to substance use treatment among justice-involved youth: Findings from a multisite cluster randomized trial. J Subst Abuse Treat. 2022;140:108829. doi:10.1016/j.jsat.2022.108829

Brown CH, Chamberlain P, Saldana L, Padgett C, Wang W, Cruden G. Evaluation of two implementation strategies in 51 child county public service systems in two states: results of a cluster randomized head-to-head implementation trial. Implement Sci. 2014;9:134. doi:10.1186/s13012-014-0134-8

Smelson DA, Chinman M, Hannah G, Byrne T, McCarthy S. An evidence-based co-occurring disorder intervention in VA homeless programs: outcomes from a hybrid III trial. BMC Health Serv Res. 2018;18(1):332. doi:10.1186/s12913-018-3123-9

Chinman M, Ebener P, Burkhart Q, et al. Evaluating the impact of getting to outcomes-underage drinking on prevention capacity and alcohol merchant attitudes and selling behaviors. Prev Sci. 2014;15(4):485-496. doi:10.1007/s11121-013-0389-3

Kilbourne AM, Goodrich DE, Nord KM, et al. Long-Term Clinical Outcomes from a Randomized Controlled Trial of Two Implementation Strategies to Promote Collaborative Care Attendance in Community Practices. Adm Policy Ment Health. 2015;42(5):642-653. doi:10.1007/s10488-014-0598-5

Resnick B, Van Haitsma K, Kolanowski A, et al. Implementation of the Evidence Integration Triangle for behavioral and psychological symptoms of dementia (EIT-4-BPSD) in care communities. Nurs Outlook. 2021;69(6):1058-1071. doi:10.1016/j.outlook.2021.06.004

Westrick SC, Owen J, Hagel H, Owensby JK, Lertpichitkul T. Impact of the RxVaccinate program for pharmacy-based pneumococcal immunization: A cluster-randomized controlled trial. J Am Pharm Assoc. 2016;56(1). doi:10.1016/j.japh.2015.11.010

Audit and Provide Feedback

This strategy has variable operational definitions and guidelines. In general, the 5 stages of audit and provide feedback are: prepare for audit, select evaluation criteria, assess performance, improve processes, and sustain improvement. Activities may include verbal or written feedback and complementary interventions (e.g., educational outreach, peer outreach).

Strength of Evidence Supporting Its Effectiveness: Supportive

Based on direct and indirect evidence from included studies and contextual systematic review evidence identified outside of this review, we judged evidence to be either supportive, moderate supportive, limited supportive, indirect supportive only, or inconclusive. We determined the strength of evidence supporting the contribution of this strategy to successful implementations was supportive.

Health Care Areas Where the Audit and Provide Feedback Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Audit and Provide Feedback Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Audit and Provide Feedback" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting.

Studies That Used Audit and Provide Feedback and Their Outcomes, by Setting

Primary care

Specialty care

Mental health

Public Health

Other

NOTE: One identified study was reviewed but did not contribute outcomes.

References

Dickinson WP, Dickinson LM, Jortberg BT, et al. A Cluster Randomized Trial Comparing Strategies for Translating Self-Management Support into Primary Care Practices. J Am Board Fam Med JABFM. 2019;32(3):341-352. doi:10.3122/jabfm.2019.03.180254

Bravata D. Assessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack: A Nonrandomized Cluster Trial. Published online 2020.

Chinman M, Goldberg R, Daniels K, et al. Implementation of peer specialist services in VA primary care: a cluster randomized trial on the impact of external facilitation. Implement Sci. 2021;16(1):60. doi:10.1186/s13012-021-01130-2

Ornstein S, Nemeth LS, Jenkins RG, Nietert PJ. Colorectal Cancer Screening in Primary Care Translating Research Into Practice. Med Care. 2010;48(10). doi:10.1097/MLR.0b013e3181ec5591

Quanbeck A, Brown RT, Zgierska AE, et al. A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care. Implement Sci. 2018;13(1):21. doi:10.1186/s13012-018-0713-1

Parchman ML, Noel PH, Culler SD, et al. A randomized trial of practice facilitation to improve the delivery of chronic illness care in primary care: initial and sustained effects. Implement Sci IS. 2013;8:93. doi:10.1186/1748-5908-8-93

Estrada CA, Safford MM, Salanitro AH, et al. A web-based diabetes intervention for physician: a cluster-randomized effectiveness trial. Int J Qual Health Care. 2011;23(6):682-689. doi:10.1093/intqhc/mzr053

McCarren M, Furmaga E, Jackevicius CA, et al. Improvement of Guideline Beta-Blocker Prescribing in Heart Failure: A Cluster-Randomized Pragmatic Trial of a Pharmacy Intervention. J Card Fail. 2013;19(8). doi:10.1016/j.cardfail.2013.06.004

Hahn EE, Munoz-Plaza CE, Pounds D, et al. Effect of a Community-Based Medical Oncology Depression Screening Program on Behavioral Health Referrals Among Patients With Breast Cancer: A Randomized Clinical Trial. JAMA. 2022;327(1):41-49. doi:10.1001/jama.2021.22596

Reynolds SS, Woltz P, Keating E, et al. Results of the CHlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections Study (CHanGing BathS): a stepped wedge cluster randomized trial. Implement Sci. 2021;16(1):45. doi:10.1186/s13012-021-01112-4

Friese CR, Yang J, Mendelsohn-Victor K, McCullagh MC. Randomized Controlled Trial of an Intervention to Improve Nurses’ Hazardous Drug Handling. Oncol Nurs Forum. 2019;46(2). doi:10.1188/19.ONF.248-256

Naar S, MacDonell K, Chapman J, et al. Tailored Motivational Interviewing in Adolescent HIV Clinics: Primary Outcome Analysis of a Stepped Wedge Implementation Trial. J Acquir Immune Defic Syndr. 2022;90(S1):S74-s83. doi:10.1097/qai.0000000000002967

Chinman M, McCarthy S, Hannah G, Byrne TH, Smelson DA. Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy. Implement Sci. 2017;12(1):34. doi:10.1186/s13012-017-0565-0

Chokron Garneau H, Assefa MT, Jo B, Ford JH, Saldana L, McGovern MP. Sustainment of Integrated Care in Addiction Treatment Settings: Primary Outcomes From a Cluster-Randomized Controlled Trial. Psychiatr Serv. 2022;73(3):280-286. doi:10.1176/appi.ps.202000293

Brookman-Frazee L, Roesch S, Chlebowski C, Baker-Ericzen M, Ganger W. Effectiveness of Training Therapists to Deliver An Individualized Mental Health Intervention for Children With ASD in Publicly Funded Mental Health Services: A Cluster Randomized Clinical Trial. JAMA Psychiatry. 2019;76(6). doi:10.1001/jamapsychiatry.2019.0011

Acosta J, Chinman M, Ebener PA, Malone PS, Cannon JS, D’Amico EJ. Sustaining an Evidence-Based Program Over Time: Moderators of Sustainability and the Role of the Getting to Outcomes® Implementation Support Intervention. Prev Sci. 2020;21(6):807-819. doi:10.1007/s11121-020-01118-2

Chinman M, Acosta J, Ebener P, Malone PS, Slaughter ME. Can implementation support help community-based settings better deliver evidence-based sexual health promotion programs? A randomized trial of Getting To Outcomes®. Implement Sci IS. 2016;11(1):78. doi:10.1186/s13012-016-0446-y

Smelson DA, Chinman M, Hannah G, Byrne T, McCarthy S. An evidence-based co-occurring disorder intervention in VA homeless programs: outcomes from a hybrid III trial. BMC Health Serv Res. 2018;18(1):332. doi:10.1186/s12913-018-3123-9

Chinman M, Ebener P, Burkhart Q, et al. Evaluating the impact of getting to outcomes-underage drinking on prevention capacity and alcohol merchant attitudes and selling behaviors. Prev Sci. 2014;15(4):485-496. doi:10.1007/s11121-013-0389-3

Tjia J, Field T, Mazor K, et al. Dissemination of Evidence-Based Antipsychotic Prescribing Guidelines to Nursing Homes: A Cluster Randomized Trial. J Am Geriatr Soc. 2015;63(7). doi:10.1111/jgs.13488

Centralize Technical Assistance

This strategy may involve setting up a centralized technical assistance entity that may, in turn, support a network of technical assistants who work directly with local implementation sites. Examples include support through a helpdesk from a centralized location (online or phone) or support via an online community with discussion boards.

Strength of Evidence Supporting Its Effectiveness: Limited Supportive

Based on direct and indirect evidence from included studies and contextual systematic review evidence identified outside of this review, we judged evidence to be either supportive, moderate supportive, limited supportive, indirect supportive only, or inconclusive. We determined the strength of evidence supporting the contribution of this strategy to successful implementations was limited supportive.

Health Care Areas Where the Centralize Technical Assistance Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Centralize Technical Assistance Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Centralize Technical Assistance" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting. 

Studies That Used Centralize Technical Assistance and Their Outcomes, by Setting

Primary care

Public Health

References

Dickinson WP, Dickinson LM, Jortberg BT, et al. A Cluster Randomized Trial Comparing Strategies for Translating Self-Management Support into Primary Care Practices. J Am Board Fam Med JABFM. 2019;32(3):341-352. doi:10.3122/jabfm.2019.03.180254

Carter BL, Levy B, Gryzlak B, et al. Cluster-Randomized Trial to Evaluate a Centralized Clinical Pharmacy Service in Private Family Medicine Offices. Circ-Cardiovasc Qual Outcomes. 2018;11(6). doi:10.1161/CIRCOUTCOMES.117.004188

Tajmir S, Raja AS, Ip IK, et al. Impact of Clinical Decision Support on Radiography for Acute Ankle Injuries: A Randomized Trial. West J Emerg Med. 2017;18(3). doi:10.5811/westjem.2017.1.33053

Fagan AA, Hanson K, Briney JS, Hawkins JD. Sustaining the Utilization and High Quality Implementation of Tested and Effective Prevention Programs Using the Communities That Care Prevention System. Am J Community Psychol. 2012;49(4-Mar). doi:10.1007/s10464-011-9463-9

Luecking CT, Vaughn AE, Burney R, Hennink-Kaminski H, Hales D, Ward DS. Fidelity and factors influencing implementation of Healthy Me, Healthy: process evaluation of a social marketing campaign for diet and physical activity behaviors of children in childcare. Transl Behav Med. 2021;11(3):733-744. doi:10.1093/tbm/ibab001

Jacob RR, Parks RG, Allen P, et al. How to “Start Small and Just Keep Moving Forward”: Mixed Methods Results From a Stepped-Wedge Trial to Support Evidence-Based Processes in Local Health Departments. Front Public Health. 2022;10. doi:10.3389/fpubh.2022.853791

Stookey JD, Evans J, Chan C, Tao-Lew L, Arana T, Arthur S. Healthy apple program to support child care centers to alter nutrition and physical activity practices and improve child weight: a cluster randomized trial. BMC Public Health. 2017;17. doi:10.1186/s12889-017-4951-y

Facilitate Collaborative Learning Environment (i.e., A Learning Collaborative)

This strategy encompasses a range of implementation activities that bring together a variety of stakeholders to share lessons learned and best practices from a group that has a shared implementation goal.

Strength of Evidence Supporting Its Effectiveness: Moderate Supportive

Based on direct and indirect evidence from included studies and contextual systematic review evidence identified outside of this review, we judged evidence to be either supportive, moderate supportive, limited supportive, indirect supportive only, or inconclusive. We determined the strength of evidence supporting the contribution of this strategy to successful implementations was moderate supportive.

Health Care Areas Where the Facilitate Collaborative Learning Environment Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Facilitate Collaborative Learning Environment Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Facilitate Collaborative Learning Environment" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting.

Studies That Used Facilitate Collaborative Learning Environment and Their Outcomes, by Setting

Primary care

Specialty care

Mental health

Public Health

Other

References

Bravata D. Assessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack: A Nonrandomized Cluster Trial. Published online 2020.

Lowery J, Fagerlin A, Larkin AR, Wiener RS, Skurla SE, Caverly TJ. Implementation of a Web-Based Tool for Shared Decision-making in Lung Cancer Screening: Mixed Methods Quality Improvement Evaluation. JMIR Hum Factors. 2022;9(2):e32399. doi:10.2196/32399

Noël PH, Barnard JM, Leng M, et al. The Coordination Toolkit and Coaching Project: Cluster-Randomized Quality Improvement Initiative to Improve Patient Experience of Care Coordination. J Gen Intern Med. 2022;37(1):95-103. doi:10.1007/s11606-021-06926-y

Naar S, MacDonell K, Chapman J, et al. Tailored Motivational Interviewing in Adolescent HIV Clinics: Primary Outcome Analysis of a Stepped Wedge Implementation Trial. J Acquir Immune Defic Syndr. 2022;90(S1):S74-s83. doi:10.1097/qai.0000000000002967

Bartels SJ, Aschbrenner KA, Pratt SI, et al. Virtual Learning Collaborative Compared to Technical Assistance as a Strategy for Implementing Health Promotion in Routine Mental Health Settings: A Hybrid Type 3 Cluster Randomized Trial. Adm Policy Ment Health. Published online August 20, 2022. doi:10.1007/s10488-022-01215-0

Chokron Garneau H, Assefa MT, Jo B, Ford JH, Saldana L, McGovern MP. Sustainment of Integrated Care in Addiction Treatment Settings: Primary Outcomes From a Cluster-Randomized Controlled Trial. Psychiatr Serv. 2022;73(3):280-286. doi:10.1176/appi.ps.202000293

Brown CH, Chamberlain P, Saldana L, Padgett C, Wang W, Cruden G. Evaluation of two implementation strategies in 51 child county public service systems in two states: results of a cluster randomized head-to-head implementation trial. Implement Sci. 2014;9:134. doi:10.1186/s13012-014-0134-8

Westrick SC, Owen J, Hagel H, Owensby JK, Lertpichitkul T. Impact of the RxVaccinate program for pharmacy-based pneumococcal immunization: A cluster-randomized controlled trial. J Am Pharm Assoc. 2016;56(1). doi:10.1016/j.japh.2015.11.010

Conduct Interactive Educational Outreach Visits (Academic Detailing)

This strategy involves having a trained person meet with individuals or teams in their work settings to educate them about the clinical innovation.

Strength of Evidence Supporting Its Effectiveness: Not Evaluated

For some of the most common strategies we judged the strength of research support based on included studies and contextual systematic review evidence identified outside of this review. We did not evaluate the strength of evidence for this strategy. The information below represents the data we collected from studies including this strategy.

Health Care Areas Where the Conduct Interactive Educational Outreach Visits (academic detailing) Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Conduct Interactive Educational Outreach Visits (academic detailing) Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Conduct Interactive Educational Outreach Visits (academic detailing)" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting.

Studies That Used Conduct Interactive Educational Outreach Visits (academic detailing) and Their Outcomes, by Setting

Primary care

Specialty care

Other

NOTE: One identified study was reviewed but did not contribute outcomes.

References

Carter BL, Levy B, Gryzlak B, et al. Cluster-Randomized Trial to Evaluate a Centralized Clinical Pharmacy Service in Private Family Medicine Offices. Circ-Cardiovasc Qual Outcomes. 2018;11(6). doi:10.1161/CIRCOUTCOMES.117.004188

Ornstein S, Nemeth LS, Jenkins RG, Nietert PJ. Colorectal Cancer Screening in Primary Care Translating Research Into Practice. Med Care. 2010;48(10). doi:10.1097/MLR.0b013e3181ec5591

Quanbeck A, Brown RT, Zgierska AE, et al. A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care. Implement Sci. 2018;13(1):21. doi:10.1186/s13012-018-0713-1

Hagedorn HJ, Gustavson AM, Ackland PE, et al. Advancing Pharmacological Treatments for Opioid Use Disorder (ADaPT-OUD): an Implementation Trial in Eight Veterans Health Administration Facilities. J Gen Intern Med. Published online January 3, 2022:1-9. doi:10.1007/s11606-021-07274-7

Reynolds SS, Woltz P, Keating E, et al. Results of the CHlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections Study (CHanGing BathS): a stepped wedge cluster randomized trial. Implement Sci. 2021;16(1):45. doi:10.1186/s13012-021-01112-4

Westrick SC, Owen J, Hagel H, Owensby JK, Lertpichitkul T. Impact of the RxVaccinate program for pharmacy-based pneumococcal immunization: A cluster-randomized controlled trial. J Am Pharm Assoc. 2016;56(1). doi:10.1016/j.japh.2015.11.010

Tjia J, Field T, Mazor K, et al. Dissemination of Evidence-Based Antipsychotic Prescribing Guidelines to Nursing Homes: A Cluster Randomized Trial. J Am Geriatr Soc. 2015;63(7). doi:10.1111/jgs.13488

Provide Internal Implementation Facilitation

This strategy involves facilitators who come from the setting where the EBP is being implemented and are familiar with the organization’s structure, procedures, culture, and clinical processes.

Strength of Evidence Supporting Its Effectiveness: Not Evaluated

For some of the most common strategies we judged the strength of research support based on included studies and contextual systematic review evidence identified outside of this review. We did not evaluate the strength of evidence for this strategy. The information below represents the data we collected from studies including this strategy.

Health Care Areas Where the Provide Internal Implementation Facilitation Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Provide Internal Implementation Facilitation Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Provide Internal Implementation Facilitation" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting.

Studies That Used Provide Internal Implementation Facilitation and Their Outcomes, by Setting

Specialty care

Mental health

Multiple

References

Grigoryan L, Naik AD, Lichtenberger P, et al. Analysis of an Antibiotic Stewardship Program for Asymptomatic Bacteriuria in the Veterans Affairs Health Care System. JAMA Netw Open. 2022;5(7):e2222530-e2222530. doi:10.1001/jamanetworkopen.2022.22530

Naar S, MacDonell K, Chapman J, et al. Tailored Motivational Interviewing in Adolescent HIV Clinics: Primary Outcome Analysis of a Stepped Wedge Implementation Trial. J Acquir Immune Defic Syndr. 2022;90(S1):S74-s83. doi:10.1097/qai.0000000000002967

Bauer MS, Miller CJ, Kim B, et al. Effectiveness of Implementing a Collaborative Chronic Care Model for Clinician Teams on Patient Outcomes and Health Status in Mental Health: A Randomized Clinical Trial. JAMA Netw Open. 2019;2(3):e190230. doi:10.1001/jamanetworkopen.2019.0230

Williams, N.J., et al., Mechanisms of Change in the ARC Organizational Strategy: Increasing Mental Health Clinicians' EBP Adoption Through Improved Organizational Culture and Capacity. Adm Policy Ment Health, 2017. 44(2): p. 269-283.

Smith SN, Liebrecht CM, Bauer MS, Kilbourne AM. Comparative effectiveness of external vs blended facilitation on collaborative care model implementation in slow-implementer community practices. Health Serv Res. 2020;55(6):954-965. doi:10.1111/1475-6773.13583

Kilbourne AM, Goodrich DE, Nord KM, et al. Long-Term Clinical Outcomes from a Randomized Controlled Trial of Two Implementation Strategies to Promote Collaborative Care Attendance in Community Practices. Adm Policy Ment Health. 2015;42(5):642-653. doi:10.1007/s10488-014-0598-5

Provide Local Technical Assistance

Strength of Evidence Supporting Its Effectiveness: Not Evaluated

For some of the most common strategies we judged the strength of research support based on included studies and contextual systematic review evidence identified outside of this review. We did not evaluate the strength of evidence for this strategy. The information below represents the data we collected from studies including this strategy.

Health Care Areas Where the Provide Local Technical Assistance Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Provide Local Technical Assistance Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Provide Local Technical Assistance" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting.

Studies That Used Provide Local Technical Assistance and Their Outcomes, by Setting

Primary care

Public Health

References

Noël PH, Barnard JM, Leng M, et al. The Coordination Toolkit and Coaching Project: Cluster-Randomized Quality Improvement Initiative to Improve Patient Experience of Care Coordination. J Gen Intern Med. 2022;37(1):95-103. doi:10.1007/s11606-021-06926-y

Tajmir S, Raja AS, Ip IK, et al. Impact of Clinical Decision Support on Radiography for Acute Ankle Injuries: A Randomized Trial. West J Emerg Med. 2017;18(3). doi:10.5811/westjem.2017.1.33053

Acosta J, Chinman M, Ebener PA, Malone PS, Cannon JS, D’Amico EJ. Sustaining an Evidence-Based Program Over Time: Moderators of Sustainability and the Role of the Getting to Outcomes® Implementation Support Intervention. Prev Sci. 2020;21(6):807-819. doi:10.1007/s11121-020-01118-2

Chinman M, Acosta J, Ebener P, Malone PS, Slaughter ME. Can implementation support help community-based settings better deliver evidence-based sexual health promotion programs? A randomized trial of Getting To Outcomes®. Implement Sci IS. 2016;11(1):78. doi:10.1186/s13012-016-0446-y

Capture and Share Local Implementation Site Knowledge

This strategy involves capturing local knowledge from implementation sites on how implementers and clinicians made something work in their setting and then sharing it with other sites.

Strength of Evidence Supporting Its Effectiveness: Not Evaluated

For some of the most common strategies we judged the strength of research support based on included studies and contextual systematic review evidence identified outside of this review. We did not evaluate the strength of evidence for this strategy. The information below represents the data we collected from studies including this strategy.

Health Care Areas Where the Capture and Share Local Implementation Site Knowledge Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Capture and Share Local Implementation Site Knowledge Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Capture and Share Local Implementation Site Knowledge" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting.

Studies That Used Capture and Share Local Implementation Site Knowledge and Their Outcomes, by Setting

Primary care

Public Health

Other

References

Ornstein S, Nemeth LS, Jenkins RG, Nietert PJ. Colorectal Cancer Screening in Primary Care Translating Research Into Practice. Med Care. 2010;48(10). doi:10.1097/MLR.0b013e3181ec5591

Brown CH, Chamberlain P, Saldana L, Padgett C, Wang W, Cruden G. Evaluation of two implementation strategies in 51 child county public service systems in two states: results of a cluster randomized head-to-head implementation trial. Implement Sci. 2014;9:134. doi:10.1186/s13012-014-0134-8

Maxwell AE, Danao LL, Cayetano RT, Crespi CM, Bastani R. Implementation of an evidence-based intervention to promote colorectal cancer screening in community organizations: a cluster randomized trial. Transl Behav Med. 2016;6(2):295-305. doi:10.1007/s13142-015-0349-5

Luecking CT, Vaughn AE, Burney R, Hennink-Kaminski H, Hales D, Ward DS. Fidelity and factors influencing implementation of Healthy Me, Healthy: process evaluation of a social marketing campaign for diet and physical activity behaviors of children in childcare. Transl Behav Med. 2021;11(3):733-744. doi:10.1093/tbm/ibab001

Spoelstra SL, Schueller M, Basso V, Sikorskii A. Results of a multi-site pragmatic hybrid type 3 cluster randomized trial comparing level of facilitation while implementing an intervention in community-dwelling disabled and older adults in a Medicaid waiver. Implement Sci. 2022;17(1):57. doi:10.1186/s13012-022-01232-5

Create an Online Learning Community

This strategy may involve regular blogs, facilitated discussion boards, access to experts, and networking opportunities.

Strength of Evidence Supporting Its Effectiveness: Not Evaluated

For some of the most common strategies we judged the strength of research support based on included studies and contextual systematic review evidence identified outside of this review. We did not evaluate the strength of evidence for this strategy. The information below represents the data we collected from studies including this strategy.

Health Care Areas Where the Create an Online Learning Community Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Create an Online Learning Community Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Create an Online Learning Community" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting.

Studies That Used Create an Online Learning Community and Their Outcomes, by Setting

Primary care

Specialty care

Other

References

Lowery J, Fagerlin A, Larkin AR, Wiener RS, Skurla SE, Caverly TJ. Implementation of a Web-Based Tool for Shared Decision-making in Lung Cancer Screening: Mixed Methods Quality Improvement Evaluation. JMIR Hum Factors. 2022;9(2):e32399. doi:10.2196/32399

Tajmir S, Raja AS, Ip IK, et al. Impact of Clinical Decision Support on Radiography for Acute Ankle Injuries: A Randomized Trial. West J Emerg Med. 2017;18(3). doi:10.5811/westjem.2017.1.33053

Schneider EC, Sorbero ME, Haas A, et al. Does a quality improvement campaign accelerate take-up of new evidence? A ten-state cluster-randomized controlled trial of the Institute for Health Improvement’s Project JOINTS. Implement Sci. 2017;12. doi:10.1186/s13012-017-0579-7

Westrick SC, Owen J, Hagel H, Owensby JK, Lertpichitkul T. Impact of the RxVaccinate program for pharmacy-based pneumococcal immunization: A cluster-randomized controlled trial. J Am Pharm Assoc. 2016;56(1). doi:10.1016/j.japh.2015.11.010

Provide Clinical Supervision (of EBP Provision)

This strategy often needs to include specific training in how to supervise the effective practice.

Strength of Evidence Supporting Its Effectiveness: Not Evaluated

For some of the most common strategies we judged the strength of research support based on included studies and contextual systematic review evidence identified outside of this review. We did not evaluate the strength of evidence for this strategy. The information below represents the data we collected from studies including this strategy.

Health Care Areas Where the Provide Clinical Supervision (of EBP provision) Strategy Was Used

Strategies were used in a variety of settings and areas of health care. The “Other” category includes non-traditional settings in which health care might be provided, like schools.

Results From Studies That Included Provide Clinical Supervision (of EBP provision) Strategy

We recorded results from four different types of outcomes across research studies that included this strategy. The table below shows the proportion of these studies that showed improvement compared to a control.

How Often Were Studies That Included the "Provide Clinical Supervision (of EBP provision)" Strategy Effective?

The tables below show the recorded outcomes of each study that used this strategy by setting.

Studies That Used Provide Clinical Supervision (of EBP provision) and Their Outcomes, by Setting

Multiple

References

Morton I, Hurley B, Castillo EG, et al. Outcomes of two quality improvement implementation interventions for depression services in adults with substance use problems. Am J Drug Alcohol Abuse. 2020;46(2):251-261. doi:10.1080/00952990.2019.1708085