Background Implementation failure is inconsistently defined and conceptually underdeveloped in the implementation science (IS) literature. This impedes implementation research, practice and learning opportunities. To address these ambiguities, we conducted a scoping review of how health-related IS literature conceptualizes implementation failure. Methods Eleven databases were searched. Studies were selected based on predefined eligibility criteria; relevant data were extracted and coded by two reviewers, using a codebook based on a modified version of the Consolidated Framework for Implementation Research. To develop themes, we used regular meetings to interpret emerging patterns, refine conceptual boundaries and strengthen the theoretical and policy relevance of the analysis. Results We found four themes relating to the context and recurring determinants of failure: 1) failures in the implementation environment, 2) gaps in implementation planning, 3) inadequate individual capability, opportunity, and motivation and 4) failure to achieve and sustain innovation-context fit. We also analyzed how failure manifests across various implementation phases, a cross-cutting theme of power and equity and conceptual relationships. Across the literature, we found “implementation failure” used without clear definitions or measurement and a conflation of implementation and innovation failure. We defined implementation failure as a gap between the aspirations and outcomes of a specific implementation process, encompassing the failure to deliver benefits of evidence-based practices to the people and communities that deserve to share in the benefits of research. Discussion Implementation failure remains conceptually ambiguous within the IS literature. The IS field must adopt clearer, more rigorous terminology to distinguish contextual challenges from outright failure. While examining failure yields insights obscured by a focus on success, we note a paradox that naming failure may individualize blame or treat ongoing adaptation as deficient. To support implementation success and promote learning, we present 1) an Implementation Failure Assessment Guide and 2) recommendations for implementation research, practice and support. Conclusion Our synthesis delivers a nuanced conceptualization of implementation failure. The value of examining failure lies in identifying where, for whom, and from whose perspective an implementation process fell short. Prioritizing the study of failure offers opportunities for learning and optimizing vital resources to accelerate implementation and ensure sustainment.

Initiatives are increasingly encouraging health and social care staff involvement in research, with evidence for patient and organisational level benefits. There is less evidence of the benefits for staff and whether this varies by type of involvement. This scoping review aimed to identify the different ways staff are involved in applied health research, the benefits experienced, and whether this varies by type of involvement. This will help to inform leaders in service organisations, funders, and researchers about how to maximise such benefits. The scoping review followed the JBI methodology. Four databases were searched: CINAHL, MEDLINE, PsycINFO and Scopus. Grey literature was identified via Google, Google Scholar and relevant websites. Records had to be UK-based, published in English between 2003 and 2023 and cover applied health and care research, health care staff involvement and report on benefits. Text was extracted from records, coded afterwards, and quality checked. The benefits were distilled by four research active health care staff. Descriptive statistics and narrative synthesis were used to report the results. In total, 49 records were reviewed, 42 records were from the database search and 7 from the grey literature search. Records were most commonly journal articles (n = 44), covering multiple care settings (n = 15) and mixed professional groups (n = 24), used qualitative methods (n = 22) and focussed on clinical academic roles (n = 21). Six benefits of involvement in research were distilled: personal fulfilment, general competencies/skills, connections/networks, opportunities for learning, opportunities for leading improvements in practice, and using evidence more effectively. Records that focussed on the more intensive clinical academic roles reported more examples of opportunities for leading improvements in practice, and the building of connections and social support. Non-clinical academic records more frequently reported that involvement in research provided opportunities for learning. These findings support efforts to involve staff in research, with a range of benefits associated with enhanced job satisfaction, even when research involvement is in a less intense form, such as participation in a study. These findings can be used to encourage involvement, with recommendations for future research to review the benefits for social care staff, and to examine more directly the effect on staff wellbeing and retention.

Despite social prescribing being promoted by the UK government for the last decade, the evidence supporting social prescribing remains weak and has mainly been confined to clinical contexts. Our study aimed to evaluate the impact of a Social Navigator (SN) service in South Tyneside on the health and well-being of users who experience financial hardship with complex health needs and limited access to mental health services.Using a mixed-methods design combining secondary analysis of service data (n=330), qualitative interviews with service users (n=15) conducted by peer researchers, and a social return On investment analysis that matched service data with health economic indicators from the UK Social Value Bank.Our findings demonstrate clear value for money with a £3 return for every £1 invested in the service, with a positive return confirmed in sensitivity analysis. SNs were able to improve the confidence of service users, with statistically significant changes across all eight confidence-related outcomes, and helped them to access other advice and financial services. This resulted in one-off financial gains (average £1237) and annual financial gains (average £1703) for service users. The interviews identified that relieving financial burden and stress improved the quality of life and mental well-being of users as a result of their involvement with the service.SN can break the cycle of multiple visits to crisis teams by building trusting relationships and providing emotional and practical support, while being responsive to the service users’ needs and available when they have needs. They play a key intermediary role in integrated care systems with a unique focus on the wider determinants of health and financial hardship, advocating for service users without time limits and navigating the complexities of the system across local government. Greater integration of local support services could be achieved by mapping all available pathways for support.

While the evidence base on successful practices in knowledge exchange is rapidly growing, much less attention has been given in the academic literature to documenting and reflecting on failures in trying to exchange different types of evidence between academics, practice partners and policymakers. However, learning from failures is just as important, if not more crucial, than celebrating successes. Therefore, in this introduction to the special issue on learning from failures in knowledge exchange, we discuss crosscutting themes across the seven papers. We start by comparing and theorising different definitions of failures, and by exploring the relational barriers and structural stressors underlying these failures. We argue for the creation of a 'failure culture' in organisations, in which failures are no longer avoided but actively encouraged. To turn failures into successes, we identify a need for more sharing and publishing of failures, early engagement with stakeholders in the knowledge exchange process, and illustrate the importance of boundary spanners. We conclude with recommendations for future work, related to promising theoretical approaches, such as system thinking, the re-addressing of power imbalances through leadership, and highlight art-based approaches as a mechanism for rebalancing power.

BACKGROUND:Although knowledge sharing online has been recognised as an important strategy for health professionals to apply research findings to their practice, limited research exists on how to develop and implement these platforms to help facilitate collaboration and knowledge sharing. OBJECTIVES:This study evaluated an online knowledge sharing platform and community of practice developed in the North East of England and Yorkshire during COVID-19 to support UK health and care professionals to reduce the impact of the wider consequences of COVID-19. METHODS:Semi-structured interviews with stakeholders (n = 8) and users of C-WorKS (n = 13), followed by an online survey (n = 19) among a wider group of users to analyse knowledge use. RESULTS:Interview and survey findings highlighted several strengths, weaknesses, opportunities and threats to support future development of online knowledge sharing platforms. DISCUSSION:Online knowledge sharing supports six 'pillars' of successful research and innovation partnerships. This requires distributed forms of leadership and linking of different knowledge sharing strategies, and careful combination of platforms with communities of practice. CONCLUSION:Online knowledge sharing provides pragmatic and timely strategies for health professionals in the UK to apply research evidence to their practice. Our study provides generalisable, practical insights in how to develop and implement a knowledge sharing platform.

Background Despite growing enthusiasm for co-production in healthcare services and research, research on co-production practices is lacking. Multiple frameworks, guidelines and principles are available but little empirical research is conducted on ‘how to do’ co-production of research to improve healthcare services. This paper brings together insights from UK-based collaborative research partnerships on leading co-production. Its aim is to inform practical guidance for new partnerships planning to facilitate the co-production of applied health research in the future. Methods Using an auto-ethnographic approach, experiential evidence was elicited through collective sense making from recorded conversations between the research team and senior leaders of five UK-based collaborative research partnerships. This approach applies a cultural analysis and interpretation of the leaders’ behaviours, thoughts and experiences of co-production taking place in 2008–2018 and involving academics, health practitioners, policy makers and representatives of third sector organisations. Results The findings highlight a variety of practices across CLAHRCs, whereby the intersection between the senior leaders’ vision and local organisational context in which co-production occurs largely determines the nature of co-production process and outcomes. We identified four tensions in doing co-production: (1) idealistic, tokenistic vs realistic narratives, (2) power differences and (lack of) reciprocity, (3) excluding vs including language and communication, (4) individual motivation vs structural issues. Conclusions The tensions were productive in helping collaborative research partnerships to tailor co-production practices to their local needs and opportunities. Resulting variation in co-production practices across partnerships can therefore be seen as highly advantageous creative adaptation, which makes us question the utility of seeking a unified ‘gold standard’ of co-production. Strategic leadership is an important starting point for finding context-tailored solutions; however, development of more distributed forms of leadership over time is needed to facilitate co-production practices between partners. Facilitating structures for co-production can enable power sharing and boost capacity and capability building, resulting in more inclusive language and communication and, ultimately, more credible practices of co-production in research. We provide recommendations for creating more realistic narratives around co-production and facilitating power sharing between partners.

Background Local government (LG) is ideally placed to influence the determinants of public health (PH) and reduce inequalities, but opportunities are routinely missed. Aims and objectives The aim of the Local Authority Champions of Research (LACoR) study was to explore ways to embed a culture of evidence use in LG. Methods Five linked work packages were undertaken using mixed methods. In this paper, we report data from semi-structured interviews with UK local authority (LA) staff (n=14). Findings Findings show a changing culture of LG: embedded researchers can enhance connectivity and interaction, build linkages, use levers of influence, and learn alongside LG navigators. Understanding the diverse microcultures of evidence use in LG is critical. Research champions can help to navigate the social, financial, political and regulatory context of LG and academia, influencing change dynamically as opportunities emerge. Discussion Changing organisational subcultures is ambitious and unpredictable given the complexities of, and variability in, local contexts. Cumulative changes appear possible by recognising existing assets, using relational approaches to respond to LG priorities. In-house capacity remains underestimated and underutilised in efforts to embed evidence use in LG decision making. Co-located embedded researchers can use contextually specific knowledge and relationships to enhance evidence use in LG in collaboration with system navigators. Conclusions There is a need for academics to adapt their approach, to take account of the context of LG to achieve meaningful health and social impacts with LG and test the contribution of embedded approaches to wider system change.

Objectives: The benefits of physical activity during and after pregnancy are well established. However, activity levels decline substantially in both inactive and active women. There is limited information on the barriers and facilitators for physical activity participation in active women, which is vital for the development of tailored interventions. The primary aim of this study is to identify the barriers and facilitators for physical activity (PA) in already active women during pregnancy and postpartum. We also explore their views on, and requirements for, the development of an intervention to support maintenance of or increase in physical activity.

Interest in and use of co-production in healthcare services and research is growing. Previous reviews have summarized co-production approaches in use, collated outcomes and effects of co-production, and focused on replicability and reporting, but none have critically reflected on how co-production in applied health research might be evolving and the implications of this for future research. We conducted this scoping review to systematically map recent literature on co-production in applied health research in the United Kingdom to inform co-production practice and guide future methodological research. This scoping review was performed using established methods. We created an evidence map to show the extent and nature of the literature on co-production and applied health research, based on which we described the characteristics of the articles and scope of the literature and summarized conceptualizations of co-production and how it was implemented. We extracted implications for co-production practice or future research and conducted a content analysis of this information to identify lessons for the practice of co-production and themes for future methodological research. Nineteen articles reporting co-produced complex interventions and 64 reporting co-production in applied health research met the inclusion criteria. Lessons for the practice of co-production and requirements for co-production to become more embedded in organizational structures included (1) the capacity to implement co-produced interventions, (2) the skill set needed for co-production, (3) multiple levels of engagement and negotiation, and (4) funding and institutional arrangements for meaningful co-production. Themes for future research on co-production included (1) who to involve in co-production and how, (2) evaluating outcomes of co-production, (3) the language and practice of co-production, (4) documenting costs and challenges, and (5) vital components or best practice for co-production. Researchers are operationalizing co-production in various ways, often without the necessary financial and organizational support required and the right conditions for success. We argue for accepting the diversity in approaches to co-production, call on researchers to be clearer in their reporting of these approaches, and make suggestions for what researchers should record. To support co-production of research, changes to entrenched academic and scientific practices are needed. Protocol registration details: The protocol for the scoping review was registered with protocols.io on 19 October 2021: https://dx.doi.org/10.17504/protocols.io.by7epzje .

Background Interest in and use of co-production in healthcare services and research is growing. Previous reviews have summarised co-production approaches in use, collated outcomes and effects of co-production and focused on replicability and reporting, but none have critically reflected on how co-production in applied health research might be evolving and the implications of this for future research. We aim to conduct a scoping review to systematically map recent literature on co-production in applied health research in the UK to inform co-production practice and guide future methodological research. Methods Scoping review using established methods. We will created an evidence map to show the extent and nature of the literature on co-production and applied health research, based on this we described the characteristics of the articles and scope of the literature and summarised conceptualisations of co-production and how it was implemented. We will extract implications for co-production practice or future research and conduct a content analysis of this information to identify lessons for the practice of co-production and themes for future methodological research. Results We will report on lessons for the practice of co-production and themes for future research on co-production.

Background Co-production of research evidence is valued by local government to improve effective decision-making about public services in times of austerity. However, underlying structural issues of power (so-called ‘dark shadows of co-production’) challenge this ambition with limited evidence on how to embed research use sustainably. In this paper we reflect on mechanisms for increasing co-production in local government. Methods This paper presents findings from a Health Foundation funded research project that explored how a culture of evidence use to improve population health could be embedded in UK local government. Five linked work packages were undertaken using mixed methods. In this paper, we report the views of UK local authority staff who participated in four workshops ( n = 54), informed by a rapid literature review and an online scoping survey. Results We identified five themes that facilitate public health evidence use in local government: (1) new governance arrangements to integrate national and local policies, (2) codifying research evidence through local system-wide approaches and (3) ongoing evaluation of programmes, and (4) overcoming political and cultural barriers by increasing absorptive capacity of Local Authorities to embed co-produced knowledge in their cognitive structures. This requires adaptive governance through relationship building between academic researchers and Local Authority staff and shared understanding of fragmented local policy making, which are supported by (5) collective spaces for reflection within local government. Conclusions Creating collective spaces for reflection in between government departments allows for iterative, interactive processes of co-production with external partners that support emergence of new governance structures to socially action the co-produced knowledge in context and build capacity for sustained evidence use.

Background The national Public Health Practice Evaluation Scheme (PHPES) is a response-mode funded evaluation programme operated by the National Institute for Health Research School for Public Health Research (NIHR SPHR). The scheme enables public health professionals to work in partnership with SPHR researchers to conduct rigorous evaluations of their interventions. Our evaluation reviewed the learning from the first five years of PHPES (2013–2017) and how this was used to implement a revised scheme within the School. Methods We conducted a rapid review of applications and reports from 81 PHPES projects and sampled eight projects (including unfunded) to interview one researcher and one practitioner involved in each sampled project ( n = 16) in order to identify factors that influence success of applications and effective delivery and dissemination of evaluations. Findings from the review and interviews were tested in an online survey with practitioners (applicants), researchers (principal investigators [PIs]) and PHPES panel members ( n = 19) to explore the relative importance of these factors. Findings from the survey were synthesised and discussed for implications at a national workshop with wider stakeholders, including public members ( n = 20). Results Strengths : PHPES provides much needed resources for evaluation which often are not available locally, and produces useful evidence to understand where a programme is not delivering, which can be used to formatively develop interventions. Weaknesses : Objectives of PHPES were too narrowly focused on (cost-)effectiveness of interventions, while practitioners also valued implementation studies and process evaluations. Opportunities : PHPES provided opportunities for novel/promising but less developed ideas. More funded time to develop a protocol and ensure feasibility of the intervention prior to application could increase intervention delivery success rates. Threats : There can be tensions between researchers and practitioners, for example, on the need to show the 'success’ of the intervention, on the use of existing research evidence, and the importance of generalisability of findings and of generating peer-reviewed publications. Conclusions The success of collaborative research projects between public health practitioners (PHP) and researchers can be improved by funders being mindful of tensions related to (1) the scope of collaborations, (2) local versus national impact, and (3) increasing inequalities in access to funding. Our study and comparisons with related funding schemes demonstrate how these tensions can be successfully resolved.

Background: Physical activity (PA) reduces significantly in active women during pregnancy and in postpartum. Objectives: To synthesise the evidence on the effectiveness of PA interventions delivered to active pregnant and postpartum women and to explore the perceptions of active women on being active during pregnancy. Search Strategy: Five databases were searched from inception up until 12th of May 2019. Selection Criteria: We included studies where a PA intervention was used to promote or prevent decline in PA levels in active pregnant and/or postpartum women, and either PA outcomes or participants’ views on physical activity were reported. Data Collection and Analysis: Data were extracted using structured data extraction forms. A narrative synthesis of quantitative and qualitative data was produced. Main Results: Three studies with a total of 2,1426 participants were included. Quantitative studies used face-to-face sessions, goal setting, and multimedia provision to exercise at home as interventions. Different methods were used to assess change in PA with both studies reporting significant positive changes in physical activity. Qualitative data suggested that already active women are enthusiastic about continuing PA during and after pregnancy. They see health benefits and empowerment as an enabler and overcoming peer judgement and stereotypes as a barrier. Conclusion: Available evidence shows that PA interventions in already active women tend to be successful in increasing physical activity levels and foster a positive perception. These findings should inform the design and delivery of successful PA interventions in already active pregnant and postpartum women. Keywords: Physical activity; Already active; Pregnant; Postpartum.

Background: Fuse was established in 2008 as one of five public health research centres of excellence in the UK funded by the UK Clinical Research Centres collaboration. The centre works across five universities in the North East of England. This is an innovative collaboration and enables the pooling of research expertise. A prime focus of the centre is not just the production of excellent research, but also its translation into usable evidence, a dual focus that remains uncommon. Aims/objectives: This practice paper outlines Fuse's approach to knowledge exchange (KE) by reflecting on ten years of collaborative research between academics and policy and practice partners in the North East of England. We will describe the principles and assumption underlying our approach and outline a conceptual model of four steps in Fuse's KE process to develop collaborative research and achieve meaningful impact on policy and practice. Key conclusions: Our model describes a fluid and dynamic approach to knowledge exchange broken down in four steps in the KE process that are concurrent, iterative and vary in intensity over time: awareness raising; knowledge sharing; making evidence fit for purpose; and supporting uptake and implementation of evidence. These steps support the relational context of KE. Relationship building and maintenance is essential for all stages of KE to develop trust and explore the meaning and usefulness of evidence in a multi-directional information flow that supports the co-creating and application of evidence.

Background – Activity levels decline substantially in both inactive and active women during pregnancy and postpartum. There is limited information on the barriers and facilitators for physical activity participation in active women during this period. The primary aim of this study is to identify the barriers and facilitators for physical activity in already active women during pregnancy and postpartum. We also explore their views on, and requirements for, the development of an intervention to support the maintenance of or increase in physical activity. Methods - Five focus groups, with a total of 19 participants, were conducted. Transcripts were analysed using a thematic analysis approach. Results – Out of the 19 participants, four were postpartum, and 15 were pregnant. Analysing the focus group transcripts, 22 codes were generated and grouped into eight themes: 1-cognizant of physical activity’s benefits, 2-sources of advice, 3-reasons to be active during pregnancy, 4-reasons for reducing physical activity levels during pregnancy, 5-barriers to physical activity during and after pregnancy, 6-facilitators of physical activity during and after pregnancy, 7-ideal physical activity intervention, and 8-evaluation support. Conclusions – Among already active pregnant and postpartum women, factors such as pregnancy-related body changes, childcare and lack of targeted activities deter participation in physical activity. A new programme with social and group elements, including both familiar and new activities, and providing ‘satisfaction and fun’ should be developed to help increase or maintain their activity levels.