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Request for Assistance

Implementation science researchers can offer methods for exploring and evaluating ideas or solutions that aim to address the evidence-practice gap.

In order for our team to efficiently respond to your request, please provide the following information. We endeavour to respond to all requests within 7-days.

This questionnaire has been developed by Jill Francis, Stephanie Best, Sanne Peters, Lisa Guccione and Marlena Klaic as a collaborative project between the Melbourne School of Health Sciences, Peter MacCallum Cancer Centre and the VCCC Alliance.

Thank you.

What is your name?

Email address.

Contact number.

What is your role?

Where are you employed?

The University of Melbourne

Peter MacCallum

Other

If other, please describe.

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Please tell us why you are visiting this page.

I require support with an implementation problem

I am interested in learning more about implementation science

Other

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If other, please tell us why you are visiting this page today.

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How would you like to learn more about implementation science?

I would like a conversation with an implementation scientist

I would like structured training in implementation science

I would like implementation science resources I can access in my own time

All of the above

What is the implementation problem you want to address? Please select relevant options.

Intervention under development - need to assess acceptability and feasibility in case it is clinically effective

Slow uptake of a new intervention that is clinically effective

Unwarranted variation in care that is associated with health inequities

Premature or continued uptake of an intervention or technology that is now known to be ineffective, wasteful or harmful

Failure to keep up with changes in evidence relating to an existing intervention

Need to evaluate an existing implementation intervention

Other

Unsure

If other, please describe.

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Please describe your implementation problem in 1-2 sentences.

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Please briefly describe evidence about the care gap (how do you know there is a problem?)

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The image below illustrates the different phases that an idea or research project may go through. For example T1 usually involves developing treatments and interventions where ideas can be evaluated, often as a first in humans study. By contrast, T3 focuses on research to change practice once an idea or intervention has been found to be effective.

Referring to the illustration above, at what stage is your idea?

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Please briefly describe your idea to address the evidence-care gap (100 words max.)

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Please describe the level and amount of evidence that the idea leads to benefits (200 words max.)

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Have consumers been involved in any aspect of your idea?

Yes

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If yes, please briefly describe consumer engagement to date.

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Please list the key members of the research team and their disciplines.

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How do you propose to fund the implementation science researcher?

Application to a competitive funding round

Application for funding from a healthcare provider

Existing funds

Unfunded

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Please provide details of funding including e.g., funder, round, timeline and amount

We have limited capacity as a team of implementation science specialists. If there is no funding for collaborating, please tell us why we should prioritise your idea.

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Any further comments? For example project stage, team availability for meetings, likely impact etc...? (200 words max.)

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How did you hear about us?

Web search / Website

Professional event e.g. University of Melbourne or Peter Mac or VCCC Alliance event

Conversation with an implementation scientist

Word-of-mouth

Other

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If other, please describe.

We note that you did not answer some questions. We would like to understand why so we can continue to improve this questionnaire. Could you please select all of the boxes below that most relate to you as to why you did not answer some questions?

The questionnaire took too long to complete

I didn't understand the questions

I realised my projects isn't ready for an implementation investigation

Other

If other, please describe

I consent to the (anonymised) data collected in this form being used for research purposes, as described in the plain language statement.

* must provide value

Yes

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.