Table_1_Expanding Hybrid Studies for Implementation Research: Intervention, Implementation Strategy, and Context.XLSX

Successful implementation reflects the interplay between intervention, implementation strategy, and context. Hybrid effectiveness-implementation studies allow investigators to assess the effects of both intervention and implementation strategy, though the role of context as a third independent variable (IV) is incompletely specified. Our objective is to expand the hybrid typology to include mixtures of all three types of IVs: intervention, implementation strategy, and context. We propose to use I to represent the IV of intervention, IS to represent implementation strategy, and C to represent context. Primary IVs are written first and in upper case. Secondary IVs are written after a forward slash and in lower case; co-primary IVs are written after a dash and in upper case. The expanded framework specifies nine two-variable hybrid types: I/is, I-IS, IS/i, IS/c, IS-C, C/is, C/i, I-C, and I/c. We describe four in detail: I/is, IS/c, IS-C, and C/is. We also specify seven three-variable hybrid types. We argue that many studies already meet our definitions of two- or three-variable hybrids. Our proposal builds from the typology proposed by Curran et al. (1), but offers a more complete specification of hybrid study types. We need studies that measure the implementation-related effects of variations in contextual determinants, both to advance the science and to optimize intervention delivery in the real world. Prototypical implementation studies that evaluate the effectiveness of an implementation strategy, in isolation from its context, risk perpetuating the gap between evidence and practice, as they will not generate context-specific knowledge around implementation, scale-up, and de-implementation.</p

Table_2_Expanding Hybrid Studies for Implementation Research: Intervention, Implementation Strategy, and Context.DOCX

Successful implementation reflects the interplay between intervention, implementation strategy, and context. Hybrid effectiveness-implementation studies allow investigators to assess the effects of both intervention and implementation strategy, though the role of context as a third independent variable (IV) is incompletely specified. Our objective is to expand the hybrid typology to include mixtures of all three types of IVs: intervention, implementation strategy, and context. We propose to use I to represent the IV of intervention, IS to represent implementation strategy, and C to represent context. Primary IVs are written first and in upper case. Secondary IVs are written after a forward slash and in lower case; co-primary IVs are written after a dash and in upper case. The expanded framework specifies nine two-variable hybrid types: I/is, I-IS, IS/i, IS/c, IS-C, C/is, C/i, I-C, and I/c. We describe four in detail: I/is, IS/c, IS-C, and C/is. We also specify seven three-variable hybrid types. We argue that many studies already meet our definitions of two- or three-variable hybrids. Our proposal builds from the typology proposed by Curran et al. (1), but offers a more complete specification of hybrid study types. We need studies that measure the implementation-related effects of variations in contextual determinants, both to advance the science and to optimize intervention delivery in the real world. Prototypical implementation studies that evaluate the effectiveness of an implementation strategy, in isolation from its context, risk perpetuating the gap between evidence and practice, as they will not generate context-specific knowledge around implementation, scale-up, and de-implementation.</p

STROBE statement—Checklist of items that should be included in reports of observational studies.

STROBE statement—Checklist of items that should be included in reports of observational studies.</p

The appendix contains the list of quantitative variables utilized in the analysis.

The appendix contains the list of quantitative variables utilized in the analysis.</p

Intervention acceptability stratified by youth vs. non-youth (n = 117).

Intervention acceptability stratified by youth vs. non-youth (n = 117).</p

Additional file 1 of Application of the Expert Recommendations for Implementing Change (ERIC) compilation of strategies to health intervention implementation in low- and middle-income countries: a systematic review

Additional file 1. PRISMA 2020 checklist

Priorities and unmet needs with regard to mental health (n = 117).

This figure presents participant ratings of the importance of various mental health-related issues as well as ratings of satisfaction with current approaches to addressing those issues. Circle size and color correspond with the relative proportion of participant responses endorsing each importance or satisfaction level. Larger and lighter circles correspond with a greater proportion of participant endorsement. Responses are stratified by youth self-identification.</p

Actions and innovations for an adolescent mental health-friendly Seattle.

Actions and innovations for an adolescent mental health-friendly Seattle.</p

Questionnaire participant characteristics stratified by youth vs. non-youth (n = 117).

Questionnaire participant characteristics stratified by youth vs. non-youth (n = 117).</p

Open text comments on interventions described in the cross-sectional quantitative survey of youths and adults.

Open text comments on interventions described in the cross-sectional quantitative survey of youths and adults.</p