Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda.
An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. This paper advances the concept of "implementation outcomes" distinct from service system and clinical treatment outcomes. This paper proposes a heuristic, working "taxonomy" of eight conceptually distinct implementation outcomes-acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability-along with their nominal definitions. We propose a two-pronged agenda for research on implementation outcomes. Conceptualizing and measuring implementation outcomes will advance understanding of implementation processes, enhance efficiency in implementation research, and pave the way for studies of the comparative effectiveness of implementation strategies.
George Warren Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA. ekp@wustl.edu
Enola
E
Proctor
Hiie
H
Silmere
Ramesh
R
Raghavan
Peter
P
Hovmand
Greg
G
Aarons
Alicia
A
Bunger
Richard
R
Griffey
Melissa
M
Hensley
D035843:Biomedical Research / Q000379:methods* / Q000458:organization & administration*; D004059:Diffusion of Innovation; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000458:organization & administration