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Título : How is tailored implementation undertaken using a self-guided toolkit? Qualitative study of the ItFits-toolkit in the ImpleMentAll project
Autoría: Finch, Tracy L.
Potthoff, Sebastian  
May, Carl R.
Girling, Melissa  
Perkins, Neil  
Vis, Christiaan  
Bührmann, Leah
Etzelmueller, Anne  
Van Genugten, Claire Rosalie  
Schuurmans, Josien  
Piera-Jiménez, Jordi  
Rapley, Tim  
Citación : Finch, T. [Tracy], Potthoff, S. [Sebastian], May, C. [Carl], Girling, M. [Melissa], Perkins, N. [Neil], Vis, C. [Christiaan], Bührmann, L. [Leah], Etzelmueller, A. [Anne], Van Genugten, C. R. [Claire Rosalie], Schuuemans, J. [Josein], Piera-Jiménez, J. [Jordi] & Rapley, T. [Tim]. (2024). How is tailored implementation undertaken using a self-guided toolkit? Qualitative study of the ItFits-toolkit in the ImpleMentAll project. Implementation Science, 19(1), 1-15. doi: 10.1186/s13012-024-01380-w
Resumen : Background: The process of tailored implementation is ill-defined and under-explored. The ItFits-toolkit was developed and subsequently tested as a self-guided online platform to facilitate implementation of tailored strategies for internet-based cognitive behavioural therapy (iCBT) services. In ImpleMentAll, ItFits-toolkit had a small but positive effect on the primary outcome of iCBT normalisation. This paper investigates, from a qualitative perspective, how implementation teams developed and undertook tailored implementation using the toolkit within the trial. Methods: Implementation teams in thirteen sites from nine countries (Europe and Australia) used the ItFits-toolkit for six months minimum, consistent with the trial protocol. A qualitative process evaluation was conducted. Descriptive data regarding goals, barriers, strategies, and implementation plans collected within the toolkit informed qualitative data collection in real time. Qualitative data included remote longitudinal interviews (n = 55) with implementation team members (n = 30) and observations of support calls (n = 19) with study sites. Qualitative data were analysed thematically, using a team-based approach. Results: Implementation teams developed and executed tailored implementation projects across all steps in the toolkit process. Working in a structured way but with room for flexibility, decisions were shaped by team members’ ideas and goals, iterative stakeholder engagement, internal and external influences, and the context of the ImpleMentAll project. Although teams reported some positive impacts of their projects, ‘time’, both for undertaking the work, and for seeing project impacts, was described as a key factor in decisions about implementation strategies and assessments of success. Conclusion: This study responds directly to McHugh et al.’s (2022) call for empirical description of what implementation tailoring looks like in action, in service settings. Self-guided facilitation of tailored implementation enables implementers in service settings to undertake tailoring within their organisations. Implementation tailoring takes considerable time and involves detailed work but can be supported through the provision of implementation science informed guidance and materials, iterative and ongoing stakeholder engagement, and working reflectively in response to external influencing factors. Directions for advancement of tailored implementation are suggested.
Palabras clave : implementation strategies
tailoring
toolkit
implementers
self-guidance
determinants assessment
DOI: https://doi.org/10.1186/s13012-024-01380-w
Tipo de documento: info:eu-repo/semantics/article
Versión del documento: info:eu-repo/semantics/publishedVersion
Fecha de publicación : 11-jul-2024
Licencia de publicación: http://creativecommons.org/licenses/by/3.0/es/  
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