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Research Methods & Reporting

Standards for Reporting Implementation Studies (StaRI) Statement

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.i6795 (Published 06 March 2017) Cite this as: BMJ 2017;356:i6795
  1. Hilary Pinnock, professor of primary care respiratory medicine1,
  2. Melanie Barwick, senior scientist, head of Child and Youth Mental Health Research Unit2,
  3. Christopher R Carpenter, associate professor, emergency medicine3,
  4. Sandra Eldridge, professor of biostatistics4,
  5. Gonzalo Grandes, head of unit, coordinator of primary health care research, Biocruces Research Institute5,
  6. Chris J Griffiths, professor of primary care6,
  7. Jo Rycroft-Malone, pro-vice chancellor, research and impact7,
  8. Paul Meissner, director of research program development8,
  9. Elizabeth Murray, professor of ehealth and primary care, and head of research9,
  10. Anita Patel, professor of health economics6,
  11. Aziz Sheikh, director1,
  12. Stephanie J C Taylor, professor in public health and primary care6
  13. for the StaRI Group
  1. 1Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh EH8 9AG, UK
  2. 2Research Institute, Hospital for Sick Children; Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Canada
  3. 3Washington University Division of Emergency Medicine. Washington University School of Medicine in St Louis, USA
  4. 4Pragmatic Clinical Trials Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
  5. 5Primary Care Research Unit of Bizkaia, Basque Health Service, Spain
  6. 6Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
  7. 7Bangor Institute for Health & Medical Research, Bangor University, UK
  8. 8Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, New York, USA
  9. 9Research Department of Primary Care and Population Health, University College London, UK
  1. Correspondence to: H Pinnock hilary.pinnock{at}ed.ac.uk
  • Accepted 27 October 2016

Abstract

Implementation studies are often poorly reported and indexed, reducing their potential to inform initiatives to improve healthcare services. The Standards for Reporting Implementation Studies (StaRI) initiative aimed to develop guidelines for transparent and accurate reporting of implementation studies. Informed by the findings of a systematic review and a consensus-building e-Delphi exercise, an international working group of implementation science experts discussed and agreed the StaRI Checklist comprising 27 items. It prompts researchers to describe both the implementation strategy (techniques used to promote implementation of an underused evidence-based intervention) and the effectiveness of the intervention that was being implemented. An accompanying Explanation and Elaboration document (published in BMJ Open, doi:10.1136/bmjopen-2016-013318) details each of the items, explains the rationale, and provides examples of good reporting practice. Adoption of StaRI will improve the reporting of implementation studies, potentially facilitating translation of research into practice and improving the health of individuals and populations.

Footnotes

  • Members of the the StaRI Group are: Melanie Barwick, Chris Carpenter, Peter Craig, Sandra Eldridge, Eleni Epiphaniou, Gonzalo Grandes Odriozola, Chris Griffiths, Martin Gulliford, Jo Rycroft-Malone, Paul Meissner, Brian Mittman, Elizabeth Murray, Anita Patel, Gemma Pearce, Hilary Pinnock, Aziz Sheikh, and Steph Taylor.

    Members of the PRISMS team (Eleni Epiphaniou, Gemma Pearce, and Hannah Parke) supported the underpinning literature work, and the e-Delphi exercise was handled by ClinVivo. We thank colleagues (implementation science experts, healthcare researchers, clinicians, PhD students) who reviewed the penultimate draft of the StaRI statement and provided a reality check and constructive feedback: Helen Ashdown, David Chambers, Louise Craig, Clarisse Dibao-Dina, Peter Hanlon, Roger Jones, Rachel Jordan, Chris del Mar, Brian McKinstry, Susan Morrow, John Ovretveit, David Price, Kamran Siddiqui, Rafael Stelmach, Paul Stephenson, Shaun Treweek, Bryan Weiner. We also thank Melissa Goodbourn and Allison Worth, who arranged feedback from the Edinburgh Clinical Research Facility Patient Advisory Panel (Stephanie Ashby, Alison Williams), and Steven Towndrow who coordinated feedback from the Patient and Public Involvement representatives of the NIHR CLAHRC North Thames (Ben Wills-Eve, Rahila Bashir, Julian Ashton, Colleen Ewart, Karen Williams).

  • Contributors: HP initiated the idea for the study and with ST led the development of the protocol, securing of funding, study administration, workshop, and writing of the paper. AS, CG, and SE advised on the development of the protocol and data analysis. All authors participated in the StaRI international working group along with GP, BM, MG. HP wrote the initial draft of the paper, to which all the authors contributed. HP is the study guarantor.

  • Funding: The StaRI initiative and workshop were funded by contributions from the Asthma UK Centre for Applied Research (AC-2012-01); Chief Scientist Office, Scottish Government Health and Social Care Directorates (PCRCA_08_01); the Centre for Primary Care and Public Health, Queen Mary University of London; and with contributions in kind from the PRISMS team (NIHR HS&DR Grant 11/1014/04). ST was (in part) supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart’s Health NHS Trust. AS is supported by the Farr Institute. The funding bodies had no role in the design, in the collection, analysis, and interpretation of data; in the writing of the manuscript; nor in the decision to submit the manuscript for publication.

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: research grants from Chief Scientist Office (HP), Asthma UK (AS, HP, ST), Farr Institute (AS), NIHR HS&DR (HP, ST), NIHR CLAHRC (ST) for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; CC is deputy editor-in-chief for Academic Emergency Medicine and on the editorial boards for the Journal of the American Geriatrics Society and Annals of Internal Medicine's ACP Journal Club and serves as paid faculty for Emergency Medical Abstracts, JR-M is director of the NIHR HS&DR Programme, no other relationships or activities that could appear to have influenced the submitted work.

  • Disclaimers: The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

  • Provenance of the paper: The StaRI Checklist was informed by the findings of a literature review and an e-Delphi exercise, an international consensus workshop, and the subsequent email correspondence among members of the StaRI Group. The international authors contributed expertise on clinical practice, public health, knowledge exchange, implementation science, complex interventions, and a range of methodologies including quantitative and qualitative evaluations.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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