Implementation outcome | Definition (adapted from [88]) | |
---|---|---|
Acceptability | Perception of key stakeholders (e.g. health professionals, patients, community members, members of the priority population, other stakeholders) that the intervention is agreeable, palatable or satisfactory | • Is the intervention acceptable for the priority population? • Is the intervention acceptable for improving health equity? |
Adoption | Intention, decision or action to implement an intervention | • Is adoption of the intervention equitable across different settings/contexts? If not, why might this be? • Are there any differences between settings relating to adoption of the intervention, e.g. high and low resource settings? • What equity-specific strategies are/could be utilised in the implementation pathway to achieve equitable adoption? And, if tested, how successful were these? |
Appropriateness | Perceived fit, relevance, or compatibility of the intervention for a given setting, provider, or consumer, and/or to address a particular issue or problem | • Is the intervention appropriate for the priority population and the implementation setting/context? • Is the intervention appropriate for addressing health inequities? • Is the intervention culturally appropriate? |
Penetration/Coverage | Integration of a practice within a service setting | • Is the intervention’s reach, access, service spread or effective coverage (combines coverage and fidelity) equitable for the eligible/priority population(s)? • Who is not reached by the intervention and why? • How can those who are eligible for, but not receiving, the intervention be reached? |
Feasibility | Extent to which a new intervention can be successfully used or carried out in a given setting | • Does the intervention allow for health equity barriers to be reduced? • What is the practicability of implementing the intervention in a given setting, especially among priority populations? • What adaptations are required to improve feasibility of intervention implementation for the priority population(s)? |
Fidelity | Degree to which an intervention was implemented as originally described or intended | • To what degree is the intervention delivered as intended? • To what degree is implementation equity-focused as originally intended? |
Implementation cost | Costs associated with an implementation effort | • What is the cost of implementation in priority populations (and the general population, if applicable)? Are the implementation costs equitable? • What is the final adjusted cost-effectiveness evaluation? |
Sustainability | Extent to which a newly implemented intervention is/can be maintained as part of a service’s routine operations | • Is the intervention being equitably maintained/sustained? • In which settings and populations is the intervention being sustained? Do all settings/populations have the capacity and partnerships to sustain intervention delivery? • Are the benefits of the intervention being sustained? Are the sustained benefits equitable? If not, why? • Are health inequities reduced or increased by adaptations to the intervention? • Which strategies (short, medium and long-term) could ensure the maintenance, continuation, durability/embedding or scale up of the intervention in the priority population(s)? |