The sustainable future of implementation research: On the development of the field and its paradoxes

__Abstract__ As fashionable as implementation studies were in the 1970s and 1980s, as en vogue it has become four decades later to consider implementation as a research theme of the past. It is clear that in the study of government new themes and concepts have been put on the agenda. In the ‘age of governance’ that study takes place under a variety of headings beyond ‘implementation’. At the same time a continued attention to what happens with policies-on-paper can be observed. In this special issue the development of implementation research as a scholarly field is assessed. A closer look reveals some paradoxes, but also steady advancement

Efficacious, effective, and embedded interventions: Implementation research in infectious disease control

Background: Research in infectious disease control is heavily skewed towards high end technology; development of new drugs, vaccines and clinical interventions. Oft ignored, is the evidence to inform the best strategies that ensure the embedding of interventions into health systems and amongst populations. In this paper we undertake an analysis of the challenge in the development of research for the sustainable implementation of disease control interventions. Results: We highlight the fundamental differences between the research paradigms associated with the development of technologies and interventions for disease control on the one hand and the research paradigms required for enhancing the sustainable uptake of those very same interventions within the communities on the other. We provide a definition for implementation research in an attempt to underscore its critical role and explore the multidisciplinary science needed to address the challenges in disease control. Conclusion: The greatest value for money in health research lies in the sustainable and effective implementation of already proven, efficacious solutions. The development of implementation research that can help provide some solutions on how this can be achieved is sorely needed

Implementation and the Governance Problem: A Pressure Participant Perspective

This article has two aims: to qualify the UK government's ‘problem' of governance in a comparison with Scotland and Wales, and to use implementation studies (the ancestors of the new governance literature) to explore policy developments since devolution in Britain. It presents a puzzling finding from extensive interview research: that while we may expect UK government policy to suffer a bigger ‘implementation gap' based on distinctive governance problems (such as greater service delivery fragmentation and the unintended consequences of top-down policy styles), pressure participants in Scotland and Wales are more likely to report implementation failures. Using a ‘top-down' framework, it explores three main explanations for this finding: that the size of the implementation gap in England is exaggerated by a focus on particular governance problems; that pressure participant dissatisfaction follows unrealistic expectations in the devolved territories; and that the UK government undermines devolved policy implementation, by retaining control of key policy instruments and setting the agenda on measures of implementation success