ArticleImplementation science : IS2020
Rugged landscapes: complexity and implementation science.
Article in Implementation science : IS, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Investigating the implementation of infection prevention and control practices in neonatal care across country income levels: a systematic review.Antimicrobial resistance and infection control · 2025Pooled it
- Knowledge and attitudes of Implementation Support Practitioners-Findings from a systematic integrative review.PloS one · 2022Pooled it
- How can policies impact the relational process of deprescription? A realist review protocol with an initial theory.Frontiers in public health · 2025Article
- Gaps in communication theory paradigms when conducting implementation science research: qualitative observations from interviews with administrators, implementors, and evaluators of rural health programs.Implementation science : IS · 2024Article
- What is context in knowledge translation? Results of a systematic scoping review.Health research policy and systems · 2024Article
- Advancing healthcare equity through dissemination and implementation science.Health services research · 2023Review
- Guidance on the use of complex systems models for economic evaluations of public health interventions.Health economics · 2023Review
- Community-based care for autistic youth: community providers' reported use of treatment practices in the United States.Frontiers in psychiatry · 2023Article
- Using decision analysis to support implementation planning in research and practice.Implementation science communications · 2022Article
- Simulating the role of knowledge brokers in policy making in state agencies: An agent-based model.Health services research · 2022Article
- "It's good to feel like you're doing something": a qualitative study examining state health department employees' views on why ineffective programs continue to be implemented in the USA.Implementation science communications · 2022Article
- From Creative Engagement to Illustrative Insights: Exploring the Role of Design Probes for Implementation Research.Implementation research and practiceArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundMis-implementation-defined as failure to successfully implement and continue evidence-based programs-is widespread in public health practice. Yet the causes of this phenomenon are poorly understood.
methodsWe develop an agent-based computational model to explore how complexity hinders effective implementation. The model is adapted from the evolutionary biology literature and incorporates three distinct complexities faced in public health practice: dimensionality, ruggedness, and context-specificity. Agents in the model attempt to solve problems using one of three approaches-Plan-Do-Study-Act (PDSA), evidence-based interventions (EBIs), and evidence-based decision-making (EBDM).
resultsThe model demonstrates that the most effective approach to implementation and quality improvement depends on the underlying nature of the problem. Rugged problems are best approached with a combination of PDSA and EBI. Context-specific problems are best approached with EBDM.
conclusionsThe model's results emphasize the importance of adapting one's approach to the characteristics of the problem at hand. Evidence-based decision-making (EBDM), which combines evidence from multiple independent sources with on-the-ground local knowledge, is a particularly potent strategy for implementation and quality improvement.
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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.