Researchers’ Perceived Impact of Determinants on Implementation Outcomes: Questionnaire Development and Retrospective Cross-Sectional Study Across Diverse Health Interventions

Examining the relationship between determinants and implementation outcomes is key to advancing implementation science. However, the vast number of approaches, determinants, and outcomes make it difficult to synthesize findings. The aim of this exploratory paper was to assess the association between key determinants and outcomes across diverse health interventions. To that end, the Implementation Determinants and Outcomes Questionnaire (IDOQ) was developed, refined with face validity, and administered to implementation researchers ( N = 208). The IDOQ asks participants to rate the success of a recent implementation project for five outcomes (Feasibility, Adoption, Fidelity, Penetration, and Sustainability) and the impact of five determinants (Available Resources, Compatibility, Leadership Engagement, Formal Internal Implementation Leaders, and External Implementation Change Agents) on those outcomes. We examined the relationship between determinants and outcomes using multiple regression analyses. While exploratory, all five determinants were found to be significant predictors of at least one outcome—in 10 instances as barriers and in nine instances as facilitators (out of 50 possible pairings). Available Resources, functioning as a barrier, was found to be a significant predictor for every outcome. Overall, Available Resources and Compatibility were the most common significant predictors of implementation outcomes. In conclusion, by examining the relationship between key determinants and outcomes across program type and setting, we can more systematically understand these complex relationships. This may lead to causal frameworks and models, further advancing the power of implementation science. In addition, the nuance of whether determinants functioned as a barrier or a facilitator may support more adaptive approaches to implementation and sustainment across diverse health interventions.