The mechanisms of change of a multifaceted implementation strategy on fidelity to a guideline for the prevention of mental health problems at the workplace.

Lydia Kwak, PhD
Karolinska Institute

Andreas Rödlund, PhD
Karolinska Institute

ABSTRACT:
A key priority in implementation science is to understand the mechanisms of implementation strategies, describing how and why they function. Yet, the knowledge about mechanisms of implementation strategies is scarce, and experimental studies exploring these mechanisms are still few. This presentation will share findings from a cluster-randomized controlled trial exploring mechanisms of change of a multifaceted implementation strategy for implementing a guideline for the prevention of mental health problems at the workplace in Swedish schools. First, we will present results from our quantitative study on mechanisms of the multifaceted strategy, where we tested the mediational pathways of nine hypothesized mediators derived from the Theoretical Domains Framework. Second, we will present our qualitative study that used a novel approach to illuminate the specific pathways of each of the discrete implementation strategies delivered within the multifaceted package. Together, these complementary approaches advance understanding of how multifaceted implementation strategies operate in complex, multi-level settings like schools and offer insights relevant to implementing evidence-based practices in other contexts.