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Juliane Mielke successfully defended her dissertation on 10th May 2022
Juliane Mielke’s dissertation addresses CONtextual analySis in implEmeNtation Science (CONSENS) and describes a methodology for studying context.
Context is a key determinant in successful and sustainable translation of interventions in real-world practice, yet contextual analysis remains a weak part of the implementation science methodology. Juliane Mielke’s dissertation aims to strengthen the theoretical and methodological foundation for contextual analysis in implementation science.
This dissertation presents contextual analysis as a separate, foundational phase of an implementation science project, the results of which inform all subsequent phases. Based on previous work by Stange and Glasgow as well as expert brainstorming sessions a methodology was developed that provides guidance for researchers on how to perform a contextual analysis: the Basel Approach for coNtextual ANAlysis (BANANA). The application of the approach is illustrated to an ongoing multisite, multiphase implementation science project, the SMILe project (Development/adaption, implementation and testing of an integrated care model in allogeneic SteM cell transplantatIon faciLitated by eHealth).
Further, this dissertation includes an evidence gap map that summarizes and graphically depicts the methodological approaches to contextual analysis applied in implementation intervention studies, as well as highlighting notable gaps in those approaches. As part of this work, a novel approach to literature searches and a framework for summarizing and evaluating methodological approaches for contextual analysis is provided.
Finally, suggestions are provided on how contextual analysis can be enhanced to overcome its current limitations, many of which arise from gaps in the currently prevalent postpositivist perspective. The suggestions apply not only to the concept of context but also to methodological and design considerations and are exemplified using COVID-19 vaccine hesitancy as case example. The suggestions include complementing current perspectives of context by adding five constructivist concepts—(1) social space; (2) social place; (3) agency; (4) sensation; and (5) embodiment)—that contribute to a more comprehensive and multilayered understanding of context to reveal complex dynamics not visible via the post-positivist perspective.
Overall this dissertation both provides a foundation to support enhanced uses of contextual analysis and strengthens implementation science methodology. Its findings help to speed up the translational pipeline, i.e., to accelerate and enhance the translation of interventions into real-world settings and contribute to improve overall quality and success of implementation science projects.