ArticleImplementation science : IS2025
When the parts are greater than the whole: how understanding mechanisms can advance implementation research.
Article in Implementation science : IS, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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
22 citing papers in PubMed.
- Exploring change mechanisms of implementation strategies for providing guideline-adherent care by interprofessional teams in inpatient settings: a realist synthesis.Implementation science : IS · 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
- Implementing a multimodal lifestyle intervention for depression and overweight in primary and secondary care: protocol for an implementation study exploring what works, how, and under what conditions.Implementation science communications · 2026Article
- Strategies to increase medications for opioid use disorder in hospital settings in the USA: protocol for a scoping review.BMJ open · 2026Article
- The roads towards fidelity: a mixed-method study of mechanisms of a multifaceted implementation strategy to improve implementation of a guideline for the prevention of mental Ill-health at the workplace in a school setting.Implementation science communications · 2026Article
- Mapping Methods: Charting Future Priorities for Research Methods in Dissemination and Implementation Science.Research square · 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
- Advancing knowledge translation processes in motor rehabilitation for children with cerebral palsy and developmental coordination disorder: insights from a scoping review.BMC health services research · 2026Article
- Tracing the threads: a system dynamics and network diffusion model of kangaroo care implementation in neonatal care.Implementation science communications · 2026Article
- Rethinking barriers and facilitators in implementation science: conceptual, methodological, and practical challenges, and ways forward.Implementation science communications · 2026Article
- Mechanism-informed transition from pediatric to adult care in sickle cell disease: a case study.BMC health services research · 2026Article
- Conducting rigorous implementation evaluations in real word settings: lessons from a consensus approach to perioperative pathway implementation for elective surgery.Implementation science communications · 2026Article
- The challenge of adopting the health assessment when implementing antenatal and postnatal Group Care: identifying and understanding cross-country modifications and corresponding strategies to enable its adoption.Implementation science communications · 2026Article
- Transfer effects of animal-assisted therapy on socioemotional skills in adult inpatient rehabilitation after acquired brain injury: a randomized controlled trial.Frontiers in rehabilitation sciences · 2026Article
- What It Takes to Manage Change: A Qualitative Study of Healthcare Managers' Role Perceptions in Supporting and Sustaining TeamSTEPPS Implementation.Journal of healthcare leadership · 2026Article
- Hybrid type 1 effectiveness-implementation studies: why and how to do them.Frontiers in health services · 2026Article
- Failing to succeed: advancing mechanistic understanding of implementation strategies through retrospective and prospective use of causal pathway diagrams.Implementation science communications · 2025Article
- Implementation mechanisms used in national efforts to improve community services to keep individuals with mental illness out of local jails.Implementation science communications · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundDoes the importance of context in implementation imply that generalizing about the effects of strategies is ultimately limited? Conceptual approaches for generalizing in the presence of significant contextual heterogeneity could advance implementation research but require novel perspectives. MAIN BODY: Drawing from perspectives from Realist approaches, Pearl's transportability framework and philosophy of science, this paper outlines a mechanism-based approach to generalizing about the effects of implementation strategies. We suggest that understanding mechanisms creates a conceptual bridge between the effects of a strategy and the influence of the implementation context. Using directed acyclic graphs to represent the mechanisms of strategies, we show how conceptualizing mediators of overall effects offer a basis for considering the effects of context. Hence, theorizing and testing a mechanistic understanding enriches the ways in which we can consider how context could change those effects. Such an approach allows us to understand how a strategy works within a given implementation context, determine what information from new contexts are needed to infer across contexts, and if that information is available, what those effects would be - thereby advancing generalizing in implementation research. We consider particular implementation strategies (e.g., Community Adherence Groups and practice facilitation) as examples to illustrate generalizing into different contexts.
conclusionMechanisms can help implementation research by simultaneously accommodating the importance of context as well as the imperative to generalize. A shift towards a mechanism-focused approach that goes beyond identifying barriers and facilitators can enhance the value of implementation research.
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Registered trials
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