The dissemination and implementation (D&I) of evidence at the community level is critical to improve health and advance health equity. Social networks are considered essential to D&I efforts, but there lacks clarity regarding how best to study and leverage networks. We examined networks in community-level D&I frameworks to characterize the range of network actors, activities, and change approaches. We conducted a narrative review of 66 frameworks. Among frameworks that explicitly addressed networks – that is, elaborated on network characteristics, structure, and/or activities – we extracted and synthesized network concepts using descriptive statistics and narrative summaries. A total of 24 (36%) frameworks explicitly addressed networks. Commonly included actors were implementers, adopters/decision-makers, innovation developers, implementation support professionals, and innovation recipients. Network activities included the exchange of resources, knowledge, trust, and norms. Most network-explicit frameworks characterized ties within and across organizations and considered element(s) of network structure – for example, size, centrality, and density. The most common network change strategy was identifying individuals to champion D&I efforts. We discuss opportunities to expand network inquiry in D&I science, including understanding networks as implementation determinants, leveraging network change approaches as implementation strategies, and exploring network change as an implementation outcome.

Dental service providers have limited capacity to identify strategies to implement evidence-based practices (EBPs). We developed a rigorous yet parsimonious scoping review approach to identify, select, and rate implementation strategies based on an oral health system context. From 153 strategies identified, we selected the top 11 strategies, which had a moderate level of support of evidence and where managers were the main actors. The main actions were to educate, remind, structure, and influence. Targets included dentists, dental hygienists, and assistants and managers from a large prepaid dental care delivery system. This approach responds to calls for rapid and innovative methods to implement EBPs in oral health.

Physical inactivity in older adults presents a significant problem within modern societies globally. Using a mixed-method approach, this study explored strategies for the development and delivery of physical activity (PA) interventions by investigating what behaviour change techniques (BCTs) are useful, and how these techniques should be implemented to be feasible for older adults. Sixty-six older adults completed a survey indicating the most useful BCTs, mapping on to motivational, volitional and automatic factors. Of these, 48 older adults participated in an interview exploring strategies for a PA intervention targeted at older adults. The most useful BCT identified in the survey was autonomy support (61.3%), followed by instruction to perform the behaviour (43.5%) and having a credible source of information about PA (42.6%). The key themes discussed in the interviews included providing support in making an informed choice, instruction on how to perform PA, information about health consequences, social support, goal setting, action and coping plans, behavioural demonstration and practice, and monitoring PA. The interviews also revealed key aspects of programme implementation including face-to-face delivery, followed up with additional materials; low cost; age-appropriate PA level; and individualised approach. Interventions assisting older adults in increasing their PA participation across a range of settings should incorporate BCTs targeting multiple processes, while tailoring their delivery to older adults’ preferences to ensure their feasibility in supporting regular PA engagement.

Large Australian and Swiss banks have been trimming their workforces since the mid-1990s. With further rounds of downsizing activities predicted, this study sought to identify, examine, and compare the adopted organizational downsizing implementation strategies. The primary purpose of this cross-cultural study was to determine how large Australian and Swiss banks implemented downsizing in their most recent endeavors. The research has revealed three key findings. First, Australian banks primarily adopted workforce reduction strategies, whereas Swiss banks employed a mixture of organization redesign, workforce reduction, and systemic strategies. Second, Australian banks had considerable depth in their downsizing, whereas Swiss banks had more breadth in their overall strategies. Third, Australian banks favored reorientation approaches, whereas Swiss banks embraced reinforcement approaches. It remains unclear as to why large Australian and Swiss banks differed in the selection of implementation strategies and why they diverged in their overall approaches to downsizing. Further research is required to explore aspects that are likely to influence the adoption of downsizing strategies in both Australia and Switzerland.

Frail older patients suffer from multiple, complex needs that often go unmet in an acute care setting. Failure to recognize the geriatric giants in frail older adults is resulting in the misclassification of this population. This study investigated “sub-acute” frail, older-adult in-patients in a tertiary care teaching hospital. Although identified as being no longer acutely ill, all participants (n = 62) required active medical and/or nursing care. Frail older patients, often acutely ill, were being misclassified as sub-acute when the acuity of their illness went unrecognized which resulted in equally unrecognized disease presentations. The majority of participants wished to be cared for at or closer to home. The lack of post-acute-care service within our health care system and risk aversion on the part of hospital staff resulted in lengthy hospital stays and/or in patients being funneled into existing services (nursing homes) against their desire to go home.