Context Matters, So How Do We Get Better at Working With Context in Implementation Research and Practice?; Comment on “Stakeholder Perspectives of Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Multi-country Analysis”

Document Type : Commentary


Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia


In the field of implementation research, it is widely recognised that ‘context matters.’ Attempts to implement innovations, research and new knowledge into practice invariably meet contextual challenges at multiple levels during the process of implementation. The paper by Squires and colleagues provides a detailed insight into the many different features and attributes of context. Yet, as this commentary argues, there are significant challenges ahead if we are to apply our growing understanding about context to improve the practice of implementation in everyday healthcare. This will require attention to the practicalities of working with context to achieve successful implementation.


  • epublished Author Accepted Version: February 12, 2022
  • epublished Final Version: March 2, 2022
  1. May CR, Johnson M, Finch T. Implementation, context and complexity. Implement Sci. 2016;11(1):141. doi:1186/s13012-016-0506-3
  2. Squires JE, Hutchinson AM, Coughlin M, et al. Stakeholder perspectives of attributes and features of context relevant to knowledge translation in health settings: a multi-country analysis. Int J Health Policy Manag. 2021. doi:34172/ijhpm.2021.32
  3. Rycroft-Malone J, Seers K, Eldh AC, et al. A realist process evaluation within the Facilitating Implementation of Research Evidence (FIRE) cluster randomised controlled international trial: an exemplar. Implement Sci. 2018;13(1):138. doi:1186/s13012-018-0811-0
  4. Powell BJ, Beidas RS, Lewis CC, et al. Methods to improve the selection and tailoring of implementation strategies. J Behav Health Serv Res. 2017;44(2):177-194. doi:1007/s11414-015-9475-6
  5. Jäger C, Steinhäuser J, Freund T, et al. Process evaluation of five tailored programs to improve the implementation of evidence-based recommendations for chronic conditions in primary care. Implement Sci. 2016;11(1):123. doi:1186/s13012-016-0473-8
  6. Harvey G, Lynch E. Enabling continuous quality improvement in practice: the role and contribution of facilitation. Front Public Health. 2017;5:27. doi:3389/fpubh.2017.00027
  7. Albers B, Metz A, Burke K, et al. Implementation support skills: findings from a systematic integrative review. Res Soc Work Pract. 2021;31(2):147-170. doi:1177/1049731520967419
  8. Kitson AL, Harvey G. Methods to succeed in effective knowledge translation in clinical practice. J Nurs Scholarsh. 2016;48(3):294-302. doi:1111/jnu.12206
  9. Seers K, Rycroft-Malone J, Cox K, et al. Facilitating Implementation of Research Evidence (FIRE): an international cluster randomised controlled trial to evaluate two models of facilitation informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. Implement Sci. 2018;13(1):137. doi:1186/s13012-018-0831-9
  10. Moore GF, Audrey S, Barker M, et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350:h1258. doi:1136/bmj.h1258
  11. Glasgow RE, Chambers D. Developing robust, sustainable, implementation systems using rigorous, rapid and relevant science. Clin Transl Sci. 2012;5(1):48-55. doi:1111/j.1752-8062.2011.00383.x
  12. Ramanadhan S, Davis MM, Armstrong R, et al. Participatory implementation science to increase the impact of evidence-based cancer prevention and control. Cancer Causes Control. 2018;29(3):363-369. doi:1007/s10552-018-1008-1
  13. Boland L, Kothari A, McCutcheon C, Graham ID. Building an integrated knowledge translation (IKT) evidence base: colloquium proceedings and research direction. Health Res Policy Syst. 2020;18(1):8. doi:1186/s12961-019-0521-3
  14. Laycock A, Bailie J, Matthews V, Bailie R. Using developmental evaluation to support knowledge translation: reflections from a large-scale quality improvement project in Indigenous primary healthcare. Health Res Policy Syst. 2019;17(1):70. doi:1186/s12961-019-0474-6
  15. Pfadenhauer LM. Conceptualizing context and intervention as a system in implementation science: learning from complexity theory comment on "stakeholder perspectives of attributes and features of context relevant to knowledge translation in health settings: a multi-country analysis". Int J Health Policy Manag. 2021. doi:34172/ijhpm.2021.147
Volume 11, Issue 8
August 2022
Pages 1587-1589
  • Receive Date: 14 January 2022
  • Revise Date: 09 February 2022
  • Accept Date: 09 February 2022
  • First Publish Date: 12 February 2022