Sustainable improvement of cervical cancer screening effectiveness is an implementation research challenge. The INSPIRE (Integrative Systems Praxis for Implementation Research) model is an operational roadmap that combines and draws upon different frameworks, theories and strategies and was developed to overcome this specific challenge. There are four iterative phases to the model, all of which have a specific objective and are theoretically grounded in the consolidated framework for implementation research (CFIR) and health systems frameworks. Phase 1 seeks to create a shared understanding of the current system, including using mixed methods research and soft systems methodology (SSM). This is done by creating visuals, particularly process maps and flowcharts, of the current system to highlight differences in stakeholder perspectives and the system’s interconnected nature. The phase 2 objective is to find leverage for change through facilitating discussions and analyses comparing different scenarios that might be successful in sustainably improving screening system effectiveness. The objective of phase 3 is to act strategically by collaboratively designing and executing the implementation plan. In phase 4, the research team and collaborators learn and adapt. Changes in system function are monitored using an interrupted time-series design and elements of SSM are used to monitor the human agency affecting system performance. The INSPIRE model is grounded in participatory action research (PAR), acknowledging that an internally derived intervention is essential for high adoption and sustainability in global implementation research.
To learn more about the INSPIRE model from Patti Gravitt, one of our principal investigators, click here.
What is Participatory Action Research (PAR)?
How did we apply PAR?
Identified stakeholders in screening program