Lisa Saldana is the Director and Senior Research Scientist at Chestnut Health Systems’ Lighthouse Institute and Director for the Center for Implementation Science at Lighthouse Institute. She has a research emphasis on advancing the use of evidence-based practice in public serving systems. A clinical psychologist by training, she is an NIH-funded implementation scientist focused on the development, evaluation, and implementation of prevention-focused EBPs. Lisa has led a multidisciplinary team of researchers and together during their time at Oregon Social Learning Center they developed the Stages of Implementation Completion ®(SIC) and Cost of Implementing New Strategies (COINS) tools that have been widely adopted to measure, track, and facilitate implementation process, milestones, and resource use for different behavioral and physical healthcare programs worldwide. She serves as a mentor to many emerging scientists with an interest in implementation science and evidence-based practice and has the privilege of collaborating with investigators and community partners throughout the country on numerous federally funded projects. 

The following is an interview between Elvin Geng, Editor-in-Chief of Implementation Science Communications, and Lisa.

Elvin: Thank you so much for joining the journal as an AE.  The timing is crucial - we have had a surge in submissions and we need the kind of expertise that you bring to guide the journal as well as the field.  On a personal level, I’m also very excited to work more closely with you because I have followed your work for years.  You developed the Stages of Implementation Completion and COINS — tools that have shaped how the field measures and supports implementation. These are major contributions to the field.  could I ask you to say a word or two about these, how they came out, and what has surprised you about how the research community has ended up using them?

Lisa: Thanks Elvin! I can’t tell you how excited I am to join this esteemed editorial board and team. Implementation Science Communications is one of my favorite journals and I’m delighted to support it during this period of massive growth. And congratulations to you and the editors for earning such an incredible initial impact score. 

Thanks for asking about the SIC and COINS tools and I wish I could take credit for the initial idea of measuring implementation process, but this idea originated from one of the original implementation trials funded under NIH’s initial dissemination and implementation research in health initiative. The grant was awarded to Oregon Social Learning Center with Patti Chamberlain as the PI and Hendricks Brown was a Co-I. Hendricks had the original notion that passing of time and what you did with that time was important for understanding implementation. The gap we were trying to fill was significant – the study was a head-to-head trial comparing the effectiveness of two bundled implementation strategies, and we needed to determine if the strategies were actually being used, how they were being used, and if they ended in successful implementation. All things that are a given part of your original proposal now, but for those initial trials, we were trying to figure out what the plane was actually supposed to look like, while we were building it, and flying it. 

I was at the right place at the right time, happened to have some measurement development skills, and was very privileged to be asked to lead this effort. I integrated my behavioral observation background and spent a lot of time grappling with how to operationalize processes. I also happened to have some (very minimal) training in economics and policy, and it was clear that as we observed implementation processes, that significant fiscal decisions were impacting implementation along the way. We, in turn, developed the COINS tool to be used alongside the SIC to capture the costs associated with the implementation process.  While both were developed to help us observe our outcomes for that initial trial, they now are commonly used throughout the field which has been such a fun ride to get to collaborate with people all over the world and learn about the really cool innovations they are trying to move into practice but has also absolutely unexpected. 

Elvin: As you step into the associate editor role at Implementation Science Communications, where do you see the biggest white spaces in the current literature? What kinds of manuscripts are you hoping to champion? 

Lisa: This is probably not surprising, but I am very grounded in the practical and pragmatic side of implementation science and I would like to see the field move toward helping systems integrate and utilize the knowledge learned over the last couple of decades to create systems change and build sustainable infrastructures. I would like to see us move beyond the theoretical and apply what we have learned on a larger scale. Across the globe we are witnessing how vulnerable our healthcare and scientific infrastructures are with many systems being dismantled with rapid speed. During the period of rebuild, it would be wonderful to see more manuscripts providing examples of methods, strategies, and outcomes focused on using knowledge from the IS field to help create infrastructures that can exist and sustain within communities independent of external resources. 

Elvin: If you had to name one conceptual or methodological shift you'd like to see the field make in the next five years, what would it be — and why?

Lisa: Great question. I would love to see rigorous designs developed that also take into consideration that real world partners do not work on the same timeline as research trials. This goes in both directions – partners who want to adopt an intervention but need more time than a particular design allows, and partners who need to implement a solution to an immediate need, now, and cannot wait for the study timeline. There are, of course, really cool variations of rollout designs emerging and it will be interesting to see how these methods evolve. And I am thrilled that “pacing” of implementation is gaining increased attention in the field, in part thanks to the special collection that ISC and IS are supporting.

There will always be a tension between the pace of science and real-world need, but I would love to see more innovation toward solving this gap. 

Elvin: One of the things I like to ask is what your favorite paper has been recently in implementation science and why. 

Lisa: Another great question. There is so much great work happening that it is hard to pick one, but related to your last question, I would have to say the recent article by Hendricks Brown and colleagues on rollout designs in Implementation Science, “What scientific inferences can be made with randomized implementation rollout trials.” I think this is a great example of a paper that challenges us to think beyond our typical effectiveness designs and to think about how we can leverage learnings across time from different cohorts that are on different implementation timelines. I appreciated how the authors laid out different methods that could be utilized to answer different questions. What really struck me though, was how they outlined the steps that are needed to maintain rigor for example, recommendations for when randomization of sites should occur under different designs. This seems simple, but it is anything but, and I found these insights really helpful as I think about our current and future trials. 

Elvin: Can you tell us the last book you read, what it was about and why you liked it? 

Lisa: I am biased, but my sister is an author and recently wrote a book, “What we remember will be saved.” It is a written documentary of the stories of refugees in the middle east who sustain their culture and values through their art and what they can literally bring with them on their backs. She brings a voice to their stories of preserving their heritage through food, song, textiles, dance and so forth. I really appreciated this book, not only because it was written by my sister, but because it provided a beautiful example of hope and the steps that people naturally take to sustain what is most valuable to them, even in the most unpredictable and challenging times. 

Elvin: Anything else you would like us to know about you?  

Lisa: Folks can say that I am a little pollyannaish, but I hope that glass half full perspective helps propel the Implementation Science field forward. I truly believe that our expertise is what is needed right now to help shape the direction of equitable and quality healthcare. I am excited to help support these advancement through my role with IS Communications! 

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