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Clinical interventions, implementation interventions, and the potential greyness in between -a discussion paper
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.;Linkoping Univ, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden..
Queens Univ, Kingston, ON, Canada..
Publ Hlth Ontario, Toronto, ON, Canada..
Univ Ottawa, Ottawa, ON, Canada..
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2017 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, article id 16Article in journal (Refereed) Published
Abstract [en]

Background: There is increasing awareness that regardless of the proven value of clinical interventions, the use of effective strategies to implement such interventions into clinical practice is necessary to ensure that patients receive the benefits. However, there is often confusion between what is the clinical intervention and what is the implementation intervention. This may be caused by a lack of conceptual clarity between 'intervention' and 'implementation', yet at other times by ambiguity in application. We suggest that both the scientific and the clinical communities would benefit from greater clarity; therefore, in this paper, we address the concepts of intervention and implementation, primarily as in clinical interventions and implementation interventions, and explore the grey area in between. Discussion: To begin, we consider the similarities, differences and potential greyness between clinical interventions and implementation interventions through an overview of concepts. This is illustrated with reference to two examples of clinical interventions and implementation intervention studies, including the potential ambiguity in between. We then discuss strategies to explore the hybridity of clinical-implementation intervention studies, including the role of theories, frameworks, models, and reporting guidelines that can be applied to help clarify the clinical and implementation intervention, respectively. Conclusion: Semantics provide opportunities for improved precision in depicting what is 'intervention' and what is 'implementation' in health care research. Further, attention to study design, the use of theory, and adoption of reporting guidelines can assist in distinguishing between the clinical intervention and the implementation intervention. However, certain aspects may remain unclear in analyses of hybrid studies of clinical and implementation interventions. Recognizing this potential greyness can inform further discourse.

Place, publisher, year, edition, pages
2017. Vol. 17, article id 16
Keywords [en]
Concept, Implementation, Implementation Science, Intervention, Knowledge Translation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-315820DOI: 10.1186/s12913-016-1958-5ISI: 000391923400001PubMedID: 28061856OAI: oai:DiVA.org:uu-315820DiVA, id: diva2:1076096
Available from: 2017-02-22 Created: 2017-02-22 Last updated: 2017-11-29Bibliographically approved

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