ArticleImplementation science : IS2013
Between and within-site variation in qualitative implementation research.
Article in Implementation science : IS, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Barriers and facilitators to training delivery and subsequent implementation of a localised child and adolescent mental health initiative: a qualitative content analysis.BMC medical education · 2023Pooled it
- Applying system support mapping combined with the matrixed multiple case study approach to identify and analyse implementation determinants: lessons from a multi-site implementation study in German neonatal intensive care units.BMC health services research · 2026Trial
- Perceptions of event notification following discharge to improve geriatric care: qualitative interviews of care team members from a 2-site cluster randomized trial.Journal of the American Medical Informatics Association : JAMIA · 2021Trial
- Implementing Cultural Safety and Anti-Racism Training in Master of Public Health Curricula: A Multi-Institutional Case Study and Practical Self-Assessment Tool.Pedagogy in health promotion · 2026Article
- Patient perspectives of jail based MOUD treatment: views of individuals who have returned to the community following incarceration.Health & justice · 2025Article
- Health-care organization characteristics in cancer care delivery: an integrated conceptual framework with content validation.Journal of the National Cancer Institute · 2024Article
- Integrating Perspectives on Family Caregiving After Critical Illness: A Qualitative Content Analysis.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2024Article
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- Reformed child and adolescent mental health services in a devolved healthcare system: a mixed-methods case study of an implementation site.Frontiers in health services · 2023Article
- Perspectives of Parents and Teachers on the Impact of the COVID-19 Pandemic on Children's Socio-Emotional Well-Being.Early childhood education journal · 2022Article
- Where Rabies Is Not a Disease. Bridging Healthworlds to Improve Mutual Understanding and Prevention of Rabies.Frontiers in veterinary science · 2022Article
- End-user perceptions of a patient- and family-centred intervention to improve nutrition intake among oncology patients: a descriptive qualitative analysis.BMC nutrition · 2020Article
- Pragmatic trials and implementation science: grounds for divorce?BMC medical research methodology · 2019Article
- Explaining variation of implementation outcomes of centralized waiting lists for unattached patients.Journal of health organization and management · 2019Article
- "Struggling with practices" - a qualitative study of factors influencing the implementation of clinical quality registries for cardiac rehabilitation in England and Denmark.BMC health services research · 2019Article
- Shedding light on conditions for the successful passive dissemination of recommendations in primary care: a mixed methods study.Implementation science : IS · 2018Article
- Sowing the seeds of transformative practice to actualize women's rights to respectful maternity care: reflections from Kenya using the consolidated framework for implementation research.BMC women's health · 2017Article
- Article
- Using the Consolidated Framework for Implementation Research to Identify Barriers and Facilitators for the Implementation of an Internet-Based Patient-Provider Communication Service in Five Settings: A Qualitative Study.Journal of medical Internet research · 2015Article
- Identification of promising strategies to sustain improvements in hospital practice: a qualitative case study.BMC health services research · 2014Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultisite qualitative studies are challenging in part because decisions regarding within-site and between-site sampling must be made to reduce the complexity of data collection, but these decisions may have serious implications for analyses. There is not yet consensus on how to account for within-site and between-site variations in qualitative perceptions of the organizational context of interventions. The purpose of this study was to analyze variation in perceptions among key informants in order to demonstrate the importance of broad sampling for identifying both within-site and between-site implementation themes.
methodsCase studies of four sites were compared to identify differences in how Department of Veterans Affairs (VA) medical centers implemented a Primary Care/Mental Health Integration (PC/MHI) intervention. Qualitative analyses focused on between-profession variation in reported referral and implementation processes within and between sites.
resultsKey informants identified co-location, the consultation-liaison service, space, access, and referral processes as important topics. Within-site themes revealed the importance of coordination, communication, and collaboration for implementing PC/MHI. The between-site theme indicated that the preexisting structure of mental healthcare influenced how PC/MHI was implemented at each site and that collaboration among both leaders and providers was critical to overcoming structural barriers.
conclusionsWithin- and between-site variation in perceptions among key informants within different professions revealed barriers and facilitators to the implementation not available from a single source. Examples provide insight into implementation barriers for PC/MHI. Multisite implementation studies may benefit from intentionally eliciting and analyzing variation within and between sites. Suggestions for implementation research design are presented.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.