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ToolsSquires, Janet E., Graham, Ian D., Santos, Wilmer J. and Hutchinson, Alison M. and The ICON Team (2023) The Implementation in Context (ICON) Framework: A meta-framework of context domains, attributes and features in healthcare: A meta-framework of context domains, attributes and features in healthcare. Health Research Policy and Systems, 21. ISSN 1478-4505
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Abstract
Background: There is growing evidence that context mediates the effects of implementation interventions intended to increase healthcare professionals’ use of research evidence in clinical practice. However, conceptual clarity about what comprises context is elusive. The purpose of this study was to advance conceptual clarity on context by developing the Implementation in Context Framework, a meta-framework of the context domains, attributes and features that can facilitate or hinder healthcare professionals’ use of research evidence and the effectiveness of implementation interventions in clinical practice. Methods: We conducted a meta-synthesis of data from three interrelated studies: (1) a concept analysis of published literature on context (n = 70 studies), (2) a secondary analysis of healthcare professional interviews (n = 145) examining context across 11 unique studies and (3) a descriptive qualitative study comprised of interviews with heath system stakeholders (n = 39) in four countries to elicit their tacit knowledge on the attributes and features of context. A rigorous protocol was followed for the meta-synthesis, resulting in development of the Implementation in Context Framework. Following this meta-synthesis, the framework was further refined through feedback from experts in context and implementation science. Results: In the Implementation in Context Framework, context is conceptualized in three levels: micro (individual), meso (organizational), and macro (external). The three levels are composed of six contextual domains: (1) actors (micro), (2) organizational climate and structures (meso), (3) organizational social behaviour (meso), (4) organizational response to change (meso), (5) organizational processes (meso) and (6) external influences (macro). These six domains contain 22 core attributes of context and 108 features that illustrate these attributes. Conclusions: The Implementation in Context Framework is the only meta-framework of context available to guide implementation efforts of healthcare professionals. It provides a comprehensive and critically needed understanding of the context domains, attributes and features relevant to healthcare professionals’ use of research evidence in clinical practice. The Implementation in Context Framework can inform implementation intervention design and delivery to better interpret the effects of implementation interventions, and pragmatically guide implementation efforts that enhance evidence uptake and sustainability by healthcare professionals.
| Item Type: | Article |
|---|---|
| Additional Information: | Availability of data and materials: The ICON features, the ranking of ICON attributes from the 2019 Knowledge Utilization Colloquium and the ICON screening tool are provided as additional files. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Funding: This research was supported by two Canadian Institutes of Health Research (CIHR) Project Grants (Awards #: 326947 and 426122). The CIHR had no role in the study’s design, conduct or reporting. |
| Uncontrolled Keywords: | context,framework,healthcare,implementation,knowledge translation,health policy ,/dk/atira/pure/subjectarea/asjc/2700/2719 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > School of Health Sciences |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 26 Feb 2025 14:30 |
| Last Modified: | 26 Feb 2025 14:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/98610 |
| DOI: | 10.1186/s12961-023-01028-z |
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