Rugged landscapes: complexity and implementation science.

ABSTRACT:

Background

Mis-implementation-defined as failure to successfully implement and continue evidence-based programs-is widespread in public health practice. Yet the causes of this phenomenon are poorly understood.

Methods

We develop an agent-based computational model to explore how complexity hinders effective implementation. The model is adapted from the evolutionary biology literature and incorporates three distinct complexities faced in public health practice: dimensionality, ruggedness, and context-specificity. Agents in the model attempt to solve problems using one of three approaches-Plan-Do-Study-Act (PDSA), evidence-based interventions (EBIs), and evidence-based decision-making (EBDM).

Results

The model demonstrates that the most effective approach to implementati

SUBMITTER: Ornstein JT 

PROVIDER: S-EPMC7523395 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature