Prioritizing Implementation Barriers

Toolkit for designing an implementation initiative

Who is this toolkit for?

This toolkit is for researchers implementing an evidence-based intervention (EBI) at a specific setting such as a clinic or school.

This toolkit may also be helpful for partners or collaborators at the site who are helping to implement the EBI.

Getting Started

What is an implementation barrier?

An “implementation barrier” is anything that inhibits the integration of an evidence-based intervention (EBI) in a specific setting, such as a physician practice, hospital, mental health clinic, or school. Implementation barriers belong to a broader class of factors called “determinants,” which are contextual features that influence — positively or negatively — the implementation of EBIs.

Common determinants that are implementation barriers might include:

  • The EBI is too costly
  • The clinic staff lack the skills for EBI delivery
  • The clinic workflow makes EBI delivery difficult
  • There is no reimbursement for EBI delivery
  • The clinic has done little planning for implementation


Why prioritize implementation barriers?

Often, researchers and their implementation partners identify more barriers to implementing an EBI than they can feasibly address, given available time, effort, and resources. Focusing on developing implementation strategies for the most high-priority barriers increases the likelihood of successful EBI implementation.

When do I use this toolkit?

This toolkit assumes you and your team have identified implementation barriers. The toolkit is to help your team determine which barriers are most important to address for your EBI implementation effort.

What is included in this toolkit?

This toolkit contains:

  • Criteria for prioritizing implementation barriers
  • Scoring systems for rating barriers using the criteria
  • Guidance for using scores and criteria
  • Free or low-cost tools to support rating barriers
  • Recommendations for identifying and addressing interdependence among barriers


How should I use this toolkit?

This toolkit is a one-stop shop for nearly everything you need to prioritize implementation barriers. After the introduction and sections on how to prioritize barriers and address their interdependence, look at the sections on frequently asked questions and references if you need more information.

Thank you for downloading the toolkit. We would like to understand more about who is using these methods and how they are being used.

We are interested in your feedback on the toolkit. If you are willing to be contacted for feedback in the future (e.g., a brief survey), please provide your email below.

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Funding acknowledgment

Funding for this toolkit comes from the National Institute of Mental Health (P50MH126219) and the National Cancer Institute (P50CA244432).