Strategies and frameworks

What are implementation strategies?

Implementation strategies are actions that help put suicide prevention approaches into practice. They help to ensure they are effective, reach their intended audience and are sustained over time.

For example, aftercare is a common, evidence-based suicide prevention approach designed to support people following a suicide attempt. Implementation strategies are what we do to take this evidence-based approach and apply it in the ‘real world’. These actions might include training healthcare providers, forming expert advisory groups or tailoring approaches to meet local needs.

What strategies are right for me?

Selecting the right implementation strategies can be challenging and may feel overwhelming, especially with so many options available. To make it easier, the Expert Recommendations for Implementing Change (ERIC) project collected feedback from both clinical practice and implementation science, creating a list of different implementation strategies.²

There are tools available to help you match implementation strategies with common barriers. For instance, the Consolidated Framework for Implementation Research (CFIR) can identify factors that might influence your implementation efforts. Once these factors have been identified, the CFIR-ERIC matching tool can suggest strategies that may be helpful.³

Researchers have used the CFIR to explore what affects the implementation of suicide prevention approaches.^4,5 The quick reference guide below can be used to see which implementation strategies are recommended for common barriers in suicide prevention. For example, if the barrier is having limited resources, strategies might include applying for funding or working with other organisations.

Using theories, models and frameworks

Theories, models or frameworks are the backbone of implementation. They provide a structure that helps us to understand how or why an implementation process works.

Theories, models and frameworks are often grouped based on the overarching aim¹:

1. To describe or guide the process of translating evidence into practice.
2. To explain what influences implementation outcomes.
3. To evaluate implementation.

What theories, models and frameworks are there?

With so many theories, models and frameworks, it can be challenging to know where to start. To make it easier, they can be grouped into five categories:

• Process models: These models aim to guide the process of translating research into practice.
• Determinant frameworks: These frameworks specify different factors or ‘determinants’ that hinder or enable implementation.
• Classic theories: These theories originate from fields outside of implementation science, like psychology or sociology. They can be applied to enhance understanding or explain aspects of implementation.
• Implementation theories: These theories also aim to enhance understanding or explain aspects of implementation, but were developed by implementation researchers, either from scratch or by adapting existing theories.
• Evaluation frameworks: These frameworks detail aspects of implementation to support evaluation and determine implementation success.

How do I know which is right for me?

The decision support tool below has been developed to help you to choose a theory, model or framework based on your goals. Based on the selection made, the tool will provide examples of relevant theories, models or frameworks that may be suitable.