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September 10, 2026Implementation Science CommunicationsOpen Access

Tracking implementation strategies using the Iowa Implementation for Sustainability Framework (IISF) in real world settings: VA Office of Rural Health enterprise-wide initiatives

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Authors

KHKirsten HanrahanAKAnna KruppELElyse Laures

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Overview

Descriptive study reveals distinct implementation strategy patterns across veteran health initiatives, highlighting the utility of structured frameworks for tracking real-world healthcare rollout.

Key Points

  • To examine the patterns, timing, and domains of implementation strategies used in evaluation reports from 26 enterprise-wide healthcare initiatives using the Iowa Implementation for Sustainability Framework (IISF).
  • Conducted a descriptive study using deductive content analysis of evaluation reports from 26 enterprise-wide initiatives (EWIs) funded by the VA Office of Rural Health.
  • Categorized reported strategies using the 75-strategy IISF taxonomy and analyzed patterns across implementation phases, domains, RE-AIM dimensions, and rurality using descriptive statistics.
  • Catalogued 1,032 strategy applications across 60 distinct IISF strategies, with EWIs utilizing an average of 39.7 strategies (range: 12–87).
  • Observed the highest concentration of strategies during Phase 3 (Promote Action & Adoption; 55.6%, f=564), in the Data domain (38.4%, f=390), and under the RE-AIM Implementation dimension (39.1%, f=397).
  • Identified higher average strategy utilization in non-rural initiatives (mean 45.3 strategies) compared to rural initiatives (mean 33.8 strategies).

Cite This Study

Hanrahan et al. (2026) studied this question.

synapsesocial.com/papers/6aa27c4958559d80afc7611bhttps://doi.org/10.1186/s43058-026-01097-5
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