Table 1

Types of hybrid implementation effectiveness studies

Type 1Type 2Type 3
Primary focus
  • To study the effectiveness of a clinical intervention

  • To study the effectiveness of a clinical intervention

And
  • To study the adoption and feasibility of the implementation strategy used to deliver the intervention

  • To study the effectiveness of an implementation strategy to deliver the intervention

Secondary focus
  • To gather information on implementation aspects

  • To assess patient outcomes as result of the intervention

Measures
  • Effectiveness: patients symptoms and functioning, and possibly costs

  • Implementation: barriers and facilitators for implementation, feasibility and acceptability of the intervention

  • Effectiveness: patients symptoms and functioning, and possibly costs

  • Implementation: adoption and fidelity of the intervention, and related barriers and facilitators

  • Implementation: Implementation outcomes (acceptability, appropriateness, feasibility, adoption, fidelity, penetration and sustainability) and related barriers and facilitators

  • Effectiveness: patient symptoms, functioning and service use

Evaluation methods
  • Effectiveness: quantitative

  • Implementation: mixed methods (eg, interview, survey and/ or observation of participants)

  • Effectiveness: quantitative

  • Implementation: mixed methods (eg, interview, survey and/ or observation of participants, administrative data)

  • Implementation: mixed methods (eg, interview, survey and/ or observation of participants, administrative data)

  • Effectiveness: quantitative (preferably administrative/registry data)

When indicated?
  • No or mixed data on intervention effectiveness.

  • Evidence of intervention effectiveness in other settings or populations is available, but not in the context or population of the current study (so there is uncertainty whether the intervention leads to similar effects).

Or
  • Only preliminary effectiveness data available but there is a strong push to use the intervention because of system or policy requirements.

  • When there are concerns about the extent to which the intervention can be delivered correctly in real-world settings.

Or
  • When there is a strong momentum for the implementation of an intervention despite a limited evidence base.

Requirement for using this hybrid type
  • None

  • Evidence of intervention effectiveness in other settings or populations available

  • Enough data on barriers and facilitators for the implementation of the intervention to select implementation strategies

  • Strong evidence of intervention effectiveness is available

  • Enough data on barriers and facilitators for the implementation of the intervention to select implementation strategies