Studying implementation strategies in the field: the Veterans Affairs Quality Enhancement Research Initiative implementation strategy tracking and dissemination (I-STRAND) project

Introduction The Veterans Affairs Quality Enhancement Research Initiative funds program centers to implement evidence-based practices (EBPs) with operational partners. Prior work has highlighted the importance of using standardized tools to describe how strategies for improving uptake of EBPs are operationalized. Methods We developed an electronic form based on Expert Recommendations for Implementing Change groupings and survey questions. Prior to fielding in May-June 2024, we iteratively reviewed the form with experts. We determined strategy frequencies and identified correlations between strategy groupings. We also determined how frequently evaluation designs and frameworks were used to test strategies. Results There were 54 projects across 17 centers. The most common implementation strategy groupings selected were “Education” (94.4%), “Interested Parties” (90.7%), “Assistance” (87.0%), “Tailoring” (87.0%), and “Evaluation” (87.0%). The most common individual strategies selected were “Assess for Readiness and Identify Determinants” (81.5%), “Facilitation” (79.6%), and “Distribute Educational Materials” (75.9%), with more than half (57.4%) selecting all three. Most projects reported using CFIR or RE-AIM frameworks (CFIR only 22.6%; RE-AIM only 34.0%; both 24.5%) and hybrid implementation-effectiveness designs (64.2%). Nearly all projects indicated that the form was able to capture information “Well” or “Very Well” for strategies and study designs (98.1% and 94.4%, respectively). Conclusions Although the form was brief, respondents indicated that it effectively captured information on strategies and designs. Our findings also highlight the strategies, designs, and frameworks used to support EBP implementation in a national quality improvement initiative. This work expands existing infrastructure for strategy identification and will support future work comparing the relative effectiveness of strategies.