title: The struggle of translating science into action: Foundational concepts of implementation science.
abstract: RATIONALE, AIMS, AND OBJECTIVES: "Implementation science," the scientific study of methods translating research findings into practical, useful outcomes, is contested and complex, with unpredictable use of results from routine clinical practice and different levels of continuing assessment of implementable interventions. The authors aim to reveal how implementation science is presented and understood in health services research contexts and clarify the foundational concepts: diffusion, dissemination, implementation, adoption, and sustainability, to progress knowledge in the field.
  
  
  
  Implementation science models, theories, and frameworks are critiqued, and their value for laying the groundwork from which to implement a study's findings is emphasised. The paper highlights the challenges of turning research findings into practical outcomes that can be successfully implemented and the need for support from change agents, to ensure improvements to health care provision, health systems, and policy. The paper examines how researchers create implementation plans and what needs to be considered for study outputs to lead to sustainable interventions. This aspect needs clear planning, underpinned by appropriate theoretical paradigms that rigorously respond to a study's aims and objectives.
  
  
  
  Researchers might benefit from a return to first principles in implementation science, whereby applications that result from research endeavours are both effective and readily disseminated and where interventions can be supported by appropriate health care personnel. These should be people specifically identified to promote change in service organisation, delivery, and policy that can be systematically evaluated over time, to ensure high-quality, long-term improvements to patients' health.
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Australia.
authors.forename: Frances
authors.identifier: 0000-0002-4428-2826
authors.initials: F
authors.lastname: Rapport
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Clay-Williams
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Churruca
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Australia.
authors.forename: Patti
authors.initials: P
authors.lastname: Shih
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Hogden
authors.affiliation: Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Braithwaite
mesh_terms: D004059:Diffusion of Innovation; D055317:Evidence-Based Practice / Q000592:standards; D006284:Health Plan Implementation / Q000592:standards; D006302:Health Services Research / Q000379:methods / Q000458:organization & administration; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D010818:Practice Patterns, Physicians' / Q000592:standards*; D058996:Quality Improvement; D057170:Translational Research, Biomedical / Q000379:methods*
keywords: evidence-based health care and policy; health services research; implementable research findings; implementation science