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Implementation Science in School-Based, Universal-Level Intervention Research: A Scoping Review

American Speech-Language-Hearing Association
Language, Speech, and Hearing Services in Schools
Authors:
Aoife L Gallagher at University of Limerick
Aoife L Gallagher
Rachel Murphy at University College Dublin
Rachel Murphy
Ciara Ni Eochaidh
Ciara Ni Eochaidh
Ciara Ni Eochaidh
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Johanna Fitzgerald at Mary Immaculate College
Johanna Fitzgerald
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Purpose The aim of this study was to map the use of implementation science frameworks, models, and theories in intervention research targeting learning needs in the classroom. Method A scoping review was conducted. Electronic database and manual searches were conducted. Two reviewers independently completed screening, data extraction, and quality appraisal. Qualitative content analysis was undertaken using Nilsen's taxonomy and the domains of the Consolidated Framework for Implementation Research (CFIR). The data were further analyzed using the CFIR valence and strength rating scales. Results Included papers (n = 22) used a diverse sample of implementation science frameworks and models. Most studies used determinant frameworks to guide data collection and analysis. Few studies used implementation science theory. Most studies were mixed methods (n = 11), published since 2019 (n = 20), and conducted in North America (n = 15). Over half of the interventions targeted social, emotional, and mental health (n = 13). A complex interplay of inner setting factors was identified as having a strong influence on implementation. Teachers' knowledge and beliefs, adaptability, and complexity of interventions were also identified as important considerations when conducting research in this context. Conclusions Early engagement with stakeholders in education is recommended when designing universal level speech, language, and communication interventions for use in the ordinary classroom. Adaptive, hybrid designs that test both implementation strategies and effectiveness of interventions may be warranted given the influence of inner setting factors on implementation outcomes.
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• • • •
Review Article
Implementation Science in School-Based,
Universal-Level Intervention Research: A
Scoping Review
Aoife L. Gallagher,
a,b
Rachel Murphy,
b
Ciara Ni Eochaidh,
b
Johanna Fitzgerald,
c
Carol-Anne Murphy,
a,b
and James Law
d
a
Health Research Institute, University of Limerick, Ireland
b
School of Allied Health, Faculty of Education and Health Sciences, University of
Limerick, Ireland
c
Mary Immaculate College, Limerick, Ireland
d
Department of Speech Sciences, Newcastle University, Newcastle upon Tyne,
United Kingdom
AR T I CLE I N F O
Article History:
Received November 8, 2022
Revision received February 27, 2023
Accepted June 22, 2023
Editor-in-Chief: Kelly Farquharson
Editor: Rouzana Komesidou
https://doi.org/10.1044/2023_LSHSS-22-00181
Correspondence to Aoife L. Gallagher: aoife.gallagher@ul.ie. In
memory of our collaborator, James Law, who passed away during
the preparation of this research, we gratefully acknowledge his contri-
butions to the research. Publisher Note: This article is part of the
Forum: Implementation Science in School-Based Settings. Disclosure:
The authors have declared that no competing financial or nonfinancial
interests existed at the time of publication.
AB ST R A C T
Purpose: The aim of this study was to map the use of implementation science
frameworks, models, and theories in intervention research targeting learning
needs in the classroom.
Method: A scoping review was conducted. Electronic database and manual
searches were conducted. Two reviewers independently completed screening,
data extraction, and quality appraisal. Qualitative content analysis was under-
taken using Nilsen’s taxonomy and the domains of the Consolidated Framework
for Implementation Research (CFIR). The data were further analyzed using the
CFIR valence and strength rating scales.
Results: Included papers (n = 22) used a diverse sample of implementation
science frameworks and models. Most studies used determinant frameworks to
guide data collection and analysis. Few studies used implementation science
theory. Most studies were mixed methods (n = 11), published since 2019 (n =
20), and conducted in North America (n = 15). Over half of the interventions tar-
geted social, emotional, and mental health (n = 13). A complex interplay of inner
setting fac tors was identified as having a strong influence on implementation.
Teachers’ knowledge and beliefs, adaptability, and complexity of interventions
were also identified as important considerations when conducting research in
this context.
Conclusions: Early engagement with stakeholders in education is recommended
when designing universal level speech, language, and communication interven-
tions for use in the ordinary classroom. Adaptive, hybrid designs that test both
implementation strategies and effectiveness of interventions may be warranted
given the influence of inner setting factors on implementation outcomes.
The most prevalent special educational needs in the
school-age population relate to speech, language, and
communication (Lindsay & Strand, 2016; Norbury et al.,
2016). Speech, language, and communication needs
(SLCN) can occur in association with a biomedical
condition because of significant limitations in language
exposure, or with no obvious cause, as a part of a neuro-
developmental disorder. Difficulties can present in com-
prehension and in expressive language and can impact
negatively on the development of literacy and socializa-
tion. For some, SLCN can have lifelong negative implica-
tions in terms of reduced employability, poor mental
health, and independent living (Botting et al., 2016; Conti-
Ramsden & Durkin, 2012; Conti-Ramsden et al., 2018).
Many educational systems use response to interven-
tion approaches as a means of allocating support in school
to children with additional needs (Ehren & Nelson, 2005;
Language, Speech, and Hearing Services in Schools Vol. 54 1173–1194 October 2023 Copyright © 2023 American Speech-Language-Hearing Association 1173
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