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Making sense of complexity in context and implementation: the Context and Implementation of Complex Interventions (CICI) framework

Overview of attention for article published in Implementation Science, February 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (94th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

blogs
1 blog
policy
2 policy sources
twitter
45 tweeters

Citations

dimensions_citation
376 Dimensions

Readers on

mendeley
657 Mendeley
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Title
Making sense of complexity in context and implementation: the Context and Implementation of Complex Interventions (CICI) framework
Published in
Implementation Science, February 2017
DOI 10.1186/s13012-017-0552-5
Pubmed ID
Authors

Lisa M. Pfadenhauer, Ansgar Gerhardus, Kati Mozygemba, Kristin Bakke Lysdahl, Andrew Booth, Bjørn Hofmann, Philip Wahlster, Stephanie Polus, Jacob Burns, Louise Brereton, Eva Rehfuess

Abstract

The effectiveness of complex interventions, as well as their success in reaching relevant populations, is critically influenced by their implementation in a given context. Current conceptual frameworks often fail to address context and implementation in an integrated way and, where addressed, they tend to focus on organisational context and are mostly concerned with specific health fields. Our objective was to develop a framework to facilitate the structured and comprehensive conceptualisation and assessment of context and implementation of complex interventions. The Context and Implementation of Complex Interventions (CICI) framework was developed in an iterative manner and underwent extensive application. An initial framework based on a scoping review was tested in rapid assessments, revealing inconsistencies with respect to the underlying concepts. Thus, pragmatic utility concept analysis was undertaken to advance the concepts of context and implementation. Based on these findings, the framework was revised and applied in several systematic reviews, one health technology assessment (HTA) and one applicability assessment of very different complex interventions. Lessons learnt from these applications and from peer review were incorporated, resulting in the CICI framework. The CICI framework comprises three dimensions-context, implementation and setting-which interact with one another and with the intervention dimension. Context comprises seven domains (i.e., geographical, epidemiological, socio-cultural, socio-economic, ethical, legal, political); implementation consists of five domains (i.e., implementation theory, process, strategies, agents and outcomes); setting refers to the specific physical location, in which the intervention is put into practise. The intervention and the way it is implemented in a given setting and context can occur on a micro, meso and macro level. Tools to operationalise the framework comprise a checklist, data extraction tools for qualitative and quantitative reviews and a consultation guide for applicability assessments. The CICI framework addresses and graphically presents context, implementation and setting in an integrated way. It aims at simplifying and structuring complexity in order to advance our understanding of whether and how interventions work. The framework can be applied in systematic reviews and HTA as well as primary research and facilitate communication among teams of researchers and with various stakeholders.

Twitter Demographics

The data shown below were collected from the profiles of 45 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 657 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Thailand 1 <1%
Belgium 1 <1%
Unknown 654 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 115 18%
Student > Ph. D. Student 101 15%
Student > Master 99 15%
Student > Doctoral Student 44 7%
Other 31 5%
Other 126 19%
Unknown 141 21%
Readers by discipline Count As %
Medicine and Dentistry 147 22%
Nursing and Health Professions 92 14%
Social Sciences 82 12%
Psychology 46 7%
Business, Management and Accounting 16 2%
Other 93 14%
Unknown 181 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 41. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 April 2022.
All research outputs
#790,988
of 21,751,441 outputs
Outputs from Implementation Science
#135
of 1,689 outputs
Outputs of similar age
#23,355
of 446,723 outputs
Outputs of similar age from Implementation Science
#1
of 9 outputs
Altmetric has tracked 21,751,441 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,689 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.6. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 446,723 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 9 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them