Two layers in one project
A community exercise program might be the intervention. Training staff, changing referral procedures, or providing delivery feedback might be implementation strategies.
The participants and outcomes can differ across layers: residents receive the program, while staff or organizations receive implementation support.
Name the target of each action
| Action | Immediate target |
|---|---|
| Participant exercise session | Participant activity and function |
| Staff training | Delivery knowledge or skill |
| Referral-system change | Access to the program |
| Performance feedback | Delivery consistency or quality |
An action can have several effects, but its intended pathway should be explicit.
Evaluate both layers
If staff training improves delivery, that is useful implementation evidence. It does not automatically prove that the underlying intervention improves health. Conversely, a beneficial intervention may remain unused if the implementation strategy does not address local barriers.
Avoid the unnamed bundle
A project that introduces a new program, new staff, new software, and new incentives at once may struggle to identify which changes matter. When a bundle is necessary, describe its components and the questions the design can answer.
Clear terminology helps teams select measures and interpret findings without attributing every improvement to the most visible part of the project.
