title: A Guide for applying a revised version of the PARIHS framework for implementation.
abstract: BACKGROUND
  Based on a critical synthesis of literature on use of the Promoting Action on Research Implementation in Health Services (PARIHS) framework, revisions and a companion Guide were developed by a group of researchers independent of the original PARIHS team. The purpose of the Guide is to enhance and optimize efforts of researchers using PARIHS in implementation trials and evaluations.
  
  
  METHODS
  Authors used a planned, structured process to organize and synthesize critiques, discussions, and potential recommendations for refinements of the PARIHS framework arising from a systematic review. Using a templated form, each author independently recorded key components for each reviewed paper; that is, study definitions, perceived strengths/limitations of PARIHS, other observations regarding key issues and recommendations regarding needed refinements. After reaching consensus on these key components, the authors summarized the information and developed the Guide.
  
  
  RESULTS
  A number of revisions, perceived as consistent with the PARIHS framework's general nature and intent, are proposed. The related Guide is composed of a set of reference tools, provided in Additional files. Its core content is built upon the basic elements of PARIHS and current implementation science.
  
  
  CONCLUSIONS
  We invite researchers using PARIHS for targeted evidence-based practice (EBP) implementations with a strong task-orientation to use this Guide as a companion and to apply the revised framework prospectively and comprehensively. Researchers also are encouraged to evaluate its use relative to perceived strengths and issues. Such evaluations and critical reflections regarding PARIHS and our Guide could thereby promote the framework's continued evolution.
authors: Independent Consultant, Amherst, Massachusetts, USA; Health Services Department, Boston University School of Public Health, Boston, MA, USA. cheryl.stetler@comcast.net
authors: Cheryl B
authors: CB
authors: Stetler
authors: Laura J
authors: LJ
authors: Damschroder
authors: Christian D
authors: CD
authors: Helfrich
authors: Hildi J
authors: HJ
authors: Hagedorn
mesh_terms: D019317:Evidence-Based Medicine / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D017408:Guidelines as Topic / Q000592:standards*; D006302:Health Services Research / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D016730:Program Development