How the experiences of implementation support recipients contribute to implementation outcomes

Metz AJ, Jensen TM, Afkinich JL, Disbennett ME and Farley AB (2024) How the experiences of implementation support recipients contribute to implementation outcomes. Front. Health Serv. 4:1323807. doi: 10.3389/frhs.2024.1323807 

Introduction: There is a growing body of literature on the activities and competencies of implementation support practitioners (ISPs) and the outcomes of engaging ISPs to support implementation efforts. However, there remains limited knowledge about the experiences of implementation support recipients who engage with ISPs and how these experiences shape the trajectory of implementation and contribute to implementation outcomes. This study aimed to extend the research on ISPs by describing the experiences of professionals who received implementation support and inform our understanding of the mechanisms by which ISPs produce behavior change and contribute to implementation outcomes.

Methods: Thirteen individuals with roles in supporting implementation efforts at a private foundation participated in semi-structured interviews. Data were analyzed using qualitative narrative analysis and episode profile analysis approaches. Iterative diagramming was used to visualize the pathway of experiences of implementation support recipients evidenced by the interview data.

Results: The majority of recipients described how positive experiences and trusting relationships with ISPs increased acceptance of implementation science throughout the foundation and increased the perception of implementation science as both an appropriate and feasible approach for strengthening the impact of foundation strategies. As perceptions of appropriateness and feasibility increased, recipients of implementation support described increasing knowledge and application of implementation science in their funding engagements and internal foundation strategies. Finally, recipients reported that the application of implementation science across the foundation led to sustained implementation capacity and better outcomes.

Discussion: The experiences of implementation support recipients described in this paper provide a source for further understanding the mechanisms of change for delivering effective implementation support leading to better implementation quality. Insights from these experiences can enhance our understanding for building implementation capacity and the rationales for evolving approaches that emphasize the dynamic, emotional, and highly relational nature of supporting others to use evidence in practice.

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Marita Brack is the Associate Director for Psychology within NHS Education for Scotland, and has worked as a Clinical Psychologist for 25 years. Her clinical work has principally been within specialist mental health services for children, young people and their families, both in Scotland and Australia. Marita has also worked within university settings in relation to the training of Applied Psychologists, and was the Clinical Practice Director on the MSc in Applied Psychology for Children and Young People, delivered in partnership between the NHS and the University of Edinburgh. Marita joined NES in 2010 as the Head of Programme for the Parenting and Infant Mental Health workstream, within the Psychology Directorate, and through this role has led on the development and implementation of several strands of work, including the Psychology of Parenting Project (PoPP), the NES Infant Mental Health training plan, the Early Intervention Framework, and most recently Marita has been co-leading on the implementation of the Enhanced Psychological Practice-Children and Young People certificate level course that has been created within NES. Marita has a long-standing interest in early intervention and prevention approaches to strengthening mental health and wellbeing, evidence-based parent-child relationship interventions and public health. 

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