부산대학교 도서관

Many studies have explored organizational factors that facilitate implementation. However, there is still a limited understanding of determinants external to the implementing organization and their effects on evidence-based intervention (EBI) adoption, implementation, and outcomes. The purpose of this scoping review was to assess definitions of context and identify salient determinants of outer context found in dissemination and implementation theories, models, and frameworks. We employed a compilation of dissemination and implementation frameworks from two reviews as the data source. We abstracted the following information: type of article, outcomes of the framework, presence of a context definition, presence of any outer setting definition and the definition, number and domains of outer setting mentioned, definitions of outer context constructs, and any quantitative measures of outer setting. We identified 19 definitions of outer context. Forty-seven (49%) frameworks reported one or more specific constructs of the outer setting. While the outer context domains described in the frameworks varied, the most common domains were policy (n = 24), community (n = 20), partnerships (n = 13), and communications (n = 12). Based on our review of the frameworks, more conceptualization and measurement development for outer context domains are needed. Few measures were found and definitions of domains varied across frameworks. Expanding outer context construct definitions would advance measure development for important factors external to the organizations related to EBI implementation. There is still a limited understanding of factors external to the implementing organization and their effects on evidence-based intervention adoption, implementation, and outcomes. This scoping study focuses on understanding definitions of context and important factors of outer context found in dissemination and implementation theories, models, and frameworks. We identified 19 definitions of outer context and 47 frameworks or theories that reported one or more specific constructs of the outer setting. Common domains found were policy (n = 25), community (n = 19), partnerships (n = 13), and communications (n = 13). We described gaps related to the current knowledge of outer context factors and offer future research directions. We recommended the development of outer context-specific scales, further exploration of the culture domain, and testing of how these outer context factors impact implementation outcomes. Keywords Context, Outer context, Theories, Frameworks, Implementation, Evidenced-based Implications Practice: Understanding of policy, community, economic, and partnership factors external to an organization are important considerations for implementing evidence-based interventions (EBIs) or practices. Policy: Policymakers who want to increase the spread and adoption of EBIs should explore the use of policies or regulations and funding for these efforts. Research: Future research should explore common outer context constructs used in the dissemination and implementation field and examine the relationship of outer context variables to implementation outcomes such as adoption and implementations of EDIs.
INTRODUCTION Many public health theories, models, and frameworks include context, defined as "a set of characteristics and circumstances that surround the implementation effort" [1] and are related to the adoption [...]