i-PARIHS Framework

Background

The Promoting Action on Research Implementation in Health Services (PARIHS) framework, introduced in 1998, has been widely used to explain and predict the success of evidence implementation in healthcare settings. It highlights the complex and multi-dimensional nature of implementation, with a strong emphasis on context. However, critiques have identified areas for improvement, prompting the development of an integrated version (i-PARIHS). The figure schematic view of the facilitator’s role and processes.

Key Revisions & Operationalization

The i-PARIHS framework builds on empirical studies and feedback, refining several elements:

• Evidence Description: A broader and more structured approach to defining evidence
• Role of Individuals & Teams: Greater incorporation of key stakeholders in implementation
• Context Definition: A more detailed breakdown of contextual factors influencing implementation
• Facilitation: A critical element ensuring that implementation is actively supported

M&E Considerations

• Process Evaluation: Assessing how the revised framework improves evidence application.
• Outcome Measurement: Evaluating the impact of facilitation and contextual factors on implementation success.
• Stakeholder Engagement: Monitoring the involvement of individuals and teams in operationalizing the framework.
• Adaptability & Feedback: Continuous refinement based on real-world testing and stakeholder input.

The facilitation role and process

Conclusion

The i-PARIHS framework provides a coherent, practical and integrated approach to implementation science. At its core is facilitation, which plays a vital role in enhancing the monitoring and evaluation of evidence-based interventions, ensuring their effective translation into routine practice.

Reference

Harvey G, Kitson A. PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice. Implement Sci. 2016. https://doi.org/10.1186/s13012-016-0398-2

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SAGE (Staff Assessment of enGagement with Evidence)

Background

This includes a trial evaluating the effectiveness of a multifaceted program to improve the capacity of health policy agencies to use research in the development of policies and programs, entitled SPIRIT (Supporting Policy in Health with Research: an Intervention Trial). SAGE is based on the SPIRIT Action Framework which describes the steps, barriers, facilitators, and contextual influences along the pathway to research use in policymaking.

This framework underpinned SPIRIT by informing the selection of intervention strategies and outcome measures used in the trial. More generally, however, the framework aims to guide a systematic approach for selection and testing of strategies for building capacity for research use. 

The framework does not assume that policymaking is a linear, predictable process, but provides a simplified schematic to capture the process through which research informs policymaking. Once the need for research to inform policy is identified, policymakers initiate a number of (A) research engagement actions such as (i) searching for and (ii) obtaining research, (iii) appraising its relevance and (iv) quality, (v) generating new research or analyses, and (vi) interacting with researchers. Once relevant research has been obtained and/or generated, it can then be (B) used to inform policy making.

This may take place in four ways: (i) research may directly influence what issues to prioritize, or what decisions should be made with regard to the identified issue(s), including decisions to reject or disinvest in existing policies (instrumental); (ii) it may provide new ideas, understanding, or concepts to clarify thinking about the policy issue without directly influencing content (conceptual); (iii) it may be used to justify or lend weight to pre-existing decisions and courses of action relating to the issue, or make a case for changes to be made to existing policies (tactical); and/or (iv) be used to meet organizational, legislative, or funding requirements to use research (imposed).

The SAGE interview guide contains 22 questions that address each of the SPIRIT domains. Questions were framed in relation to the development of a specific policy or program document. This tool can assess the research engagement actions undertaken by a policymaker, the ways research was used by the policymaker, and the barriers that impacted upon their ability to use research.

Conclusion

By measuring research use validly, policy organizations may be able to implement initiatives to improve research use among staff, leading to evidence-based policies, more efficient health spending, and better health outcomes for the community.

Reference

Steve R. Makkar, Sue Brennan, Tari Turner, Anna Williamson, Sally Redman, Sally Green, The development of SAGE: A tool to evaluate how policymakers’ engage with and use research in health policymaking, Research Evaluation, Volume 25, Issue 3, July 2016, Pages 315–328, https://doi.org/10.1093/reseval/rvv044

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Knowledge to Action

Overview

The Knowledge to Action (K2A) Framework outlines three phases - research, translation, and institutionalization and the decision points, interactions, and support structures within the phases that are necessary to move knowledge into sustainable action. It is designed for facilitators, practioners and researchers, providing a structured approach to bridging research and practice.and control of chronic diseases.

M&E Considerations in the K2A Framework

1. Evaluation as a Continuous Process:
• The K2A framework integrates evaluation at every stage to assess effectiveness, scalability, and sustainability of interventions.
• M&E ensures that evidence-based programs remain relevant and adaptable to real-world challenges.
2. Assessing Translation Effectiveness:
• Measures the extent to which research findings inform and influence public health practices, policies, and programs.
• Identifies barriers and facilitators affecting the translation of evidence into action.
3. Impact Measurement:
• Evaluates the public health outcomes resulting from evidence-based interventions.
• Tracks the long-term institutionalization of successful programs.
4. Supporting Structures & Decision Points:
• M&E frameworks assess how well translation is integrated into existing public health systems.
• Reviews the efficiency of cross-disciplinary collaboration and resource allocation.

Conclusion

The K2A framework strengthens M&E by embedding evaluation throughout the knowledge translation process. This ensures that public health programs are not only evidence-driven but also scalable, and sustainable. By systematically assessing knowledge translation activities, the CDC can maximize the impact of research on public health outcomes.

Reference

Wilson KM, Brady TJ, Lesesne C; NCCDPHP Work Group on Translation. An organizing framework for translation in public health: the Knowledge to Action Framework. Prev Chronic Dis. 2011 Mar;8(2):A46. Epub 2011 Feb 15. PMID: 21324260; PMCID: PMC3073439.

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Scoring policymakers’ use of research

• A conjoint analysis using the scoring system of the SAGE
• The implications for policy and pratique: organization of benchmark and improve research use, identification of critical areas by policymakers
• This study focuses on monitoring and evaluating (M&E) the use of research in health policymaking by developing a standardized measurement and scoring tool. The tool assesses four domains of research use—instrumental, conceptual, tactical, and imposed—breaking them down into key sub-actions that can be systematically scored.
• To establish the relative importance of each sub-action, the study used conjoint analysis, engaging 54 knowledge translation experts in a choice-based survey. The responses were analyzed using Generalized Estimating Equations, which assigned utility coefficients to each sub-action, determining their influence on research use.

Conclusion

The tool provides an empirically validated scoring system, allowing organizations to quantify the extent of research utilization in policymaking and identify areas needing improvement. From an M&E perspective, this framework offers a structured approach to tracking and evaluating research integration into health policies, enabling continuous learning and evidence-informed decision-making.

Reference

Makkar SR, Williamson A, Turner T, Redman S & Louviere J. (2015). Using conjoint analysis to develop a system of scoring policymakers' use of research in policy and program development. Health Research Policy and Systems https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-015-0022-y.

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Review of frameworks for translating research evidence into policy and practice

The need to find unified approach for research translation: importance of a common language across disciplines, implementation of frameworks yes, but also monitoring scaling interventions

1. RE-AIM (reach, effectiveness, adoption, implementation, and maintenance of interventions),
2. Knowledge Translation Continuum (‘T’ Models)

This study examines research translation — the process of moving research evidence into policy and practice—and the frameworks used to measure and evaluate its success. Translational research is a priority for funding agencies worldwide, yet its interpretation varies across disciplines. While some view it as a bench-to-bedside approach focused on new treatments and technologies, others see it as applying evidence to health policies and systems.

The study highlights the challenges in measuring research translation due to diverse terminologies like knowledge translation, knowledge-to-action (KTA), and evidence-based practice. Despite these variations, all perspectives agree on the need for a structured, dynamic process that engages researchers, policymakers, and practitioners.

From an M&E perspective, the review assesses existing research translation frameworks by identifying their strengths, weaknesses, and applicability. The study used a systematic literature review to analyze theoretical models, case studies, and descriptive studies on research translation from 1990–2014. The findings emphasize the importance of conceptual frameworks in monitoring and evaluating the effectiveness of research translation efforts, ensuring that evidence informs healthcare policies, programs, and interventions efficiently.

Knowledge to Action (KPA) Framework

Reference

Milat AJ, Li B. Narrative review of frameworks for translating research evidence into policy and practice. Public Health Res Pract. 2017;27(1):e2711704. https://dx.doi.org/10.17061/phrp2711704.

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