title: AIMD - a validated, simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies.
abstract: Proliferation of terms describing the science of effectively promoting and supporting the use of research evidence in healthcare policy and practice has hampered understanding and development of the field. To address this, an international Terminology Working Group developed and published a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. This paper presents results of validation work and a second international workgroup meeting, culminating in the updated AIMD framework [Aims, Ingredients, Mechanism, Delivery].
  
  
  
  Framework validity was evaluated against terminology schemas (n = 51); primary studies (n = 37); and reporting guidelines (n = 10). Framework components were independently categorized as fully represented, partly represented, or absent by two researchers. Opportunities to refine the framework were systematically recorded. A meeting of the expanded international Terminology Working Group updated the framework by reviewing and deliberating upon validation findings and refinement proposals.
  
  
  
  There was variation in representativeness of the components across the three types of literature, in particular for the component 'causal mechanisms'. Analysis of primary studies revealed that representativeness of this concept lowered from 92 to 68% if only explicit, rather than explicit and non-explicit references to causal mechanisms were included. All components were very well represented in reporting guidelines, however the level of description of these was lower than in other types of literature. Twelve opportunities were identified to improve the framework, 9 of which were operationalized at the meeting. The updated AIMD framework comprises four components: (1) Aims: what do you want your intervention to achieve and for whom? (2) Ingredients: what comprises the intervention? (3) Mechanisms: how do you propose the intervention will work? and (4) Delivery: how will you deliver the intervention?
  
  
  
  The draft simplified framework was validated with reference to a wide range of relevant literature and improvements have enhanced useability. The AIMD framework could aid in the promotion of evidence into practice, remove barriers to understanding how interventions work, enhance communication of interventions and support knowledge synthesis. Future work needs to focus on developing and testing resources and educational initiatives to optimize use of the AIMD framework in collaboration with relevant end-user groups.
authors.affiliation: BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, VIC, 3800, Australia. peter.bragge@monash.edu.
authors.forename: Peter
authors.identifier: 0000-0003-0745-5131
authors.initials: P
authors.lastname: Bragge
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa, School of Epidemiology, Public Health and Preventive Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Grimshaw
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Lokker
authors.affiliation: Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Ave, Toronto, ON, M5G 1V7, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Colquhoun
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D006291:Health Policy; D006801:Humans; D036301:Qualitative Research; D011787:Quality of Health Care
keywords: Dissemination and implementation; Framework validation; Healthcare quality improvement; Implementation science; Knowledge translation