How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework

Charlene Weight; Billy Vinette; Rachael  Laritz; Meagan Mooney; Sonia Angela  Castiglione; Marc-André Maheu-Cadotte; Nikolas Argiropoulos; Kristin Konnyu; Christine e. Cassidy; Simonne  Collins; Sonia Semenic; Nicola Straiton; Sandy Middleton; Natalie  Taylor; Marie-Pierre Gagnon; Shuang  Liang; Laura  Crump; Olivia  Di Lalla; Talia Meyers; Daniel N.  Elakpa; Guillaume Fontaine

doi:10.1186/s13012-025-01442-7

How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework

Charlene Weight
, Billy Vinette
, Rachael Laritz
, Meagan Mooney
, Sonia Angela Castiglione
, Marc-André Maheu-Cadotte
, Nikolas Argiropoulos
, Kristin Konnyu
, Christine e. Cassidy
, Simonne Collins
, Sonia Semenic
, Nicola Straiton
, Sandy Middleton
, Natalie Taylor
, Marie-Pierre Gagnon
, Shuang Liang
, Laura Crump
, Olivia Di Lalla
, Talia Meyers
, Daniel N. Elakpa

Guillaume Fontaine^* (Corresponding Author)

^*Corresponding author for this work

Aberdeen Centre for Evaluation

McGill University
Sir Mortimer B. Davis Jewish General Hospital
University of Montreal
Dalhousie University
IWK Health Centre
Australian Catholic University
St. Vincent's Hospital Melbourne
University of New South Wales
Université Laval
CHU de Québec-Université Laval
Sir Mortimer B. Davis Jewish General Hospital
Ottawa Hospital Research Institute

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Background
Clear specification and reporting of implementation strategies and their targeted healthcare professional behaviors are essential for replication, adaptation, and cumulative learning in implementation science. However, critical gaps remain in the consistent use of reporting frameworks. This study aimed to: (1) assess the completeness of implementation strategy reporting using the Template for Intervention Description and Replication (TIDieR) checklist; (2) examine trends in implementation strategy reporting over time; and (3) assess the completeness of the reporting of healthcare professional behaviors targeted for change using the Action, Actor, Context, Target, Time (AACTT) framework.

Methods
We conducted a secondary analysis of 204 trials included in a systematic review of implementation strategies aimed at changing healthcare professional behavior. Implementation strategies were assessed using the 12-item TIDieR checklist; target behaviors were characterized using the five AACTT domains. Two independent reviewers extracted and coded the data. Descriptive statistics were used to summarize reporting patterns. Data were synthesized narratively and presented in tables, with trends illustrated via a scatterplot.

Results
Assessment of implementation strategy reporting using TIDieR showed that procedural details (98%), materials used (95%), and modes of delivery (88%) were frequently reported. Critical elements such as strategy tailoring (28%), fidelity assessment (19% planned; 17% actual), and modifications (10%) were often missing. A modest improvement in reporting was observed after the publication of TIDieR, with median scores increasing from 15.0 (IQR: 13.0–16.0) pre-2014 to 16.0 (IQR: 15.0–18.0) post-2014. Assessment of target healthcare professional behavior reporting using AACTT indicated that actions (e.g., “assess illness”) and actors (e.g., nurses) were generally well reported at a high level. However, key contextual and temporal details were largely absent. While physical context was documented in all studies, the emotional and social contexts of behaviors were rarely reported. Crucial information on the duration, frequency, and period of behaviors was rarely reported.

Conclusions
Implementation strategies and target behaviors are not consistently or sufficiently reported in trials. Increased adoption of structured reporting tools such as TIDieR and AACTT is essential to enhance transparency. Incorporating these frameworks during protocol development could strengthen intervention evaluation and reporting, advancing implementation science and fostering cumulative knowledge.

Original language	English
Article number	28
Number of pages	19
Journal	Implementation Science
Volume	20
Issue number	1
Early online date	2 Jun 2025
DOIs	https://doi.org/10.1186/s13012-025-01442-7
Publication status	Published - Dec 2025

Bibliographical note

Acknowledgements
The authors wish to acknowledge the contribution of Jérémie Blondin for the development of search strategies and the search in bibliographical databases. We thank Ariane Ballard for contributing to study selection. We wish to thank the members of the team who contributed to study selection and data extraction in the overarching systematic review.

Data Availability Statement

All data are included in this published article and its supplementary information files.

Funding

GF is supported by a Junior 1 Research Scholar Award from the Fonds de recherche du Québec – Santé (FRQ-S). This project is supported by a project grant from the Quebec Health Research Fund (FRQ-S) and the Réseau de recherche en interventions en sciences infirmières du Québec/Quebec Network on Nursing Intervention Research (RRISIQ).

Funders
Quebec Health Research Fund
Quebec Network on Nursing Intervention Research

Keywords

implementation practice
implementation science
implementation research
knowledge translation
barriers
facilitators
reporting standards
reporting checklists

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Cite this

Weight, C., Vinette, B., Laritz, R., Mooney, M., Castiglione, S. A., Maheu-Cadotte, M.-A., Argiropoulos, N., Konnyu, K., Cassidy, C. E., Collins, S., Semenic, S., Straiton, N., Middleton, S., Taylor, N., Gagnon, M.-P., Liang, S., Crump, L., Di Lalla, O., Meyers, T., ... Fontaine, G. (2025). How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework. Implementation Science, 20(1), Article 28. https://doi.org/10.1186/s13012-025-01442-7

How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework. / Weight, Charlene; Vinette, Billy; Laritz, Rachael et al.
In: Implementation Science, Vol. 20, No. 1, 28, 12.2025.

Research output: Contribution to journal › Article › peer-review

Weight, C, Vinette, B, Laritz, R, Mooney, M, Castiglione, SA, Maheu-Cadotte, M-A, Argiropoulos, N, Konnyu, K, Cassidy, CE, Collins, S, Semenic, S, Straiton, N, Middleton, S, Taylor, N, Gagnon, M-P, Liang, S, Crump, L, Di Lalla, O, Meyers, T, Elakpa, DN & Fontaine, G 2025, 'How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework', Implementation Science, vol. 20, no. 1, 28. https://doi.org/10.1186/s13012-025-01442-7

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title = "How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework",

abstract = "Background Clear specification and reporting of implementation strategies and their targeted healthcare professional behaviors are essential for replication, adaptation, and cumulative learning in implementation science. However, critical gaps remain in the consistent use of reporting frameworks. This study aimed to: (1) assess the completeness of implementation strategy reporting using the Template for Intervention Description and Replication (TIDieR) checklist; (2) examine trends in implementation strategy reporting over time; and (3) assess the completeness of the reporting of healthcare professional behaviors targeted for change using the Action, Actor, Context, Target, Time (AACTT) framework. Methods We conducted a secondary analysis of 204 trials included in a systematic review of implementation strategies aimed at changing healthcare professional behavior. Implementation strategies were assessed using the 12-item TIDieR checklist; target behaviors were characterized using the five AACTT domains. Two independent reviewers extracted and coded the data. Descriptive statistics were used to summarize reporting patterns. Data were synthesized narratively and presented in tables, with trends illustrated via a scatterplot. Results Assessment of implementation strategy reporting using TIDieR showed that procedural details (98\%), materials used (95\%), and modes of delivery (88\%) were frequently reported. Critical elements such as strategy tailoring (28\%), fidelity assessment (19\% planned; 17\% actual), and modifications (10\%) were often missing. A modest improvement in reporting was observed after the publication of TIDieR, with median scores increasing from 15.0 (IQR: 13.0–16.0) pre-2014 to 16.0 (IQR: 15.0–18.0) post-2014. Assessment of target healthcare professional behavior reporting using AACTT indicated that actions (e.g., “assess illness”) and actors (e.g., nurses) were generally well reported at a high level. However, key contextual and temporal details were largely absent. While physical context was documented in all studies, the emotional and social contexts of behaviors were rarely reported. Crucial information on the duration, frequency, and period of behaviors was rarely reported. Conclusions Implementation strategies and target behaviors are not consistently or sufficiently reported in trials. Increased adoption of structured reporting tools such as TIDieR and AACTT is essential to enhance transparency. Incorporating these frameworks during protocol development could strengthen intervention evaluation and reporting, advancing implementation science and fostering cumulative knowledge.",

keywords = "implementation practice, implementation science, implementation research, knowledge translation, barriers, facilitators, reporting standards, reporting checklists",

author = "Charlene Weight and Billy Vinette and Rachael Laritz and Meagan Mooney and Castiglione, \{Sonia Angela\} and Marc-Andr{\'e} Maheu-Cadotte and Nikolas Argiropoulos and Kristin Konnyu and Cassidy, \{Christine e.\} and Simonne Collins and Sonia Semenic and Nicola Straiton and Sandy Middleton and Natalie Taylor and Marie-Pierre Gagnon and Shuang Liang and Laura Crump and \{Di Lalla\}, Olivia and Talia Meyers and Elakpa, \{Daniel N.\} and Guillaume Fontaine",

note = "Acknowledgements The authors wish to acknowledge the contribution of J{\'e}r{\'e}mie Blondin for the development of search strategies and the search in bibliographical databases. We thank Ariane Ballard for contributing to study selection. We wish to thank the members of the team who contributed to study selection and data extraction in the overarching systematic review.",

year = "2025",

month = dec,

doi = "10.1186/s13012-025-01442-7",

language = "English",

volume = "20",

journal = "Implementation Science",

issn = "1748-5908",

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number = "1",

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TY - JOUR

T1 - How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework

AU - Weight, Charlene

AU - Vinette, Billy

AU - Laritz, Rachael

AU - Mooney, Meagan

AU - Castiglione, Sonia Angela

AU - Maheu-Cadotte, Marc-André

AU - Argiropoulos, Nikolas

AU - Konnyu, Kristin

AU - Cassidy, Christine e.

AU - Collins, Simonne

AU - Semenic, Sonia

AU - Straiton, Nicola

AU - Middleton, Sandy

AU - Taylor, Natalie

AU - Gagnon, Marie-Pierre

AU - Liang, Shuang

AU - Crump, Laura

AU - Di Lalla, Olivia

AU - Meyers, Talia

AU - Elakpa, Daniel N.

AU - Fontaine, Guillaume

N1 - Acknowledgements The authors wish to acknowledge the contribution of Jérémie Blondin for the development of search strategies and the search in bibliographical databases. We thank Ariane Ballard for contributing to study selection. We wish to thank the members of the team who contributed to study selection and data extraction in the overarching systematic review.

PY - 2025/12

Y1 - 2025/12

N2 - Background Clear specification and reporting of implementation strategies and their targeted healthcare professional behaviors are essential for replication, adaptation, and cumulative learning in implementation science. However, critical gaps remain in the consistent use of reporting frameworks. This study aimed to: (1) assess the completeness of implementation strategy reporting using the Template for Intervention Description and Replication (TIDieR) checklist; (2) examine trends in implementation strategy reporting over time; and (3) assess the completeness of the reporting of healthcare professional behaviors targeted for change using the Action, Actor, Context, Target, Time (AACTT) framework. Methods We conducted a secondary analysis of 204 trials included in a systematic review of implementation strategies aimed at changing healthcare professional behavior. Implementation strategies were assessed using the 12-item TIDieR checklist; target behaviors were characterized using the five AACTT domains. Two independent reviewers extracted and coded the data. Descriptive statistics were used to summarize reporting patterns. Data were synthesized narratively and presented in tables, with trends illustrated via a scatterplot. Results Assessment of implementation strategy reporting using TIDieR showed that procedural details (98%), materials used (95%), and modes of delivery (88%) were frequently reported. Critical elements such as strategy tailoring (28%), fidelity assessment (19% planned; 17% actual), and modifications (10%) were often missing. A modest improvement in reporting was observed after the publication of TIDieR, with median scores increasing from 15.0 (IQR: 13.0–16.0) pre-2014 to 16.0 (IQR: 15.0–18.0) post-2014. Assessment of target healthcare professional behavior reporting using AACTT indicated that actions (e.g., “assess illness”) and actors (e.g., nurses) were generally well reported at a high level. However, key contextual and temporal details were largely absent. While physical context was documented in all studies, the emotional and social contexts of behaviors were rarely reported. Crucial information on the duration, frequency, and period of behaviors was rarely reported. Conclusions Implementation strategies and target behaviors are not consistently or sufficiently reported in trials. Increased adoption of structured reporting tools such as TIDieR and AACTT is essential to enhance transparency. Incorporating these frameworks during protocol development could strengthen intervention evaluation and reporting, advancing implementation science and fostering cumulative knowledge.

AB - Background Clear specification and reporting of implementation strategies and their targeted healthcare professional behaviors are essential for replication, adaptation, and cumulative learning in implementation science. However, critical gaps remain in the consistent use of reporting frameworks. This study aimed to: (1) assess the completeness of implementation strategy reporting using the Template for Intervention Description and Replication (TIDieR) checklist; (2) examine trends in implementation strategy reporting over time; and (3) assess the completeness of the reporting of healthcare professional behaviors targeted for change using the Action, Actor, Context, Target, Time (AACTT) framework. Methods We conducted a secondary analysis of 204 trials included in a systematic review of implementation strategies aimed at changing healthcare professional behavior. Implementation strategies were assessed using the 12-item TIDieR checklist; target behaviors were characterized using the five AACTT domains. Two independent reviewers extracted and coded the data. Descriptive statistics were used to summarize reporting patterns. Data were synthesized narratively and presented in tables, with trends illustrated via a scatterplot. Results Assessment of implementation strategy reporting using TIDieR showed that procedural details (98%), materials used (95%), and modes of delivery (88%) were frequently reported. Critical elements such as strategy tailoring (28%), fidelity assessment (19% planned; 17% actual), and modifications (10%) were often missing. A modest improvement in reporting was observed after the publication of TIDieR, with median scores increasing from 15.0 (IQR: 13.0–16.0) pre-2014 to 16.0 (IQR: 15.0–18.0) post-2014. Assessment of target healthcare professional behavior reporting using AACTT indicated that actions (e.g., “assess illness”) and actors (e.g., nurses) were generally well reported at a high level. However, key contextual and temporal details were largely absent. While physical context was documented in all studies, the emotional and social contexts of behaviors were rarely reported. Crucial information on the duration, frequency, and period of behaviors was rarely reported. Conclusions Implementation strategies and target behaviors are not consistently or sufficiently reported in trials. Increased adoption of structured reporting tools such as TIDieR and AACTT is essential to enhance transparency. Incorporating these frameworks during protocol development could strengthen intervention evaluation and reporting, advancing implementation science and fostering cumulative knowledge.

KW - implementation practice

KW - implementation science

KW - implementation research

KW - knowledge translation

KW - barriers

KW - facilitators

KW - reporting standards

KW - reporting checklists

U2 - 10.1186/s13012-025-01442-7

DO - 10.1186/s13012-025-01442-7

M3 - Article

SN - 1748-5908

VL - 20

JO - Implementation Science

JF - Implementation Science

IS - 1

M1 - 28

ER -

How well are implementation strategies and target healthcare professional behaviors reported? A secondary analysis of 204 implementation trials using the TIDieR checklist and AACTT framework

Abstract

Bibliographical note

Data Availability Statement

Funding

Keywords

Access to Document

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