{"doi":"10.1186/s13012-024-01395-3","title":"Gaps in communication theory paradigms when conducting implementation science research: qualitative observations from interviews with administrators, implementors, and evaluators of rural health programs","abstract":"<jats:title>Abstract</jats:title><jats:sec>\n                <jats:title>Background</jats:title>\n                <jats:p>Communication is considered an inherent element of nearly every implementation strategy. Often it is seen as a means for imparting new information between stakeholders, representing a Transaction orientation to communication. From a Process orientation, communication is more than information-exchange and is acknowledged as being shaped by (and shaping) the individuals involved and their relationships with one another. As the field of Implementation Science (IS) works to strengthen theoretical integration, we encourage an interdisciplinary approach that engages communication theory to develop richer understanding of strategies and determinants of practice.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Methods</jats:title>\n                <jats:p>We interviewed 28 evaluators, 12 implementors, and 12 administrators from 21 Enterprise-Wide Initiatives funded by the Department of Veteran Affairs Office of Rural Health. Semi-structured interviews focused on experiences with implementation and evaluation strategies. We analyzed the interviews using thematic analysis identifying a range of IS constructs. Then we deductively classified those segments based on a Transaction or Process orientation to communication.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Results</jats:title>\n                <jats:p>We organized findings using the two IS constructs most commonly discussed in interviews: Collaboration and Leadership Buy-in. The majority of segments coded as Collaboration (<jats:italic>n</jats:italic> = 34, 74%) and Leadership Buy-in (<jats:italic>n</jats:italic> = 31, 70%) discussed communication from a Transaction orientation and referred to communication as synonymous with information exchange, which emphasizes the task over the relationships between the individuals performing the tasks. Conversely, when participants discussed Collaboration and Leadership Buy-in from a Process orientation, they acknowledged both constructs as the result of long-term efforts to develop positive relationships based on trust and respect, and emphasized the time costliness of such strategies. Our findings demonstrate that participants who discussed communication from a Process orientation recognized the nuance and complexity of interpersonal interactions, particularly in the context of IS.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Conclusions</jats:title>\n                <jats:p>Efficient, reliable information exchange is a critical but often overemphasized element of implementation. Practitioners and researchers must recognize and incorporate the larger role of communication in IS. Two suggestions for engaging a Process orientation to communication are to: (a) use interview probes to learn how communication is enacted, and (b) use process-oriented communication theories to develop interventions and evaluation tools.</jats:p>\n              </jats:sec>","journal":"Implementation Science","year":2024,"id":642429,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":2,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1671006,"name":"Jennifer Van Tiem","orcid":null,"position":1,"is_corresponding":false},{"id":1671007,"name":"Erin Balkenende","orcid":null,"position":2,"is_corresponding":false},{"id":1271412,"name":"DeShauna Jones","orcid":"0000-0002-1781-361X","position":3,"is_corresponding":false},{"id":1671008,"name":"Julia E. Friberg","orcid":null,"position":4,"is_corresponding":false},{"id":687094,"name":"Emily E. Chasco","orcid":"0000-0002-9542-2454","position":5,"is_corresponding":false},{"id":1671009,"name":"Jane Moeckli","orcid":null,"position":6,"is_corresponding":false},{"id":1671010,"name":"Kenda S. Steffensmeier","orcid":null,"position":7,"is_corresponding":false},{"id":1671011,"name":"Melissa J. A. Steffen","orcid":null,"position":8,"is_corresponding":false},{"id":391319,"name":"Kanika Arora","orcid":"0000-0001-9537-8708","position":9,"is_corresponding":false},{"id":322435,"name":"Borsika A. Rabin","orcid":"0000-0001-9837-7866","position":10,"is_corresponding":false},{"id":737234,"name":"Heather Schacht Reisinger","orcid":"0000-0002-5348-063X","position":11,"is_corresponding":false},{"id":361408,"name":"Nicole L. Johnson","orcid":"0000-0002-9519-2150","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Gaps in communication theory paradigms when conducting implementation science research: qualitative observations from interviews with administrators, implementors, and evaluators of rural health programs","abstract":"<jats:title>Abstract</jats:title><jats:sec>\n                <jats:title>Background</jats:title>\n                <jats:p>Communication is considered an inherent element of nearly every implementation strategy. Often it is seen as a means for imparting new information between stakeholders, representing a Transaction orientation to communication. From a Process orientation, communication is more than information-exchange and is acknowledged as being shaped by (and shaping) the individuals involved and their relationships with one another. As the field of Implementation Science (IS) works to strengthen theoretical integration, we encourage an interdisciplinary approach that engages communication theory to develop richer understanding of strategies and determinants of practice.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Methods</jats:title>\n                <jats:p>We interviewed 28 evaluators, 12 implementors, and 12 administrators from 21 Enterprise-Wide Initiatives funded by the Department of Veteran Affairs Office of Rural Health. Semi-structured interviews focused on experiences with implementation and evaluation strategies. We analyzed the interviews using thematic analysis identifying a range of IS constructs. Then we deductively classified those segments based on a Transaction or Process orientation to communication.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Results</jats:title>\n                <jats:p>We organized findings using the two IS constructs most commonly discussed in interviews: Collaboration and Leadership Buy-in. The majority of segments coded as Collaboration (<jats:italic>n</jats:italic> = 34, 74%) and Leadership Buy-in (<jats:italic>n</jats:italic> = 31, 70%) discussed communication from a Transaction orientation and referred to communication as synonymous with information exchange, which emphasizes the task over the relationships between the individuals performing the tasks. Conversely, when participants discussed Collaboration and Leadership Buy-in from a Process orientation, they acknowledged both constructs as the result of long-term efforts to develop positive relationships based on trust and respect, and emphasized the time costliness of such strategies. Our findings demonstrate that participants who discussed communication from a Process orientation recognized the nuance and complexity of interpersonal interactions, particularly in the context of IS.</jats:p>\n              </jats:sec><jats:sec>\n                <jats:title>Conclusions</jats:title>\n                <jats:p>Efficient, reliable information exchange is a critical but often overemphasized element of implementation. Practitioners and researchers must recognize and incorporate the larger role of communication in IS. Two suggestions for engaging a Process orientation to communication are to: (a) use interview probes to learn how communication is enacted, and (b) use process-oriented communication theories to develop interventions and evaluation tools.</jats:p>\n              </jats:sec>","is_dataset_classified":null,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"datacite_reuse_total":2,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39285406","pmcid":"PMC11403836","openalex_id":"https://openalex.org/W4402582121","authors":[],"funders":[{"funder_name":"Office of Rural Health","grant_id":"PEC 19-456","title":null}],"total_grants":1,"fwci":2.0027,"citation_percentile":0.87374214,"influential_citations":0,"citation_trend":[{"year":2024,"count":1},{"year":2025,"count":2}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://link.springer.com/content/pdf/10.1186/s13012-024-01395-3.pdf","host_type":"journal"},{"url":"https://link.springer.com/content/pdf/10.1186/s13012-024-01395-3.pdf","host_type":"publisher"},{"url":"https://link.springer.com/article/10.1186/s13012-024-01395-3/fulltext.html","host_type":"publisher"},{"url":"https://doi.org/10.1186/s13012-024-01395-3","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39285406","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11403836","host_type":"repository"},{"url":"https://doaj.org/article/a0618475936a464384bacdffa226d755","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11403836/pdf/13012_2024_Article_1395.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC11403836","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC11403836?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Health Policy Implementation Science","Community Health and Development","Complex Systems and Decision Making","Humans","Communication","Implementation Science","Qualitative Research","Leadership","Interviews as Topic","Rural Health Services","Cooperative Behavior","United States","Administrative Personnel","United States Department of Veterans Affairs","Rural Health"],"mesh_terms":["Implementation Science","Administrative Personnel","Communication","Cooperative Behavior","Humans","Interviews as Topic","Leadership","Rural Health","United States","United States Department of Veterans Affairs","Rural Health Services","Qualitative Research"],"keywords":["Health informatics","Health administration","Health services research","Field (mathematics)","Public relations","Qualitative research","Health communication","Database transaction","Knowledge management","Implementation research","Process (computing)","Orientation (vector space)","Sociology","Engineering ethics","Management science","Computer science","Medicine","Public health","Nursing","Political science","Engineering","Social science","Psychological intervention","Interviewing","Collaboration","Qualitative Methods","Veteran","Communication Theory","Leadership Buy-in","Implementation Science Strategies"],"sdg_mappings":[],"linked_datasets":[{"doi":"10.6084/m9.figshare.27042362.v1","title":"Additional file 1 of Gaps in communication theory paradigms when conducting implementation science research: qualitative observations from interviews with administrators, implementors, and evaluators of rural health programs","publisher":"figshare","resource_type":"JournalArticle"},{"doi":"10.6084/m9.figshare.27042362","title":"Additional file 1 of Gaps in communication theory paradigms when conducting implementation science research: qualitative observations from interviews with administrators, implementors, and evaluators of rural health programs","publisher":"figshare","resource_type":"JournalArticle"}],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-07T22:42:56.911405Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}