New thesis on mechanisms behind successful school implementation
Welcome to Andreas Rödlund's presentation of his thesis ”Understanding implementation mechanisms : a cluster-randomized controlled trial in schools”.
Time: 5 december, kl. 9.00
Location: IMM-salen, Nobels väg 13 och online via Zoom
Supervisor: Lydia Kwak, Associate professor, Institute of Environmental Medicine (IMM), Karolinska Institutet
Opponent: Ulrica von Thiele Schwarz, Professor, School of Health, Care and Social Welfare - Mälardalen University, and Department of Learning, Informatics, Management and Ethics - Karolinska Institutet
Zoom: https://ki-se.zoom.us/j/66472625412
Three questions to Andreas
What is the thesis about?
The thesis examined the effectiveness of two different implementation strategies on the implementation of an evidence-based guideline for the prevention of mental health problems at the workplace. Specifically, we conducted a cluster-randomized controlled trial to compare the effectiveness of a multifaceted implementation strategy with a discrete strategy on the implementation of the guideline in schools. We also explored the mechanisms behind these strategies to understand how and why they work.
Can you tell us about some interesting results?
In the first study, we found that those working at schools with higher guideline fidelity, i.e., worked in accordance with the guideline, were more likely to report better work environment and improved health compared to those working at schools with low guideline fidelity. This study contributed with evidence that addressing organizational and social risk factors in a structured way, as recommended in the guideline, leads to positive outcomes for both schools and their staff. In the second study, we found that the multifaceted implementation strategy was more effective compared to the discrete implementation strategy in improving guideline fidelity among schools. When we then examined the mechanisms of these implementation strategies, we found that the multifaceted strategy improved the capability, opportunity, and motivation of those responsible for implementing the guideline at the school, which in turn improved their fidelity to the guideline. Qualitative findings further showed that this multifaceted strategy enabled cross-level collaboration, engaged multiple change processes, and provided support that could reinforce the mechanisms over time, which in turn contributed to the school’s implementation of the guideline.
What further research is needed in the area?
Future research should examine how potential adaptations and a more strategic use of the components of the multifaceted strategy can make the implementation even more (cost)-effective and responsive to the contextual needs of specific schools.
Link to thesis: Understanding implementation mechanisms : a cluster-randomized controlled trial in schools