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Our research, of which the work reported here formed a part, had two main objectives: (1) to identify evidence about the implementation of interventions aimed at reducing unintentional injuries amongst children and young people; and (2) to explore methods for systematically reviewing evidence on implementation.
This complex review has also brought together evidence on implementation processes and challenges from 17 countries.
There was relatively little review evidence on implementation strategies at the levels of organisation and wider context.
They propose that, unlike clinical interventions, public health interventions require more evidence on implementation and sustainability, and local evidence is seen as more credible (Woelk et al. 2009).
Each workshop involved feedback and discussion of emerging findings and implications from the empirical data, which in turn generated further data collection and review of evidence on implementation strategies (see Figure 1).
Significant efforts such as PRIME (39), the 6-year research programme funded by DFID to generate evidence on implementation and scale-up of mental health care in LMICs, has explicitly stated that it aims to integrate facility and community-based care, and could benefit from expanded notions of community and culture.
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Despite the large body of published literature, the evidence base on implementation strategies remains inconclusive.
Important themes emerged from the relevant evidence identified on implementation, including the role of ERAS facilitators and the need for full support from management.
Key steps in expanding the evidence base on implementation in LMICs include studying how to: simplify interventions; train "scale-up leaders" and health workers dedicated to scale-up; reach and engage communities; match the best delivery strategy to the specific health problem and context; and raise the low profile of implementation science.
An implementation strategy was developed based on the evidence on successful implementation of care innovation [ 9].
The successive steps of the model for Accelerating Improvement, a scientific method used for action-oriented learning, were followed and an implementation strategy was developed based on the current evidence on successful implementation of care innovation [ 14, 15].
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