Margaret Cargo1, Janet Harris2, Tomas Pantoja3, Andrew Booth2, Angela Harden4, Karin Hannes5, James Thomas6, Kate Flemming7, Ruth Garside8, Jane Noyes9. 1. Health Research Institute, University of Canberra, University Drive, 22-B17, Canberra, Australia; Centre for Population Health, University of South Australia, 8th Floor Office 310, SAHMRI Building (North Terrace), Adelaide, Australia. Electronic address: margaret.cargo@canberra.edu.au. 2. School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, UK. 3. Department of Family Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Centro Médico San Joaquín, Av. Vicuna Mackenna, 4686, Macul, Santiago, Chile. 4. Institute for Health and Human Development, The University of East London, Stratford Campus, Water Lane, London, UK. 5. Social Research Methodology Group, Centre for Sociological Research, Faculty of Social Sciences, KU Leuven, Leuven, Belgium. 6. UCL Institute of Education, University College London, 20 Bedford Way, London, UK. 7. Department of Health Sciences, Faculty of Science, University of York, Seebohm Rowntree Building, Heslington, York, UK. 8. European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK. 9. School of Social Sciences, Bangor University, Bangor, Gwynedd, UK.
Abstract
OBJECTIVES: This article provides reviewers with guidance on methods for identifying and processing evidence to understand intervention implementation. STUDY DESIGN AND SETTING: Strategies, tools, and methods are applied to the systematic review process to illustrate how process and implementation can be addressed using quantitative, qualitative, and other sources of evidence (i.e., descriptive textual and nonempirical). RESULTS: Reviewers can take steps to navigate the heterogeneity and level of uncertainty present in the concepts, measures, and methods used to assess implementation. Activities can be undertaken in advance of a Cochrane quantitative review to develop program theory and logic models that situate implementation in the causal chain. Four search strategies are offered to retrieve process and implementation evidence. Recommendations are made for addressing rigor or risk of bias in process evaluation or implementation evidence. Strategies are recommended for locating and extracting data from primary studies. The basic logic is presented to assist reviewers to make initial review-level judgments about implementation failure and theory failure. CONCLUSION: Although strategies, tools, and methods can assist reviewers to address process and implementation using quantitative, qualitative, and other forms of evidence, few exemplar reviews exist. There is a need for further methodological development and trialing of proposed approaches.
OBJECTIVES: This article provides reviewers with guidance on methods for identifying and processing evidence to understand intervention implementation. STUDY DESIGN AND SETTING: Strategies, tools, and methods are applied to the systematic review process to illustrate how process and implementation can be addressed using quantitative, qualitative, and other sources of evidence (i.e., descriptive textual and nonempirical). RESULTS: Reviewers can take steps to navigate the heterogeneity and level of uncertainty present in the concepts, measures, and methods used to assess implementation. Activities can be undertaken in advance of a Cochrane quantitative review to develop program theory and logic models that situate implementation in the causal chain. Four search strategies are offered to retrieve process and implementation evidence. Recommendations are made for addressing rigor or risk of bias in process evaluation or implementation evidence. Strategies are recommended for locating and extracting data from primary studies. The basic logic is presented to assist reviewers to make initial review-level judgments about implementation failure and theory failure. CONCLUSION: Although strategies, tools, and methods can assist reviewers to address process and implementation using quantitative, qualitative, and other forms of evidence, few exemplar reviews exist. There is a need for further methodological development and trialing of proposed approaches.
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