The science of turning great health ideas into real-world impact

Many researchers and practitioners are developing great healthcare interventions. But how can you make sure they don’t end up in a drawer, but also work in practice? Implementation science is all about studying how knowledge and interventions are brought into society. “Implementation science in health service research is like the playbook for turning great health ideas into real-world impact”, explains researcher Zhu. “It's the bridge between brilliant concepts and tangible improvements in people's lives.”

Interventions for caregivers of people with dementia

In her PhD research, Eden Zhu looks at interventions for informal caregivers (mantelzorgers in Dutch) of people with dementia. One of her papers recently got accepted in the Journal of Implementation Science, which has a good reputation in the field and a high rejection rate. In the paper she did a scoping review of 67 studies that include more than 500 different interventions for caregivers. Zhu broke them down into seven different categories ranging from interventions related to exercise or education to E-health interventions.  “We saw there was no information on how to put these interventions into practice”, elaborates Zhu. “So the main goal of this paper was to help bridge that gap.”

Challenges in healthcare

The research field is relatively new as implementation science started to take off from 2010 onwards. “The healthcare system is under pressure, with a population that is becoming older and more and more short-staffed. The things we do therefore must have impact”, adds Robbert Huijsman, professor of management and organization of elderly care and the promoter of Zhu. Implementation science looks at all contextual factors that are important for the successful implementation of interventions. “You could think of organizational strategies, the business side, the preferences of healthcare professionals, but also how a good training program should look like.”

Both researchers see that in research attention is often drawn to implementing pharmaceutical interventions or interventions targeted at healthcare professionals. But in dementia care, the largest group dealing with persons with dementia are informal caregivers, like a partner or family. Huijsman:  “At the moment we are in a societal transition where informal care becomes more important. There are just not enough people that can or want to work in healthcare. But the amount of people with dementia will double in the coming decades. That’s why research into interventions related to caregivers is so important.”

Barriers and facilitators 

In implementation science it is important to look at both barriers and facilitators, so factors that hamper or enable the implementation of interventions. Say a new app is being developed that is designed to help caregivers cope with different behaviors of the patient. Zhu: “In that case you have to know if the potential users are digitally literate enough to use it. And there should be a business model. Maybe the insurance company pays, or the users pay for it themselves. These are all factors that are crucial for the success of an intervention.”

In the paper the E-learning tool ‘Partner in Balans’ is mentioned as a good example. This tool provides tailored support to caregivers, addressing their unique needs and challenges. A facilitator here was the co-creation approach, involving caregivers in the development process to ensure the intervention meets their needs effectively. “This tool was not created in an ivory tower”, says Huijsman.  “It was developed in close collaboration with the target group. The researchers asked informal caregivers what their issues are and let them test and try the tool before it went out in practice.”

Bridging the gap

You could say that the facilitators and barriers help form a checklist for researchers or practitioners who are involved in the development of interventions. Zhu and Huijsman hope there will be more awareness of implementation issues and that the research field will receive wider recognition. “I think many people know how difficult it is to implement new interventions or technology”, says Zhu.  “This paper gives that lived experience more validation. People who read it will understand there is a major need to transfer knowledge to the field. Ultimately this will lead to more successful and sustainable healthcare practices.”