ArticleImplementation science communications2023
A structured approach to applying systems analysis methods for examining implementation mechanisms.
Article in Implementation science communications, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Mechanisms of change of a multifaceted implementation strategy on fidelity to a guideline for the prevention of mental health problems at the workplace: a mechanism analysis within a cluster-randomized controlled trial.Implementation science : IS · 2025Trial
- Visualizing stigma and HIV service engagement: a participatory approach using causal loop diagrams.BMC public health · 2026Article
- Exploring working mechanism of an implementation strategy bundle on the implementation of a lifestyle intervention for community-dwelling older adults: process evaluation of a stepped wedge trial.Implementation science communications · 2026Article
- Advancing systems thinking in implementation science: An epidemiologic perspective.Annals of epidemiology · 2026Article
- Matters arising: a commentary on "Failing to succeed: advancing mechanistic understanding of implementation strategies through retrospective and prospective use of causal pathway diagrams" by Austad et al. 2025.Implementation science communications · 2026Article
- Mechanisms of practice facilitation identified using system dynamics diagramming in a tailored implementation study of unhealthy alcohol screening and treatment in primary care.Implementation science communications · 2026Article
- Tracing the threads: a system dynamics and network diffusion model of kangaroo care implementation in neonatal care.Implementation science communications · 2026Article
- Mechanism-informed transition from pediatric to adult care in sickle cell disease: a case study.BMC health services research · 2026Article
- Participatory system dynamics modeling: advancing equity through contextualized implementation science in global health.BMC global and public health · 2026Review
- What makes patient navigation work? Identifying functions and forms and conducting causal loop diagramming to specify components of a successful colorectal cancer patient navigation program.Implementation science communications · 2026Article
- Implementation pathways of a health services delivery redesign model to improve maternal and newborn outcomes in Kenya.BMJ global health · 2026Article
- Participatory systems modeling in implementation research: Exploring benefits, facilitators, and future needs.Journal of clinical and translational science · 2026Article
- Failing to succeed: advancing mechanistic understanding of implementation strategies through retrospective and prospective use of causal pathway diagrams.Implementation science communications · 2025Article
- A participatory systems approach for visualizing and testing implementation strategies and mechanisms: evidence adoption in community coalitions.Implementation science communications · 2025Article
- A Mixed-Method Case Study to Evaluate Adoption of Clinical Decision Support for Cancer Symptom Management.Applied clinical informatics · 2025Article
- The sustainability of health interventions implemented in Africa: an updated systematic review on evidence and future research perspectives.Implementation science communications · 2025Review
- Tools to improve discharge equity: Protocol for the pilot TIDE trial.Contemporary clinical trials communications · 2025Article
- Leveraging group model building to operationalize implementation strategies across implementation phases: an exemplar related to child maltreatment intervention selection.Implementation science communications · 2024Article
- Evaluating the tailored implementation of a multisite care navigation service for mental health in rural and remote Australia (The Bridging Study): protocol for a community-engaged hybrid effectiveness-implementation study.Implementation science : IS · 2024Article
- Integrating causal pathway diagrams into practice facilitation to address colorectal cancer screening disparities in primary care.BMC health services research · 2024Article
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Authors and funding
6 authors.
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Abstract
backgroundIt is challenging to identify and understand the specific mechanisms through which an implementation strategy affects implementation outcomes, as implementation happens in the context of complex, multi-level systems. These systems and the mechanisms within each level have their own dynamic environments that change frequently. For instance, sequencing may matter in that a mechanism may only be activated indirectly by a strategy through another mechanism. The dosage or strength of a mechanism may vary over time or across different health care system levels. To elucidate the mechanisms relevant to successful implementation amidst this complexity, systems analysis methods are needed to model and manage complexity.
methodsThe fields of systems engineering and systems science offer methods-which we refer to as systems analysis methods-to help explain the interdependent relationships between and within systems, as well as dynamic changes to systems over time. When applied to studying implementation mechanisms, systems analysis methods can help (i) better identify and manage unknown conditions that may or may not activate mechanisms (both expected mechanisms targeted by a strategy and unexpected mechanisms that the methods help detect) and (ii) flexibly guide strategy adaptations to address contextual influences that emerge after the strategy is selected and used.
resultsIn this paper, we delineate a structured approach to applying systems analysis methods for examining implementation mechanisms. The approach includes explicit steps for selecting, tailoring, and evaluating an implementation strategy regarding the mechanisms that the strategy is initially hypothesized to activate, as well as additional mechanisms that are identified through the steps. We illustrate the approach using a case example. We then discuss the strengths and limitations of this approach, as well as when these steps might be most appropriate, and suggest work to further the contributions of systems analysis methods to implementation mechanisms research.
conclusionsOur approach to applying systems analysis methods can encourage more mechanisms research efforts to consider these methods and in turn fuel both (i) rigorous comparisons of these methods to alternative mechanisms research approaches and (ii) an active discourse across the field to better delineate when these methods are appropriate for advancing mechanisms-related knowledge.
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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.