One challenge in health care is getting the results of research implemented into routine practice. All too often, researchers spend a great deal of time and money developing and evaluating new ways of providing health care which, despite being shown to be beneficial, are never implemented in the NHS. This problem is often referred to as the gap between evidence and practice or the "2nd translational gap".
Our proposed study addresses this problem by helping researchers consider implementation from the very beginning of their research, with the goal of ensuring research is more relevant to the NHS and has greater potential to benefit patients. We will do this by a) summarising and synthesising the existing literature to describe the causes of the translational gap and how it can be closed in primary care; b) considering the relevant theoretical frameworks, and seeing what evidence exists to support the various theoretical approaches; c) identifying existing toolkits aimed at improving implementation of research and determining which has the strongest empirical (research) and theoretical foundation and will be most acceptable to researchers; and d) asking researchers to apply the toolkit to the design of their intervention and / or trial to see if helps improve these. We will record the changes researchers make as a result of the toolkit, and observe what impact this has on implementation.
Our team has experience in developing three toolkits designed to improve implementation across a range of circumstances (NorthStar, the e-Health Implementation toolkit, and the Normalization Process Toolkit), and we know of half-a-dozen others. Hence, in this proposed research we are making no prejudgment as to which toolkit is most helpful, and we will decide which toolkit to study further once we have completed the literature reviews and sought user views about the acceptability of the various toolkits available. Additionally, if the evidence supports using more than one approach, or modifying a particular toolkit, we will do this.
Our team is well placed to do this work as we have previously developed three toolkits, already have an excellent understanding of the literature and theoretical frameworks in this field, and wide experience of undertaking research in primary care and implementing research findings.