Evaluating the successful implementation of evidence into practice using the PARIHS framework: Theoretical and practical challenges

Green College, University of Oxford, Woodstock Road, Oxford OX2 6HG, UK.
Implementation Science (Impact Factor: 4.12). 02/2008; 3(1, article 1):1. DOI: 10.1186/1748-5908-3-1
Source: PubMed


The PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavours. However, as a conceptual framework it still remains untested and therefore its contribution to the overall development and testing of theory in the field of implementation science is largely unquantified.
This being the case, the paper provides an integrated summary of our conceptual and theoretical thinking so far and introduces a typology (derived from social policy analysis) used to distinguish between the terms conceptual framework, theory and model - important definitional and conceptual issues in trying to refine theoretical and methodological approaches to knowledge translation. Secondly, the paper describes the next phase of our work, in particular concentrating on the conceptual thinking and mapping that has led to the generation of the hypothesis that the PARiHS framework is best utilised as a two-stage process: as a preliminary (diagnostic and evaluative) measure of the elements and sub-elements of evidence (E) and context (C), and then using the aggregated data from these measures to determine the most appropriate facilitation method. The exact nature of the intervention is thus determined by the specific actors in the specific context at a specific time and place. In the process of refining this next phase of our work, we have had to consider the wider issues around the use of theories to inform and shape our research activity; the ongoing challenges of developing robust and sensitive measures; facilitation as an intervention for getting research into practice; and finally to note how the current debates around evidence into practice are adopting wider notions that fit innovations more generally.
The paper concludes by suggesting that the future direction of the work on the PARiHS framework is to develop a two-stage diagnostic and evaluative approach, where the intervention is shaped and moulded by the information gathered about the specific situation and from participating stakeholders. In order to expedite the generation of new evidence and testing of emerging theories, we suggest the formation of an international research implementation science collaborative that can systematically collect and analyse experiences of using and testing the PARiHS framework and similar conceptual and theoretical approaches. We also recommend further refinement of the definitions around conceptual framework, theory, and model, suggesting a wider discussion that embraces multiple epistemological and ontological perspectives.

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Available from: Jo Rycroft-Malone, Oct 14, 2015
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    • "Participants provided relevant insights about the key components that are missing from generic community participation frameworks, that could enhance their applicability to the CHC context. Other scholars have also noted that lack of conceptual clarity of the core elements that make up a framework, and limited rigorous evaluation of the framework in different practice settings can pose challenges to the successful use and implementation of evidence-based practice frameworks (Gagliardi et al., 2011; Kitson et al., 2008). Despite the significant insights from this study, our findings should be considered in light of several limitations. "
    • "Empirical and theoretical literature about implementation of DOI: 10.1111/jonm.12320 ª 2015 John Wiley & Sons Ltd evidence-based practice (EBP) in nursing has demonstrated that a variety of factors influence the complex process of change (Kitson et al. 2008, Estabrooks 2009, Titler 2010). Leadership and facilitation interventions are consistently identified as essential (Dogherty et al. 2010, Sandstr€ om et al. 2011). "
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