Compared to outcomes in efficacy and effectiveness research, implementation outcomes cover a much broader scope of concepts, often involving multiple actors at different levels. Although conceptual frameworks exist, there is limited guidance on how to operationalize implementation outcomes for HIV research studies.

Additionally, EHE is an opportunity to harmonize measurement of outcomes across funded projects to improve reproducibility of findings and create generalizable knowledge about HIV intervention implementation. Coordination among funders, researchers, and implementers can also help to fortify the use of implementation science and achieve consensus on best practices for implementing evidence-based HIV interventions.

How Was the Guide Developed?

The domains and individual outcomes in the tool come from two frameworks: the Proctor et al. (2011) model and RE-AIM (Glasgow et al., 2019). We drew extensively from Kessler et al. (2013) for guidance on operationalization.

Drafts of the guide were iteratively refined through meetings with EHE Y1 supplement projects, consultation with representatives from CDC and HRSA, and discussion with a panel of HIV implementation science experts. The experts also rated the importance/relevance of each outcome across different stages of implementation research (e.g., implementation preparation, piloting a strategy, taking an intervention to scale).

How Can You Use This Guide in Your Work?

The guide is a menu from which you can choose the most appropriate outcomes for your specific context, HIV intervention, and research question. It can serve you as you develop a proposal, execute it, or refine it for further inquiry.

The full list of constructs can seem overwhelming; however, not all will be feasible for every study or relevant/important for your stage of research. Three major factors to consider in making your selections are as follows:

• • The outcomes are grouped by the specific research questions that they answer. You can select outcomes that align with your broader research agenda.
  • Outcomes are rated on relevance (e.g., required, recommended) by several stages of implementation research (i.e., implementation preparation, piloting an implementation strategy, taking an intervention/strategy to scale). By identifying the stage that is closest to your project, you can narrow down the list to the most important outcomes.
  • Different outcomes are measured at different levels of implementation, from the patient/client to the clinician/provider to the clinic/organization/site. For outcomes that you select, ensure that your project is assessing individuals at the correct levels.

Additional factors that may influence your selection of outcomes include your study design, target population, data sources, and implementation partner acceptability and capacity.

Feel free to reach out to your Consultation Hub for further assistance in using this tool.