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Background: A supportive context is essential for successful implementation processes. Local politicians are delivery system actors who might both enable and hinder the implementation of health and social policies. Aims and objectives: The study examines the relationship between perceived prerequisites and the type of actions taken by local political committees to support the implementation of evidence-based practice in social services. Methods: A cross-sectional web survey targeting the chair and vice-chair of committees responsible for social services in Sweden (n=181). The data was analysed with regression analysis, cluster analysis and ANOVA. Findings: Three clusters of action were identified (passive, neutral and active), capturing the reported actions taken by the committees to support implementation of EBP. The committees' perceived prerequisites (capability, motivation, and opportunity) were highest in the active cluster and lowest in the passive cluster. The clusters also differed regarding chair/vice-chair educational level, and type of municipality in which the chair/vice-chair were active. Discussions and conclusion: The variation in reported actions among the committees to support the implementation of EBP implies that some social service organisations might lack the contextual support they need for implementing EBP. The prerequisites for the committees might need to be strengthened with regard to capability, motivation and opportunity. This study is an indication of the relationship between committees' prerequisites and their actions in the implementation of EBP, but further research is needed.

ObjectiveInternational collaboration in science has received increasing attention given emphases on relevance, generalizability, and impact of research. Implementation science (IS) is a growing discipline that aims to translate clinical research findings into health services. Research is needed to identify efficient and effective ways to foster international collaboration in IS. Concept-mapping (CM) was utilized with a targeted sample for preliminary exploration of fostering international collaboration. Concept-mapping is a mixed-method approach (qualitative/quantitative) particularly suited for identifying essential themes and action items to facilitate planning among diverse stakeholders. We sought to identify key factors likely to facilitate productive and rewarding international collaborations in implementation research.ResultsWe identified eleven dimensions: Strategic Planning; Practicality; Define Common Principles; Technological Tools for Collaboration; Funding; Disseminate Importance of Fostering International Collaboration in IS; Knowledge Sharing; Innovative & Adaptive Research; Training IS Researchers; Networking & Shared Identity; Facilitate Meetings. Strategic Planning and Funding were highest rated for importance and Strategic Planning and Networking and Shared Identity were rated most feasible to institute. Fostering international collaboration in IS can accelerate the efficiency, relevance, and generalizability of implementation research. Strategies should be developed and tested to improve international collaborations and engage junior and experienced investigators in collaborations advancing implementation science and practice.

BACKGROUND: There has long been debate about the balance between fidelity to evidence-based interventions (EBIs) and the need for adaptation for specific contexts or particular patients. The debate is relevant to virtually all clinical areas. This paper synthesises arguments from both fidelity and adaptation perspectives to provide a comprehensive understanding of the challenges involved, and proposes a theoretical and practical approach for how fidelity and adaptation can optimally be managed. DISCUSSION: There are convincing arguments in support of both fidelity and adaptations, representing the perspectives of intervention developers and internal validity on the one hand and users and external validity on the other. Instead of characterizing fidelity and adaptation as mutually exclusive, we propose that they may better be conceptualized as complimentary, representing two synergistic perspectives that can increase the relevance of research, and provide a practical way to approach the goal of optimizing patient outcomes. The theoretical approach proposed, the Value Equation, provides a method for reconciling the fidelity and adaptation debate by putting it in relation to the value (V) that is produced. The equation involves three terms: intervention (IN), context (C), and implementation strategies (IS). Fidelity and adaptation determine how these terms are balanced and, in turn, the end product - the value it produces for patients, providers, organizations, and systems. The Value Equation summarizes three central propositions: 1) The end product of implementation efforts should emphasize overall value rather than only the intervention effects, 2) implementation strategies can be construed as a method to create fit between EBIs and context, and 3) transparency is vital; not only for the intervention but for all of the four terms of the equation. There are merits to arguments for both fidelity and adaptation. We propose a theoretical approach, a Value Equation, to reconciling the fidelity and adaptation debate. Although there are complexities in the equation and the propositions, we suggest that the Value Equation be used in developing and testing hypotheses that can help implementation science move toward a more granular understanding of the roles of fidelity and adaptation in the implementation process, and ultimately sustainability of practices that provide value to stakeholders.

The way the road transport system is developed in a country affects safety. This study aims to identify the roles and relationships of road transport stakeholders and to explore the understanding of control and feedback mechanisms and associated gaps influencing road safety. A System-Theoretic Accident Model and Processes (STAMP) model was applied to document and interview data (n = 30). Participants emphasised the hindrance of overlapping mandates among stakeholders on the road transport system's operations and underlined the roles of coalitions for road safety as system enablers. Further, the withdrawal of some controls by international agencies can increase system vulnerability. Most importantly, critical control and feedback gaps were shown to increase risks for safety within the road transport system. The findings underscore the complexity of the road transport system and add to the discussion on a system's approach to road safety. Practitioner summary: Using a STAMP methodology, we extensively studied the road transport system in Tanzania. Road transport stakeholders were identified through the review of documents, interviews were conducted, and the main findings were discussed. Control and feedback mechanisms and associated gaps were critically presented, recommendations were proposed, and policy implications were suggested. [ABSTRACT FROM AUTHOR]

Organizational occupational health interventions (OOHIs) that are perceived by employees as relevant for their workplace are more likely to be implemented successfully, yet little is known about the conditions that produce such perceptions. This study identifies the conditions that create a perception among employees that an intervention fits their organization as well as the conditions that result in low levels of perceived fit. We used two‐wave data from 40 Danish preschools that underwent a quasi‐experimental OOHI. Perceived fit was assessed through employee ratings at follow‐up, while survey responses from implementation team members at five time points were used to assess four context and 14 process factors. The results of a coincidence analysis showed that high levels of perceived fit were achieved through two paths. Each path consisted of a lack of co‐occurring changes together with either very high levels of managerial support (path_1) or a combination of implementation team role clarity, staff involvement, and team learning (path_2). In contrast, low levels of perceived fit were brought about by single factors: limited leader support, low degree of role clarity, or concurrent organizational changes. The findings reveal the complexity involved in implementing OOHIs and offer insights into reasons they may fail. [ABSTRACT FROM AUTHOR]

Using evidence-based interventions (EBIs) is one way to achieve good-quality social services. Adaptations of and efforts to maintain fidelity to EBIs are common. However, research addressing these issues is published across multiple journals. This scoping review aims to explore how fidelity to and adaptations of EBIs are described in the social work literature. We searched for peer-reviewed, English language articles addressing EBIs in social work journals in five databases. Data were extracted and analysed to address the aim of the study. Qualitative content analysis was used to analyse items containing more extensive information. The searches yielded 2,949 articles. The results of 236 articles are presented. Almost fifty different terms were found describing adaptations, and the variety of terms describing fidelity was significantly smaller. Various measures to achieve and/or assess fidelity were identified. The Framework for Reporting Adaptations and Modifications-Expanded was used to categorise information about adaptations. Most adaptations concerned modifications of content and were planned rather than unplanned. Thirty-eight frameworks for implementation of EBIs were identified, and fourteen dealt with fidelity and adaptations. Fidelity and adaptations are increasingly in focus in social work studies. This review contributes to increased knowledge about how fidelity and adaptations have been described in the social work literature. [ABSTRACT FROM AUTHOR]