TY - JOUR
T1 - How does embedded implementation research work? Examining core features through qualitative case studies in Latin America and the Caribbean
AU - Ilona Varallyay, N.
AU - Bennett, Sara C.
AU - Kennedy, Caitlin
AU - Ghaffar, Abdul
AU - Peters, David H.
N1 - Funding Information:
This work was supported by the Alliance for Health Policy and Systems Research, an international partnership hosted by the World Health Organization. Support from the Pan American Health Organization was received for the previous evaluation work, from which secondary data for this analysis were drawn. This article is part of the supplement ‘nnovations in Implementation Research in Low-and Middle-Income Countries’, a collaboration of the Alliance for Health Policy and Systems Research and Health Policy and Planning. The supplement and this article were produced with financial support from the Alliance for Health Policy and Systems Research. The Alliance is able to conduct its work thanks to the commitment and support from a variety of funders. These include our long-term core contributors from national governments and international institutions, as well as designated funding for specific projects within our current priorities. For the full list of Alliance donors, please visit: https://www.who.int/alliance-hpsr/part ners/en/.
Publisher Copyright:
© 2020 Oxford University Press. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Innovative strategies are needed to improve the delivery of evidence-informed health interventions. Embedded implementation research (EIR) seeks to enhance the generation and use of evidence for programme improvement through four core features: (1) central involvement of programme/policy decision-makers in the research cycle; (2) collaborative research partnerships; (3) positioning research within programme processes and (4) research focused on implementation. This paper examines how these features influence evidence-to-action processes and explores how they are operationalized, their effects and supporting conditions needed. We used a qualitative, comparative case study approach, drawing on document analysis and semi-structured interviews across multiple informant groups, to examine three EIR projects in Bolivia, Colombia and the Dominican Republic. Our findings are presented according to the four core EIR features. The central involvement of decision-makers in EIR was enhanced by decision-maker authority over the programme studied, professional networks and critical reflection. Strong research-practice partnerships were facilitated by commitment, a clear and shared purpose and representation of diverse perspectives. Evidence around positioning research within programme processes was less conclusive; however, as all three cases made significant advances in research use and programme improvement, this feature of EIR may be less critical than others, depending on specific circumstances. Finally, a research focus on implementation demanded proactive engagement by decision-makers in conceptualizing the research and identifying opportunities for direct action by decision-makers. As the EIR approach is a novel approach in these low-resource settings, key supports are needed to build capacity of health sector stakeholders and create an enabling environment through system-level strategies. Key implications for such supports include: Promoting EIR and creating incentives for decisionmakers to engage in it, establishing structures or mechanisms to facilitate decision-maker involvement, allocating funds for EIR, and developing guidance for EIR practitioners.
AB - Innovative strategies are needed to improve the delivery of evidence-informed health interventions. Embedded implementation research (EIR) seeks to enhance the generation and use of evidence for programme improvement through four core features: (1) central involvement of programme/policy decision-makers in the research cycle; (2) collaborative research partnerships; (3) positioning research within programme processes and (4) research focused on implementation. This paper examines how these features influence evidence-to-action processes and explores how they are operationalized, their effects and supporting conditions needed. We used a qualitative, comparative case study approach, drawing on document analysis and semi-structured interviews across multiple informant groups, to examine three EIR projects in Bolivia, Colombia and the Dominican Republic. Our findings are presented according to the four core EIR features. The central involvement of decision-makers in EIR was enhanced by decision-maker authority over the programme studied, professional networks and critical reflection. Strong research-practice partnerships were facilitated by commitment, a clear and shared purpose and representation of diverse perspectives. Evidence around positioning research within programme processes was less conclusive; however, as all three cases made significant advances in research use and programme improvement, this feature of EIR may be less critical than others, depending on specific circumstances. Finally, a research focus on implementation demanded proactive engagement by decision-makers in conceptualizing the research and identifying opportunities for direct action by decision-makers. As the EIR approach is a novel approach in these low-resource settings, key supports are needed to build capacity of health sector stakeholders and create an enabling environment through system-level strategies. Key implications for such supports include: Promoting EIR and creating incentives for decisionmakers to engage in it, establishing structures or mechanisms to facilitate decision-maker involvement, allocating funds for EIR, and developing guidance for EIR practitioners.
KW - Collaborative research partnerships
KW - Decision-maker-led research
KW - Embedded research
KW - Evidence coproduction
KW - Evidence-informed decision-making
KW - Evidence-to-action
KW - Health policy and systems research
KW - Implementation research
KW - Knowledge translation
KW - Latin America and the Caribbean © The Author(s) 2020
KW - Low- and middle-income countries
KW - Research- practice partnerships
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U2 - 10.1093/HEAPOL/CZAA126
DO - 10.1093/HEAPOL/CZAA126
M3 - Article
C2 - 33156937
AN - SCOPUS:85095800511
SN - 0268-1080
VL - 35
SP - II98-II111
JO - Health policy and planning
JF - Health policy and planning
ER -