So You Think You Can Write an Implementation Research Proposal
Part I
By Kate Sibley
Implementation research — the scientific study of methods to promote the systematic uptake of clinical research findings and other evidence-based practices into routine practice — represents the final frontier of knowledge translation (KT), focusing on the application of knowledge.
As a KT scientist, I‘m often approached by researchers and students looking to develop a grant submission for a KT or implementation project. Sometimes these are special funding calls, others are open competitions. I’ve found that often, people do not fully understand what goes into one of these studies. As a result, they do not position themselves to receive funding and/or conduct a good implementation research project.
In 2012, a team of researchers at Washington University, led by Dr. Enola Proctor, published an open-access paper in Implementation Science that highlights ten key ingredients for writing implementation research grant proposals (recently co-opted for the INSPECT implementation grant scoring tool). While specifically focused on writing grant applications, I believe the ingredients work very well for implementation research planning and can help determine whether or not a project is truly ready for implementation research.
Today, we’ll examine the first five ingredients. They focus on the necessary pre-cursors to an implementation study. If you cannot answer “yes” to all of these questions, you should probably hold off your application and/or project.
1. The Care or Quality Gap
Is there clear evidence that a gap exists? You need to be able to demonstrate that there is some gap between what is known, what is done, and that there is room for improvement (which your project will address). If you cannot show this through population, organization, or provider-level data, you need to stop and do a different study first.
2. The Evidence-Based Solution
Is there evidence for the efficacy of the solution? At the stage of an implementation research project, it’s not about figuring out what works. Ideally, you can demonstrate this through systematic review-level evidence (although sometimes, you can make a justification without a systematic review). If you cannot demonstrate this evidence, you need to stop and do a different study first.
3. Conceptual Model and Theoretical Justification
Is a conceptual model, theory or framework used to inform the design and variables tested? The application and evaluation of theory in KT and Implementation Science is a debated issue, with proponents arguing that the absence of theory has limited our ability to identify key contextual variables and mechanisms of action. Informed reviewers will want to see that you have thought about this. Read Leah’s post for a great guide to understanding KT frameworks.
4. Stakeholder Priorities
Have stakeholders been engaged in setting the research priorities and the change process? You need to show that your project matters to the people at the receiving end of it. Does it align with their priorities? You need to be able to demonstrate that it does with stronger evidence than mere anecdotal conversations with clinicians, patients or the public. If you cannot demonstrate this necessary qualitative or quantitative data, you need to stop and do a different study first.
5. Readiness to Adopt Solution
Is there clear evidence that reflects the site(s)’ readiness, capacity, or appetite to adopt the proposed solution? This is not to say that all implementation research should be conducted in motivated settings, but preliminary data on the organizational context can strengthen a proposal. If you cannot demonstrate that you have thoroughly assessed the implementation context, you need to stop and do some more preliminary work first.
These five ingredients can almost be considered as a rationale for your project. Consider them to help you get the funding and/or conduct a good implementation research project. In my next post, I’ll cover the remaining five ingredients, which focuses on methods.
About the Author
Dr. Kathryn Sibley is the Director of Knowledge Translation at the George & Fay Yee Centre for Healthcare Innovation (CHI), Canada Research Chair in Integrated Knowledge Translation in Rehabilitation Sciences, and Assistant Professor in Community Health Sciences at the University of Manitoba.
