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  • Experimental and quasi-expe...
    Miller, Christopher J.; Smith, Shawna N.; Pugatch, Marianne

    Psychiatry research, 01/2020, Letnik: 283
    Journal Article

    •Many implementation science questions can be addressed by experimental designs (e.g., randomized controlled trials RCTs).•Implementation trials differ in important ways, however, from more traditional efficacy- or effectiveness-oriented RCTs.•Adaptive designs can determine optimal implementation strategies within an experimental framework.•Quasi-experimental designs can be used to answer implementation science questions in the absence of randomization.•The choice of study designs in implementation science requires balancing scientific, pragmatic, and ethical issues. Implementation science is focused on maximizing the adoption, appropriate use, and sustainability of effective clinical practices in real world clinical settings. Many implementation science questions can be feasibly answered by fully experimental designs, typically in the form of randomized controlled trials (RCTs). Implementation-focused RCTs, however, usually differ from traditional efficacy- or effectiveness-oriented RCTs on key parameters. Other implementation science questions are more suited to quasi-experimental designs, which are intended to estimate the effect of an intervention in the absence of randomization. These designs include pre-post designs with a non-equivalent control group, interrupted time series (ITS), and stepped wedges, the last of which require all participants to receive the intervention, but in a staggered fashion. In this article we review the use of experimental designs in implementation science, including recent methodological advances for implementation studies. We also review the use of quasi-experimental designs in implementation science, and discuss the strengths and weaknesses of these approaches. This article is therefore meant to be a practical guide for researchers who are interested in selecting the most appropriate study design to answer relevant implementation science questions, and thereby increase the rate at which effective clinical practices are adopted, spread, and sustained.