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Table 2 Description of implementation strategies

From: Knowledge translation in child welfare—improving educational outcomes for children at risk: study protocol for a hybrid randomized controlled pragmatic trial

Strategy Classification Category of actor(s) Action Dose Action target (determinant and level) Temporalitya Outcome measure
Integral strategies in the Integrated Knowledge Translation ( IKT-K) model
Engage stakeholders and utilize local knowledge Process strategy All systems Stakeholders are in collaborative partnership to address mutually understood need for practice improvement   To utilize local knowledge on all levels and facilitate stakeholder buy-in and ownership on provider and organization levels All Feasibility
Use facilitation Process strategy Support system An assigned facilitator objectively guides co-creation discussions, promotes knowledge exchange, and minds equal participation and power imbalances Five 4-h workshopsb with each co-creation team, additional meetings if necessary Facilitate collaborative problem-solving and promote mutual consultations among stakeholders to ensure integration of different forms of knowledge on organizational and provider levels Co-creation, implementation, evaluation, and sustainment Feasibility
Develop glossary Process and dissemination strategy Support system Develop a glossary of frequent, difficult, and potentially ambiguous terms, and ban potentially offensive terms. Align project documents with glossary 4-h introduction workshop with each co-creation team Promote equal understanding and participation and prevent the use of offensive terms. At organizational level Co-creation Feasibility
Assess context Process strategy Delivery system and support system Implementation climate and readiness for change assessed by online survey to all staff.
Determinants discussed in co-creation teams
10–15-min online survey, 4-h implementation workshop with each co-creation team To assess readiness and identify barriers and facilitators to implementation at all levels Co-creation Climate for implementing evidence-based practice (EBP), readiness for change
Tailor intervention Process strategy Support system and delivery system Local knowledge and experience utilized to tailor components of the intervention to fit daily practice and address needs at each site Two 4-h intervention workshops with each co-creation team, feedback from practitioners during and after training and piloting. One 4-h adjustments workshop To develop a feasible and appropriate intervention on client, provider, and organizational levels Co-creation Feasibility, appropriateness, acceptability, fidelity, reach
Tailor strategies Process strategy Support system Local knowledge and experience utilized to tailor implementation strategies to context 4-h implementation workshop with each co-creation team. 4-h adjustments workshop To tailor strategies to address barriers and leverage facilitators identified through context assessments and knowledge exchange in co-creation teams. On provider and organizational levels Co-creation Feasibility, fidelity, reach
Develop a formal implementation plan Integration and capacity-building strategy Delivery- and support system A formal implementation plan has been created describing implementation infrastructure, goals, procedures, strategies, and adaptations to each site One formal implementation plan, site-specific implementation manuals with adaptations to each site, continuous registration of adaptations Guide and organize implementation processes on organizational and provider levels with appropriate and structured adaptations Developed during co-creation, adaptations throughout all phases Feasibility, fidelity, reach
Additional strategies based on the intervention, context assessment, and knowledge exchange in co-creation teams
Make intervention dynamic and flexible Dissemination strategy Synthesis and translation system Common elements of effective interventions have been used as basis for the intervention components to enable dynamic and flexible delivery Systematic review, common elements analysis To utilize the best available empirical evidence and improve intervention feasibility, appropriateness, and acceptability at all levels Synthesis, co-creation Feasibility, appropriateness, acceptability, fidelity
Train champions Capacity-building strategy Support system and delivery system Champions have received additional training in the intervention, knowledge translation, implementation strategies, and behavior change 7-h group training Build local implementation and coaching capacity on provider and organizational levels Implementation Feasibility,
fidelity, reach
Use ongoing coaching Capacity-building strategy and integration strategy Delivery system and support system Intervention practitioners receive group coaching from external implementation team and champions. Individual coaching is provided upon request or in cases of fidelity drift Bimonthly from external implementation team, monthly from champions, and individually on request (registered) Promote learning and integration of the intervention in practitioners and champions on provider and organizational levels Implementation, evaluation, sustainment Fidelity, reach, perceived competence
Use continuous support Capacity-building and integration strategy Support system Group consultations, booster sessions, telephone support, training of new practitioners, recruiters, and champions Bimonthly meetings with practitioners, recruiters, and champions, 4-h booster session every 6 months, telephone support, visiting support and training on request (registered) Provide support and boost engagement, implementation qualityc, and recruitment at the provider and organizational levels Implementation, evaluation, sustainment Feasibility, fidelity, reach, perceived competence
Develop contingency plans Capacity-building strategy Support system and delivery In cases of turnover, sick leaves, fidelity drift, or adverse events, specific plans of engagement are described for champions in their implementation plans Use monitored Prepare and plan for barriers and other events that threaten implementation at organizational and provider levels Developed during co-creation, adaptations throughout all phases Feasibility, fidelity, reach
Develop and distribute educational material Integration strategy Support system Created and distributed intervention handbooks, planning material, and pedagogical material Approx. 50 handbooks, 150 copies of planning material, 200 copies of sponsored reading and math material Promote intervention implementation and effectiveness at the provider and client levels Developed in co-creation, used in implementation, evaluation, and sustainment Acceptability and appropriateness of material, fidelity, primary effectiveness outcomes
Develop and distribute implementation resources Capacity-building strategy Support system Created and distributed implementation and recruitment manuals, implementation checklists/posters to champions, and recruitment flyers in 4 languages Three site-specific implementation manuals, recruitment manuals, and implementation checklists/posters, approx. 500 flyers Promote recruitment at client level and EAS implementation qualityc at organizational and provider levels Developed in co-creation, used in implementation and evaluation Feasibility, fidelity, reach
Use implementation audit and feedback Integration strategy Support system Double-informant measures of fidelity, user satisfaction and user involvement Audit after each intervention session. Group-level feedback to practitioners bimonthly Motivate and engage practitioners and prevent fidelity drift at the provider level Evaluation Fidelity, primary effectiveness outcomes
  1. aPhases of IKT-K: synthesis, co-creation, implementation, evaluation, sustainment
  2. bTotal co-creation workshops (all 4 h); 3 introduction workshops, 6 intervention workshops, 3 implementation workshops, 3 adjustments workshops
  3. cImplementation quality should be understood as the degree to which Enhanced Academic Support (EAS) reaches the target population, is used with adherence, competence, and appropriate adaptations by practitioners, and is comprehended by parents and children