Rapid and pragmatic implementation mapping for pre-implementation contextual analysis in multisite implementation trials.

BACKGROUND

Systematic and data-driven implementation strategy selection is typically a resource-intensive process limited by time and implementation science expertise. Simultaneously, implementation trials often include externally driven timelines. To facilitate the conduct of a multisite hybrid trial, we developed and deployed a tool to facilitate rigorous yet pragmatic implementation mapping for strategy selection.

METHODS

As part of the HATRICC-US hybrid type II stepped wedge trial, we developed a strategy selection process based on implementation mapping and the Implementation Research Logic Model. The novel process was refined across two sites, tested in two additional sites, and replicated through the remaining sites of the trial. We considered the resources required, duration, alignment with best practices in implementation science, and usefulness to clinical implementation partners.

RESULTS

The final rapid implementation mapping process included the following seven steps: Step 1-Data Preparation; Step 2-Determinants and Change Objective Identification; Step 3-Summary Table Development & Internal Member Checking; Step 4-Identification of Implementation Strategies; Step 5-Completion of Implementation Research Logic Model; Step 6-Internal & External Member Checking; and Step 7-Completion of Tailored Implementation Blueprint and Manual.

CONCLUSIONS

There are often significant resource barriers that prevent the rapid use of implementation mapping and the IRLM and similar tools in implementation settings. We developed rigorous and rapid methods incorporating both implementation mapping and the IRLM for leveraging pre-implementation data collection to inform implementation efforts while also being responsive to both clinical partners and funding deadlines.Clinical Trial Registration: identifier NCT04571749.