SynthesisBMC health services research2018
Defining the external implementation context: an integrative systematic literature review.
Synthesis in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Process Evaluations of Diabetes Self-Management Programs: A Systematic Review of the Literature.American journal of health promotion : AJHP · 2024Pooled it
- Quantitative measures of health policy implementation determinants and outcomes: a systematic review.Implementation science : IS · 2020Pooled it
- Systematic review of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework.Implementation science : IS · 2019Pooled it
- The role of preparation in implementation for rural healthcare innovation: a multi method evaluation of a virtual medical officer model of inpatient care in Australia.Implementation science communications · 2026Article
- Staff perceptions of patient self-care in hemodialysis treatment tasks: a qualitative exploration using the Exploration Preparation Implementation Sustainment Framework.BMC health services research · 2026Article
- Legitimacy, embedding, and learning framework: lessons from individual placement and support for analyzing sustainment and scale-up of complex psychosocial interventions.International journal of public health · 2026Review
- Article
- Strengthening health promotion at the local level: insights from Swiss municipalities (canton of Vaud) across urban and rural contexts.International journal of public health · 2026Article
- Spread and Scale-Up of a Region-Wide Telehealth Navigation Service in a Rural Context: Qualitative Process Evaluation.Journal of medical Internet research · 2025Article
- The Role of Contextual Determinants in Implementation of Complex Suicide Prevention Interventions: An Application of the Exploration, Preparation, Implementation and Sustainment (EPIS) Framework.The International journal of health planning and management · 2025Article
- Implementing capacity-building initiatives addressing health equity through community-academic partnerships: A qualitative study.Translational behavioral medicine · 2025Article
- Family-based substance use screening and intervention for adolescents with chronic medical conditions: a study protocol to implement SBIRT-family within school-based health centers.Frontiers in health services · 2025Article
- Universal substance use care for adolescents with chronic medical conditions: a protocol to examine equitable implementation determinants and strategies for SBIRT at a pediatric hospital.Addiction science & clinical practice · 2024Article
- How does the external context affect an implementation processes? A qualitative study investigating the impact of macro-level variables on the implementation of goal-oriented primary care.Implementation science : IS · 2024Article
- External context in individual placement and support implementation: a scoping review with abductive thematic analysis.Implementation science : IS · 2023Article
- Study protocol for a multi-level cross-sectional study on the equitable reach and implementation of coordinated specialty care for early psychosis.Implementation science communications · 2023Article
- Local implementation of public health policies revealed by the COVID-19 crisis: the French case.Implementation science : IS · 2023Article
- Chronic Disease in Low-Resource Settings: Prevention and Management Throughout the Continuum of Care-A Call for Papers.International journal of environmental research and public health · 2023Article
- Methodological approaches to study context in intervention implementation studies: an evidence gap map.BMC medical research methodology · 2022Article
- Conceptual and relational advances of the PARIHS and i-PARIHS frameworks over the last decade: a critical interpretive synthesis.Implementation science : IS · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundProper implementation of evidence-based interventions is necessary for their full impact to be realized. However, the majority of research to date has overlooked facilitators and barriers existing outside the boundaries of the implementing organization(s). Better understanding and measurement of the external implementation context would be particularly beneficial in light of complex health interventions that extend into and interact with the larger environment they are embedded within. We conducted a integrative systematic literature review to identify external context constructs likely to impact implementation of complex evidence-based interventions.
methodsThe review process was iterative due to our goal to inductively develop the identified constructs. Data collection occurred in four primary stages: (1) an initial set of key literature across disciplines was identified and used to inform (2) journal and (3) author searches that, in turn, informed the design of the final (4) database search. Additionally, (5) we conducted citation searches of relevant literature reviews identified in each stage. We carried out an inductive thematic content analysis with the goal of developing homogenous, well-defined, and mutually exclusive categories.
resultsWe identified eight external context constructs: (1) professional influences, (2) political support, (3) social climate, (4) local infrastructure, (5) policy and legal climate, (6) relational climate, (7) target population, and (8) funding and economic climate.
conclusionsThis is the first study to our knowledge to use a systematic review process to identify empirically observed external context factors documented to impact implementation. Comparison with four widely-utilized implementation frameworks supports the exhaustiveness of our review process. Future work should focus on the development of more stringent operationalization and measurement of these external constructs.
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What OpenQuestion holds
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.