Using Implementation Science to Work Collaboratively with Practitioners
By Dr. Spencer Lawson
Expertise is required to purposefully and effectively use the Active Implementation Frameworks to support innovations so that they can produce intended outcomes reliably and repeatedly. This expertise is developed in Implementation Teams that are formed in organizations and systems (1, p. 277)
The evidence-based movement is in a mediocre state. Wait! Hear me out. When scholars or practitioners mention an intervention is “evidence-based,” what immediately comes to your mind… Statistical significance? Magnitude of effect sizes? Randomized controlled trial? Assessments of the degree to which an intervention is “evidence-based” or not typically focus on the rigor and outcomes of the research. Do not misunderstand me. The effectiveness of an intervention is a great start to ensure it produces socially significant benefits in communities. However, social scientists have historically overlooked an important facet of the evidence-based movement: effective implementation.
The use of implementation science is essential to understand the full and effective use of an intervention in practice. Strong fidelity of an intervention promotes confidence in the validity of outcomes. Yet, research studies rarely examine implementation supports. If you disagree with me, read the methods section of a research article. More often than not, you will find a black box called “the intervention.” Descriptions of the essential components that define the intervention or discussions of implementation development are most likely weak or missing. There is no point to discuss outcome benchmarks if evaluations of fidelity are skipped.
The Active Implementation Frameworks prepare a path for scholars to move away from perpetuating the black box debacle. The implementation frameworks consist of: (1) Usable Innovations, (2) Implementation Stages, (3) Implementation Drivers, (4) Implementation Teams, (5) Improvement Cycles, and (6) Systemic Change. These interactive frameworks outline a process to assure our communities benefit from effective interventions used with high fidelity in practice.
Implementation Teams are the lynchpin of effective use of the Active Implementation Frameworks. The team members represent various levels of existing staff and stakeholders within an organization or system who facilitate implementation development and sustainability of the implementation work. Co-creation. Co-design. Co-production. Values that guide Implementation Teams when collaborating with researchers. Partnering with Implementation Teams involved in pretrial functions across 12 local jurisdictions through Indiana’s pretrial initiative has been one of the highlights of my academic career (2). Numerous scholars and stakeholders in the field with much more expertise have provided guidance on how to effectively partner with Implementation Teams. But, I thought I would share my unique perspective on collaborative work with practitioners:
1. Watch, listen…talk. Implementation Teams are comprised of experts on the intervention and processes of the organization. The team members are a valuable source of knowledge and depth of skills. Early-to late-career research partners who look and listen first before talking can more effectively facilitate discussions with the Implementation Team on implementation supports.
2. Who is at the table? It is important to understand the role of each team member during the development and institutionalization of implementation capacity. If the membership list is incomplete, you as the researcher partner should encourage the Implementation Team to open more seats at the table. But remember, effective team functioning requires more than giving every member a seat at the table. Everyone needs to have a voice at this table (from the line-level employee to the research partner to the program developer)! Whose voices are raised, and whose voices are heard?
3. Due diligence. Shamefully, I have interacted with Implementation Teams without putting in enough background work on the problem and context. Please, do not do this. The team members will know, and relationship development will deteriorate. Now, the research partner cannot be expected to know all aspects of the science and practice (and in fact if you walk in with a savior complex and think you have all the answers, this will also harm your partnership with the Implementation Team). However, put in a good-faith effort during early-stage implementation processes to know the various activities, discussions, and decisions occurring within the organization or system. If gaps in knowledge still remain, ask questions. Learn from the Implementation Team.
4. A partnership is a two-way street. John F. Kennedy’s said, “Ask not what your country can do for you – ask what you can do for your country.” These historic words are applicable when working collaboratively with Implementation Teams…Ask not what Implementation Teams can do for you – ask what you can do for Implementation Teams. While you may need data to meet publication goals, you are a research partner with the organization. Since they are helping you advance your research agenda, make sure you also prioritize (within reason) their organizational goals and expectations. This may come in the form of offering technical assistance or providing an evaluation report in the future. Do not treat them as a means to an end…A one and done interaction. Full and effective use of an intervention can take 2 to 4 years. Use this time to develop a meaningful and lasting relationship with the organization that is built on trust and respect.
5. And finally believe in yourself. Practitioners do want to hear your perspective and recommendations. If they did not, you would have not been invited. Be humble but believe in yourself. As an early career scholar, I struggle with imposter syndrome. I find myself thinking, “Surely practitioners who have been working in the field for decades cannot learn anything from me.” However, I must remember that they did invite me to the table. They respect my intellectual curiosity and research experience and want to develop a partnership to achieve socially significant outcomes in their community.
1. Fixsen, D. L., Blase, K. A., & Van Dyke, M. K. (2019). Implementation practice & science. Active Implementation Research Network.
2. Lawson, S. G., Rising, S. J., Grommon, E. , & Lowder, E. M. (2022). Pretrial risk assessment tool adoption and pretrial operations. In C. S. Scott-Hayward, J. E. Copp, & S. Demuth (Eds.), Handbook on pretrial justice (pp. 276-295). Routledge.