writing implementation research grant proposals

• Open access
• Published: 12 October 2012

Writing implementation research grant proposals: ten key ingredients

• Enola K Proctor 1 ,
• Byron J Powell 1 ,
• Ana A Baumann 1 ,
• Ashley M Hamilton 1 &
• Ryan L Santens 1  

Implementation Science volume  7 , Article number:  96 ( 2012 ) Cite this article

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All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers.

This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.

Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project’s feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research.

Peer Review reports

Investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Researchers need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, most investigators may feel ‘new to the field.’ Furthermore, young investigators may have less preliminary data, and the path to successful proposal writing may seem less clear.

This article identifies ten of the important ingredients in well-crafted implementation proposals; in particular, it addresses how investigators can set the stage for proposed work through pilot data and a well-crafted and rationalized proposed study approach. It addresses questions such as: What preliminary work is important in the grant applications, and how can implementation researchers meet this challenge? How can investigators balance scientific impact with feasibility? Where in an implementation research proposal can investigators demonstrate their capacity to conduct a study as proposed?

The importance of the question

A significant and innovative research question is the first and primary ingredient in a successful proposal. A competitive implementation research application needs to pursue scientific questions that remain unanswered, questions whose answers advance knowledge of implementation with generalizability beyond a given setting. By definition, implementation research in health focuses on a health condition or disease, healthcare settings, and particular evidence-based interventions and programs with promise of reducing a gap in quality of care. It is conducted in usual care settings with practical quality gaps that stakeholders want to reduce. However, to make a compelling argument for scientific innovation and public health significance, a research grant application must have potential beyond reducing a quality gap and implementing a particular evidence-based healthcare practice. The application must have potential to advance the science of implementation by yielding generalizable knowledge. With only one journal devoted solely to implementation science [ 1 ], researchers must be aware of implementation literature that is scattered across a host of discipline-specific journals. Implementation researchers—akin to students with multiple majors—must demonstrate their grounding in implementation science, health diseases, disorders and their treatments, and real-world healthcare delivery.

Although implementation science is often characterized as an emerging field, its bar for scientifically important questions is rising rapidly. Descriptive studies of barriers have dominated implementation science for too long, and the field is urged to ‘move on’ to questions of how and why implementation processes are effective. Accordingly, the Institute of Medicine [ 2 ] has identified studies comparing the effectiveness of alternative dissemination and implementation strategies as a top-quartile priority for comparative effectiveness research. But experimental studies testing implementation strategies need to be informed by systematic background research on the contexts and processes of implementation. While investigators must demonstrate their understanding of these complexities, their grant proposals must balance feasibility with scientific impact. This paper addresses the challenges of preparing grant applications that succeed on these fronts. Though this article focuses on U.S. funding sources and grant mechanisms, the principles that are discussed should be relevant to implementation researchers internationally.

Guidance from grant program announcements

Grant review focuses on the significance of proposed aims, impact and innovation, investigator capacity to conduct the study as proposed, and support for the study hypotheses and research design. The entire application should address these issues. Investigators early in their research careers or new to implementation science often struggle to demonstrate their capacity to conduct the proposed study and the feasibility of the proposed methods. Not all National Institutes of Health (NIH) program announcements require preliminary data. However, those that do are clear that applications must convey investigator training and experience, capacity to conduct the study as proposed, and support for the study hypotheses and research design [ 3 ]. The more complex the project, the more important it is to provide evidence of capacity and feasibility [ 4 ].

The R01grant mechanism is typically large in scope compared to the R03, R21 and R34 a . Program announcements for grant mechanisms that are preliminary to R01 studies give important clues as to how to set the stage for an R01 and demonstrate feasibility. Investigator capacity can be demonstrated by describing prior work, experience, and training relevant to the application’s setting, substantive issues, and methodology—drawing on prior employment and research experience. For example, the NIH R03 small grant mechanism is often used to establish the feasibility of procedures, pilot test instruments, and refine data management procedures to be employed in a subsequent R01. The NIH R21 and the R34 mechanisms support the development of new tools or technologies; proof of concept studies; early phases of research that evaluate the feasibility, tolerability, acceptability and safety of novel treatments; demonstrate the feasibility of recruitment protocols; and support the development of assessment protocols and manuals for programs and treatments to be tested in subsequent R01 studies. These exploratory grants do not require extensive background material or preliminary information, but rather serve as sources for gathering data for subsequent R01 studies. These grant program announcements provide a long list of how pre-R01 mechanisms can be used, and no single application can or should provide all the stage-setting work exemplified in these descriptions.

Review criteria, typically available on funding agency web sites or within program announcements, may vary slightly by funding mechanism. However grants are typically reviewed and scored according to such criteria as: significance, approach (feasibility, appropriateness, robustness), impact, innovation, investigator team, and research environment. Table 1 summarizes the ten ingredients, provides a checklist for reviewing applications prior to submission, and ties each ingredient to one or more of the typical grant review criteria.

The literature does not provide a ‘. . . a comprehensive, prescriptive, and robust-yet practical-model to help…researchers understand (the) factors need to be considered and addressed’ in an R01 study [ 5 ]. Therefore we examined a variety of sources to identify recommendations and examples of background work that can strengthen implementation research proposals. This paper reflects our team’s experience with early career implementation researchers, specifically through training programs in implementation science and our work to provide technical assistance in implementation research through our university’s Clinical and Translational Science Award CTSA program. We also studied grant program announcements, notably the R03, R21, R18, and R01 program announcements in implementation science [ 6 – 9 ]. We studied how successful implementation research R01 grant applications ‘set the stage’ for the proposed study in various sections of the proposal. We conducted a literature search using combinations of the following key words: ‘implementation research,’ ‘implementation studies,’ ‘preliminary studies,’ ‘preliminary data,’ ‘pilot studies,’ ‘pilot data,’ ‘pilot,’ ‘implementation stages,’ ‘implementation phases,’ and ‘feasibility.’ We also drew on published studies describing the introduction and testing of implementation strategies and those that characterize key elements and phases of implementation research [ 10 , 11 ].

From these reviews, we identified ten ingredients that are important in all implementation research grants: the gap between usual care and evidence-based care; the background of the evidence-based treatment to be implemented, its empirical base, and requisites; the theoretical framework for implementation and explicit theoretical justification for the choice of implementation strategies; information about stakeholders’ (providers, consumers, policymakers) treatment priorities; the setting’s (and providers’) readiness to adopt new treatments; the implementation strategies planned or considered in order to implement evidence-based care; the study team’s experience with the setting, treatment, or implementation process and the research environment; the feasibility and requisites of the proposed methods; the measurement and analysis of study variables; and the health delivery setting’s policy/funding environment, leverage or support for sustaining change.

Given the sparse literature on the importance of preliminary studies for implementation science grant applications, we ‘vetted’ our list of grant application components with a convenience sample of experts. Ultimately, nine experts responded to our request, including six members of the Implementation Science editorial board. We asked the experts to rate the importance of each of the ten elements, rating them as ‘1: Very important to address this is the application,’ ‘2: Helpful but not necessary to the application,’ or ‘3: Not very important to address’ within the context of demonstrating investigator capacity and study feasibility. Respondents were also asked whether there are any additional factors that were not listed.

While all the ten ingredients below were considered important for a successful application, several experts noted that their importance varies according to the aims of the application. For example, one expert affirmed the importance of the settings’ readiness to change, but noted that it may not be crucial to address in a given proposal: ‘the setting’s readiness may be unimportant to establish or report prior to the study, because the study purpose may be to establish an answer to this question.’ However, another maintained, ‘in a good grant application, you have to dot all the ‘I’s’ and cross all the ‘T’s.’ I consider all these important.’ One expert noted that applications might need to argue the importance of implementation research itself, including the importance of closing or reducing gaps in the quality of care. This was viewed as particularly important when the study section to review the grant may not understand or appreciate implementation research. In these cases, it may be important to define and differentiate implementation research from other types of clinical and health services research. For example, it may be useful to situate one’s proposal within the Institute of Medicine’s ‘prevention research cycle,’ which demonstrates the progression from pre-intervention, efficacy, and effectiveness research to dissemination and implementation studies that focus on the adoption, sustainability, and scale-up of interventions [ 12 ]. It may also be important to convey that implementation research is very complex, necessitating the use of multiple methods, a high degree of stakeholder involvement, and a fair amount of flexibility in order to ensure that implementers will be able to respond appropriately to unforeseen barriers.

Ten key ingredients of a competitive implementation research grant application

As emphasized at the beginning of this article, the essential ingredient in a successful implementation science proposal is a research question that is innovative and, when answered, can advance the field of implementation science. Assuming that an important question has been established to potential reviewers, we propose that the following ten ingredients can help investigators demonstrate their capacity to conduct the study and to demonstrate the feasibility of completing the study as proposed. For each ingredient, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.

The care gap, or quality gap, addressed in the application

The primary rationale for all implementation efforts, and thus a key driver in implementation science, is discovering how to reduce gaps in healthcare access, quality, or, from a public health perspective, reducing the gap between Healthy People 2020 [ 13 ] goals and current health status. Accordingly, implementation research proposals should provide clear evidence that gaps exists and that there is room for improvement and impact through the proposed implementation effort. This is a primary way of demonstrating the public health significance of the proposed work.

Gaps in the quality of programs, services, and healthcare can be measured and documented at the population-, organization-, and provider-levels [ 14 ]. Several kinds of preliminary data can demonstrate the quality gap to be reduced through the proposed implementation effort. For example, investigators can emphasize the burden of disease through data that reflect its morbidity, mortality, quality of life, and cost [ 14 ]. An implementation research grant should cite service system research that demonstrates unmet need [ 15 ], the wide variation in the use of evidence-based treatments in usual care [ 16 – 19 ], or the association between the burden of disease and variations in the use of guidelines [ 20 ]. Investigators can also document that few providers adopt evidence-based treatments [ 21 , 22 ], that evidence-based treatments or programs have limited reach [ 23 ], or that penetration [ 24 ] into a system of care can be addressed by the implementation study. Regardless of the specific approach to documenting a quality gap, investigators should use rigorous methods and involve all relevant stakeholders [ 14 ]. In fact, stakeholders can demonstrate their involvement and endorse quality gaps through letters of support attesting to the lack of evidence-based services in usual care.

The evidence-based treatment to be implemented

A second key ingredient in implementation research proposals is the evidence-based program, treatment, policies, or set of services whose implementation will be studied in the proposed research [ 25 – 27 ]. The research ‘pipeline’ [ 28 – 30 ] contains many effective programs and treatments in a backlog, waiting to be implemented. Moreover, many health settings experience a huge demand for better care. An appropriate evidence-based treatment contributes to the project’s public health significance and practical impact, presuming of course that it will be studied in a way that contributes to implementation science.

Implementation research proposals must demonstrate that the evidence-based service is ready for implementation. The strength of the empirical evidence for a given guideline or treatment [ 31 , 32 ], a key part of ‘readiness,’ can be demonstrated in a variety of ways; in some fields, specific thresholds must be met before an intervention is deemed ‘evidence-based’ or ‘empirically-supported’ [ 33 – 35 ]. For example, Chambless et al. [ 35 ] suggest that interventions should demonstrate efficacy by being shown to be superior to placebos or to another treatment in at least two between group design experiments; or by showing efficacy in a large series of single case design experiments. Further, Chambless et al. [ 35 ] note that the experiments must have been conducted with treatment manuals, the characteristics of the samples must have been clearly specified, and the effects must have been demonstrated by at least two different investigators or investigative teams.

The strength of evidence for a given treatment can also be classified using the Cochrane EPOC’s criteria for levels of evidence, which considers randomized controlled trials, controlled clinical trials, time series designs, and controlled before-and-after studies as appropriate [ 36 ]. Researchers who come to implementation research as effectiveness researchers or as program or treatment developers are well positioned, because they can point to their prior research as part of their own background work. Other researchers can establish readiness for implementation by reviewing evidence for the treatment or program as part of the background literature review, preferably relying on well-conducted systematic reviews and meta-analyses of randomized-controlled trials (if available). At a minimum, ‘evaluability assessment’ [ 37 ] can help reflect what changes or improvements are needed to optimize effectiveness given the context of the implementation effort.

Conceptual model and theoretical justification

Any research striving for generalizable knowledge should be guided by and propose to test conceptual frameworks, models, and theories [ 38 ]. Yet, theory has been drastically underutilized and underspecified in implementation research [ 38 – 40 ]. For example, in a review of 235 implementation studies, less than 25% of the studies employed theory in any way, and only 6% were explicitly theory-based [ 39 ]. While translating theory into research design is not an easy task [ 36 ], the absence of theory in implementation research has limited our ability to specify key contextual variables and to identify the precise mechanisms by which implementation strategies exert their effects.

McDonald et al. [ 41 ] present a useful hierarchy of theories and models, which serves to organize the different levels of theory and specify the ways in which they can be useful in implementation research. They differentiate between conceptual models, frameworks, and systems, which are used to represent global ideas about a phenomenon and theory, which is an ‘organized, heuristic, coherent, and systematic set of statements related to significant questions that are communicated in a meaningful whole’ [ 41 ]. Within the realm of theory, they differentiate between grand or macro theories ( e.g. , Rogers’ Diffusion of Innovations theory [ 26 ]), mid-range theories ( e.g. , transtheoretical model of change [ 42 ]), and micro-theories ( e.g. , feedback intervention theory [ 43 ]). Though models, frameworks, and systems are generally at a higher level of abstraction than theories, it is important to note that the level of abstraction varies both between and within the categories of the hierarchy. The thoughtful integration of both conceptual models and theories can substantially strengthen an application.

Conceptual models, frameworks, and systems can play a critical role in anchoring a research study theoretically by portraying the key variables and relationships to be tested. Even studies that address only a subset of variables within a conceptual model need to be framed conceptually, so that reviewers perceive the larger context (and body of literature) that a particular study proposes to inform. Given the confusion surrounding definitions and terminology within the still-evolving field of dissemination and implementation [ 44 , 45 ], grant proposals need to employ consistent language, clear definitions for constructs, and the most valid and reliable measures for the constructs that correspond to the guiding conceptual framework or theoretical model. Proposal writers should be cautioned that the theory or conceptual model used to frame the study must be used within the application. A mere mention will not suffice. A conceptual model can help frame study questions and hypotheses, anchor the background literature, clarify the constructs to be measured, and illustrate the relationships to be evaluated or tested. The application must also spell out how potential findings will inform the theory or model.

Numerous models and frameworks can inform implementation research. For example, Glasgow et al. [ 23 ] RE-AIM framework can inform evaluation efforts in the area of implementation science. Similarly, Proctor et al. [ 46 ] have proposed a model that informs evaluation by differentiating implementation, service system, and clinical outcomes, and identifying a range of implementation outcomes that can be assessed [ 24 ]. Damschroder et al. ’s [ 10 ] Consolidated Framework for Implementation Research identifies five domains that are critical to successful implementation: intervention characteristics (evidentiary support, relative advantage, adaptability, trialability, and complexity); the outer setting (patient needs and resources, organizational connectedness, peer pressure, external policy and incentives); the inner setting (structural characteristics, networks and communications, culture, climate, readiness for implementation); the characteristics of the individuals involved (knowledge, self-efficacy, stage of change, identification with organization, etc.); and the process of implementation (planning, engaging, executing, reflecting, evaluating). Others have published stage or phase models of implementation. For example, the Department of Veteran Affairs’ QUERI initiative [ 47 ] specifies a four-phase model spanning pilot projects, small clinical trials, regional implementation, and implementation on the national scale; and Aarons, Hurlburt and Horwitz [ 48 ] developed a four phase model of exploration, adoption/preparation, active implementation, and sustainment. Magnabosco [ 49 ] delineates between pre-implementation, initial implementation, and sustainability planning phases.

McDonald et al. [ 41 ] note that grand theories are similar to conceptual models, and that they generally represent theories of change. They differentiate between classical models of change that emphasize natural or passive change processes, such as Rogers’ diffusion of innovations theory [ 26 ], and planned models of change that specify central elements of active implementation efforts. Investigators may find it more helpful to draw from mid-range theories because they discuss the mechanisms of change at various levels of the implementation context [ 26 ]. For example, social psychological theories, organizational theories, cognitive psychology theories, educational theories, and a host of others may be relevant to the proposed project. While conceptual models are useful in framing a study theoretically and providing a ‘big picture’ of the hypothesized relationships between variables, mid-range theories can be more helpful in justifying the selection of specific implementation strategies specifying the mechanisms by which they may exert their effects. Given the different roles that theory can play in implementation research, investigators would be wise to consider relevant theories at multiple levels of the theoretical hierarchy when preparing their proposals. It is far beyond the scope of this article to review conceptual models and theories in detail; however, several authors have produced invaluable syntheses of conceptual models and theories that investigators may find useful [ 10 , 41 , 50 – 56 ].

Stakeholder priorities and engagement in change

Successful implementation of evidence-based interventions largely depends on their fit with the preferences and priorities of those who shape, deliver, and participate in healthcare. Stakeholders in implementation, and thus in implementation research, include treatment or guideline developers, researchers, administrators, providers, funders, community-based organizations, consumers, families, and perhaps legislators who shape reimbursement policies (see Mendel et al. ’ article [ 57 ] for a framework that outlines different levels of stakeholders). These stakeholders are likely to vary in their knowledge, perceptions, and preferences for healthcare. Their perspectives contribute substantially to the context of implementation and must be understood and addressed if the implementation effort is to succeed. A National Institute of Mental Health Council workgroup report [ 58 ] calls for the engagement of multiple stakeholder perspectives, from concept development to implementation, in order to improve the sustainability of evidence-based services in real-world practice. The engagement of key stakeholders in implementation research affects both the impact of proposed implementation efforts, the sustainability of the proposed change, and the feasibility and ultimate success of the proposed research project. Thus, implementation research grant proposals should convey the extent and manner in which key stakeholders are engaged in the project.

Stakeholders and researchers can forge different types of collaborative relationships. Lindamer et al. [ 59 ] describe three different approaches researchers and stakeholders can take that vary with respect to the level of participation of the stakeholders and community in decisions about the research. In the ‘community-targeted’ approach, stakeholders are involved in recruitment and in the dissemination of the results. In the ‘community-based’ approach, stakeholders participate in the selection of research topics, but the researcher makes the final decision on the study design, methodology, and analysis of data. Finally, the ‘community-driven’ approach or community-based participatory research (CBPR) approach entails participation of the stakeholders in all aspects of the research. Some authors advocate for the CBPR model as a strategy to decrease the gap between research and practice because it addresses some of the barriers to implementation and dissemination [ 60 – 62 ] by enhancing the external validity of the research and promoting the sustainability of the intervention. Kerner et al. [ 62 ] note:

‘When community-based organizations are involved as full partners in study design, implementation, and evaluation of study findings, these organizations may be more amenable to adopting the approaches identified as being effective, as their tacit knowledge about ‘what works’ would have been evaluated explicitly through research.’

Stakeholder analysis can be carried out to evaluate and understand stakeholders’ interests, interrelations, influences, preferences, and priorities. The information gathered from stakeholder analysis can then be used to develop strategies for collaborating with stakeholders, to facilitate the implementation of decisions or organizational objectives, or to understand the future of policy directions [ 63 , 64 ].

Implementation research grant applications are stronger when preliminary data, qualitative or quantitative, reflect stakeholder preferences around the proposed change. Engagement is also reflected in publications that the principal investigator (PI) and key stakeholders have shared in authorship, or methodological details that reflect stakeholder priorities. Letters of support are a minimal reflection of stakeholder investment in the proposed implementation project.

Context: Setting’s readiness to adopt new services/ treatments/ programs

Implementation research proposals are strengthened by information that reflects the setting’s readiness, capacity, or appetite for change, specifically around adoption of the proposed evidence-based treatment. This is not to say that all implementation research should be conducted in settings with high appetite for change. Implementation research is often criticized for disproportionate focus on settings that are eager and ready for change. ‘Cherry picking’ sites, where change is virtually guaranteed, or studying implementation only with eager and early adopters, does not produce knowledge that can generalize to usual care, where change is often challenging. The field of implementation science needs information about the process of change where readiness varies, including settings where change is resisted.

Preliminary data on the organizational and policy context and its readiness for change can strengthen an application. Typically viewed as ‘nuisance’ variance to be controlled in efficacy and effectiveness research, contextual factors are key in implementation research [ 65 – 67 ]. The primacy of context is reflected in the choice of ‘it’s all about context’ as a theme at the 2011 NIH Training Institute in Dissemination and Implementation Research in Health [ 68 ]. Because organization, policy, and funding context may be among the strongest influences on implementation outcomes, context needs to be examined front and center in implementation research [ 69 ]. A number of scales are available to capture one key aspect of context, the setting’s readiness or capacity for change. Weiner et al. [ 70 ] extensive review focusing on the conceptualization and measurement of organizational readiness for change identified 43 different instruments; though, they acknowledged substantial problems with the reliability and validity of many of the measures. Due in part to issues with reliability and validity of the measures used in the field, work in this area is ongoing [ 71 , 72 ].

Other approaches to assessing readiness have focused on organizational culture, climate, and work attitudes [ 73 ], and on providers’ attitudes towards evidence-based practices [ 21 , 22 , 74 ]. Furthermore, a prospective identification of implementation barriers and facilitators can be helpful in demonstrating readiness to change, increasing reviewers’ confidence that the PI has thoroughly assessed the implementation context, and informing the selection of implementation strategies (discussed in the following section) [ 75 – 77 ]. An evaluation of barriers and facilitators can be conducted through qualitative [ 78 – 80 ] or survey [ 81 , 82 ] methodology. In fact, a number of scales for measuring implementation barriers have been developed [ 74 , 83 , 84 ]. Letters from agency partners or policy makers, while weaker than data, can also be used to convey the setting’s readiness and capacity for change. Letters are stronger when they address the alignment of the implementation effort to setting or organizational priorities or to current or emergent policies.

Implementation strategy/process

Though the assessment of implementation barriers can play an important role in implementation research, the ‘rising bar’ in the field demands that investigators move beyond the study of barriers to research that generates knowledge about the implementation processes and strategies that can overcome them. Accordingly, the NIH has prioritized efforts to ‘identify, develop, and refine effective and efficient methods, structures, and strategies to disseminate and implement’ innovations in healthcare [ 7 ].

A number of implementation strategies have been identified and discussed in the literature [ 36 , 85 – 87 ]. However, as the Improved Clinical Effectiveness through Behavioural Research Group notes [ 38 ], the most consistent finding from systematic reviews of implementation strategies is that most are effective some, but not all of the time, and produce effect sizes ranging from no effect to a large effect. Our inability to determine how, why, when, and for whom these strategies are effective is hampered in large part by the absence of detailed descriptions of implementation strategies [ 40 ], the use of inconsistent language [ 44 ], and the lack of clear theoretical justification for the selection of specific strategies [ 39 ]. Thus, investigators should take great care in providing detailed descriptions of implementation strategies to be observed or empirically tested. Implementation Science has endorsed [ 40 ] the use of the WIDER Recommendations to Improve Reporting of the Content of Behaviour Change Interventions [ 88 ] as a means of improving the conduct and reporting of implementation research, and these recommendations will undoubtedly be useful to investigators whose proposals employ implementation strategies. Investigators may also find the Standards for Quality Improvement Reporting Excellence (SQUIRE) helpful [ 89 ]. Additional design specific reporting guidelines can be found on the Equator Network website [ 90 ]. The selection of strategies must be justified conceptually by drawing upon models and frameworks that outline critical implementation elements [ 10 ]. Theory should be used to explain the mechanisms through which implementation strategies are proposed to exert their effects [ 39 ], and it may be helpful to clarify the proposed mechanisms of change through the development of a logic model and illustrate the model through a figure [ 91 ].

According to Brian Mittman, in addition to being theory-based, implementation strategies should be: multifaceted or multilevel (if appropriate); robust or readily adaptable; feasible and acceptable to stakeholders; compelling, saleable, trialable, and observable; sustainable; and scalable [ 92 , 93 ]. We therefore emphasize taking stock of the budget impact of implementation strategies [ 94 ] as well as any cost and cost-effectiveness data related to the implementation strategies [ 95 ]. Although budget impact is a key concern to administrators and some funding agencies require budget impact analysis, implementation science to date suffers a dearth of economic evaluations from which to draw [ 96 , 97 ].

The empirical evidence for the effectiveness of multifaceted strategies has been mixed, because early research touted the benefits of multifaceted strategies [ 98 , 99 ], while a systematic review of 235 implementation trials by Grimshaw et al. found no relationship between the number of component interventions and the effects of multifaceted interventions [ 100 ]. However, Wensing et al. [ 101 ] note that while multifaceted interventions were assumed to address multiple barriers to change, many focus on only one barrier. For example, providing training and consultation is a multifaceted implementation strategy; however, it primarily serves to increase provider knowledge, and does not address other implementation barriers. Thus, Wensing et al. [ 101 ] argue that multifaceted interventions could be more effective if they address different types of implementation barriers ( e.g. , provider knowledge and the organizational context). While the methods for tailoring clinical interventions and implementation strategies to local contexts need to be improved [ 102 ], intervention mapping [ 103 ] and a recently developed ‘behaviour change wheel’ [ 104 ] are two promising approaches.

Proposals that employ multifaceted and multilevel strategies that address prospectively identified implementation barriers [ 102 ] may be more compelling to review committees, but mounting complex experiments may be beyond the reach of many early-stage investigators and many grant mechanisms. However, it is within the scope of R03, R21, and R34 supported research to develop implementation strategies and to conduct pilot tests of their feasibility and acceptability—work that can strengthen the case for sustainability and scalability. Proposal writers should provide preliminary work for implementation strategies in much the same way that intervention developers do, such as by providing manuals or protocols to guide their use, and methods to gauge their fidelity. Such work is illustrated in the pilot study conducted by Kauth et al. [ 105 ], which demonstrated that an external facilitation strategy intended to increase the use of cognitive behavioral therapy within Veteran Affairs clinics was a promising and low-cost strategy; such pilot data would likely bolster reviewers’ confidence that the strategy is feasible, scalable, and ultimately, sustainable. Investigators should also make plans to document any modifications to the intervention and, if possible, incorporate adaptation models to the implementation process, because interventions are rarely implemented without being modified [ 67 , 106 ].

While providing detailed specification of theory-based implementation strategies is critical, it is also imperative that investigators acknowledge the complexity of implementation processes. Aarons and Palinkas [ 107 ] comment:

‘It is unrealistic to assume that implementation is a simple process, that one can identify all of the salient concerns, be completely prepared, and then implement effectively without adjustments. It is becoming increasingly clear that being prepared to implement EBP means being prepared to evaluate, adjust, and adapt in a continuing process that includes give and take between intervention developers, service system researchers, organizations, providers, and consumers.’

Ultimately, proposals that reflect the PI’s understanding of the complexity of the process of implementing evidence-based practices and that provide supporting detail about strategies and processes will be perceived as more feasible to complete through the proposed methods.

Team experience with the setting, treatment, implementation process, and research environment

Grant reviewers are asked to specifically assess a PI’s capacity to successfully complete a proposed study. Grant applications that convey the team’s experience with the study setting, the treatment whose implementation is being studied, and implementation processes help convey capacity and feasibility to complete an implementation research project [ 108 ].

The reader should observe that NIH gives different scores for the team experience with the setting and for the research environment ( http://grants.nih.gov/grants/writing_application.htm ) but the purpose of both sections is demonstrating capacity to successfully carry out the study as proposed. Investigators can convey capacity through a variety of ways. Chief among them is building a strong research team, whose members bring depth and experience in areas the PI does not yet have. Implementation research exemplifies multidisciplinary team science, informed by a diverse range of substantive and methodological fields [ 96 , 109 ]. A team that brings the needed disciplines and skill sets directly to the project enhances the project’s likelihood of success. Early-stage implementation researchers who collaborate or partner with senior investigators reassure reviewers that the proposed work will benefit from the senior team member’s experience and expertise. Similarly, collaborators play important roles in complementing, or rounding out, the PI’s disciplinary perspective and methodological skill set. Early career investigators, therefore, should surround themselves with more established colleagues who bring knowledge and experience in areas key to the study aims and methods. The narrative should cite team members’ relevant work, and their prior work can be addressed in a discussion of preliminary studies. Additionally, the new formats for NIH biosketches and budget justifications enable a clear portrayal of what each team member brings to the proposed study.

For the NIH applications, the research environment is detailed in the resources and environment section of a grant application. Here, an investigator can describe the setting’s track record in implementation research; research centers, labs, and offices that the PI can draw on; and structural and historic ties to healthcare settings. For example, a PI can describe how their project will draw upon the University’s CTSA program [ 110 ], statistics or design labs, established pools of research staff, and health services research centers. Preliminary studies and biosketches provide additional ways to convey the strengths of the environment and context within which an investigator will launch a proposed study.

In summary, researchers need to detail the strengths of the research environment, emphasizing in particular the resources, senior investigators, and research infrastructure that can contribute to the success of the proposed study. A strong research environment is especially important for implementation research, which is typically team-based, requires expertise of multiple disciplines, and requires strong relationships between researchers and community based health settings. Investigators who are surrounded by experienced implementation researchers, working in a setting with strong community ties, and drawing on experienced research staff can inspire greater confidence in the proposed study’s likelihood of success.

Feasibility of proposed research design and methods

One of the most important functions of preliminary work is to demonstrate the feasibility of the proposed research design and methods. Landsverk [ 108 ] urges PIs to consider every possible question reviewers might raise, and to explicitly address those issues in the application. Data from small feasibility studies or pilot work around referral flow; participant entry into the study; participant retention; and the extent to which key measures are understood by participants, acceptable for use, and capture variability can demonstrate that the proposed methods are likely to work. The methods section should contain as much detail as possible, as well as lay out possible choice junctures and contingencies, should methods not work as planned. It is not only important to justify methodological choices, but also to discuss why potential alternatives were not selected. For example, if randomization is not feasible or acceptable to stakeholders, investigators should make that clear. Letters from study site collaborators can support, but should not replace, the narrative’s detail on study methods. For example, letters attesting the willingness of study sites to be randomized or to support recruitment for the proposed timeframe can help offset reviewer concerns about some of the real-world challenges of launching implementation studies.

Measurement and analysis

A grant application must specify a measurement plan for each construct in the study’s overarching conceptual model or guiding theory, whether those constructs pertain to implementation strategies, the context of implementation, stakeholder preferences and priorities, and implementation outcomes [ 111 ]. Yet, crafting the study approach section is complicated by the current lack of consensus on methodological approaches to the study of implementation processes, measuring implementation context and outcomes, and testing implementation strategies [ 112 , 113 ]. Measurement is a particularly important aspect of study methods, because it determines the quality of data. Unlike efficacy and effectiveness studies, implementation research often involves some customization of an intervention to fit local context; accordingly, measurement plans need to address the intervention’s degree of customization versus fidelity [ 97 ]. Moreover, implementation science encompasses a broad range of constructs, from a variety of disciplines, with little standardization of measures or agreement on definitions of constructs across different studies, fields, authors, or research groups, further compounding the burden to present a clear and robust measurement plan along with its rationale. Two current initiatives seek to advance the harmonization, standardization, and rigor of measurement in implementation science, the U.S. National Cancer Institute’s (NCI) Grid-Enabled Measures (GEM) portal [ 114 ] and the Comprehensive Review of Dissemination and Implementation Science Instruments efforts supported by the Seattle Implementation Research Conference (SIRC) at the University of Washington [ 115 ]. Both initiatives engage the implementation science research community to enhance the quality and harmonization of measures. Their respective web sites are being populated with measures and ratings, affording grant writers an invaluable resource in addressing a key methodological challenge.

Key challenges in crafting the analysis plan for implementation studies include: determining the unit of analysis, given the ‘action’ at individual, team, organizational, and policy environments; shaping meditational analyses given the role of contextual variables; and developing and using appropriate methods for characterizing the speed, quality, and degree of implementation. The proposed study’s design, assessment tools, analytic strategies, and analytic tools must address these challenges in some manner [ 113 ]. Grant applications that propose the testing of implementation strategies or processes often provide preliminary data from small-scale pilot studies to examine feasibility and assess sources of variation. However, the magnitude of effects in small pilots should be determined by clinical relevance [ 113 ], given the uncertainty of power calculations from small scale studies [ 116 ].

Policy/funding environment; leverage or support for sustaining change

PIs should ensure that grant applications reflect their understanding of the policy and funding context of the implementation effort. Health policies differ in many ways that impact quality [ 117 ], and legal, reimbursement, and regulatory factors affect the adoption and sustainability of evidence-based treatments [ 118 ]. Raghavan et al. [ 119 ] discuss the policy ecology of implementation, and emphasize that greater attention should be paid to marginal costs associated with implementing evidence-based treatments, including expenses for provider training, supervision, and consultation. Glasgow et al. [ 120 ] recently extended their heretofore behaviorally focused RE-AIM framework for public health interventions to health policies, revealing the challenges associated with policy as a practice-change lever.

PIs can address the policy context of the implementation initiative through the narrative, background literature, letters of support, and the resource and environment section. Proposals that address how the implementation initiative aligns with policy trends enhance their likelihood of being viewed as having high public health significance, as well as greater practical impact, feasibility, and sustainability. It is important to note that it may behoove investigators to address the policy context within a proposal even if it is not likely to be facilitative of implementation, because it demonstrates to reviewers that the investigator is not naïve to the challenges and barriers that exist at this level.

We identify and discuss ten key ingredients in implementation research grant proposals. The paper reflects the team’s experience and expertise: writing for federal funding agencies in the United States. We acknowledge that this will be a strength for some readers and a limitation for international readers, whom we encourage to contribute additional perspectives. Setting the stage with careful background detail and preliminary data may be more important for implementation research, which poses a unique set of challenges that investigators should anticipate and demonstrate their capacity to manage. Data to set the stage for implementation research may be collected by the study team through preliminary, feasibility, or pilot studies, or the team may draw on others’ work, citing background literature to establish readiness for the proposed research.

Every PI struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project’s feasibility and likelihood of success. The relative emphasis on, and thus length of text addressing, the various sections of a grant proposal varies with the program mechanism, application ‘call,’ and funding source. For NIH applications, most attention and detail should be allocated to the study method because the ‘approach’ section is typically weighted most heavily in scoring. Moreover, the under-specification or lack of detail in study methodology usually receives the bulk of reviewer criticism. Well-constructed, parsimonious tables, logic models, and figures reflecting key concepts and the analytic plan for testing their relationships all help add clarity, focus reviewers, and prevent misperceptions. All implementation research grants need to propose aims, study questions, or hypotheses whose answers will advance implementation science. Beyond this fundamental grounding, proposed implementation studies should address most, if not all, of the ingredients identified here. While no application can include a high level of detail about every ingredient, addressing these components can help assure reviewers of the significance, feasibility, and impact of the proposed research.

a For more information regarding different grant mechanisms, please see: http://grants.nih.gov/grants/funding/funding_program.htm .

Authors’ information

EKP directs the Center for Mental Health Services Research at Washington University in St. Louis (NIMH P30 MH085979), the Dissemination and Implementation Research Core (DIRC) of the Washington University Institute of Clinical and Translational Sciences (NCRR UL1RR024992), and the Implementation Research Institute (NIMH R25 MH080916).

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Preparation of this paper was supported in part by National Center for Research Resources through the Dissemination and Implementation Research Core of Washington University in St. Louis’ Institute of Clinical and Translational Sciences (NCRR UL1 RR024992) and the National Institute of Mental Health through the Center for Mental Health Services Research (NIMH P30 MH068579), the Implementation Research Institute (NIMH R25 MH080916), and a Ruth L. Kirschstein National Research Service Award (NIMH T32 RR024992). An earlier version of this paper was an invited presentation at an early investigator workshop, held at the 4 th Annual National Institutes of Health Conference on Advancing the Science of Dissemination and Implementation on March 22, 2011 in Bethesda, Maryland.

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EKP conceived the idea for this paper and led the writing. BJP, AAB, AMH, and RLS contributed to the conceptualization, literature review, and the writing of this manuscript. All authors read and approved the final manuscript.

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Proctor, E.K., Powell, B.J., Baumann, A.A. et al. Writing implementation research grant proposals: ten key ingredients. Implementation Sci 7 , 96 (2012). https://doi.org/10.1186/1748-5908-7-96

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Writing implementation research grant proposals: ten key ingredients

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Background: All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers.

Discussion: This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.

Summary: Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project's feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research.

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Writing implementation research grant proposals: Ten key ingredients

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Background: All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers.Discussion: This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.Summary: Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project's feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research.

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• research implementation Social Sciences 100%
• Organized Financing Medicine & Life Sciences 92%
• grant Social Sciences 64%
• Research Design Medicine & Life Sciences 62%
• competitive proposal Social Sciences 47%
• Research Personnel Medicine & Life Sciences 43%
• applicant Social Sciences 24%
• Implementation Science Medicine & Life Sciences 23%

T1 - Writing implementation research grant proposals

T2 - Ten key ingredients

AU - Proctor, Enola K.

AU - Powell, Byron J.

AU - Baumann, Ana A.

AU - Hamilton, Ashley M.

AU - Santens, Ryan L.

N1 - Funding Information: Ten key ingredients of a competitive implementation research grant application Funding Information: Writing implementation research grant proposals: ten key ingredients

PY - 2012/10/12

Y1 - 2012/10/12

N2 - Background: All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers.Discussion: This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.Summary: Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project's feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research.

AB - Background: All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers.Discussion: This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.Summary: Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project's feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research.

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PRDV009: Writing Grant Proposals

Ten key ingredients for writing research grant proposals.

Review this academic article that specifies ten key ingredients for scientific proposals, which are relevant to grants in other fields as well.

All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers.

This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.

Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project's feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research.

Investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Researchers need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, most investigators may feel 'new to the field'. Furthermore, young investigators may have less preliminary data, and the path to successful proposal writing may seem less clear.

This article identifies ten of the important ingredients in well-crafted implementation proposals; in particular, it addresses how investigators can set the stage for proposed work through pilot data and a well-crafted and rationalized proposed study approach. It addresses questions such as: What preliminary work is important in the grant applications, and how can implementation researchers meet this challenge? How can investigators balance scientific impact with feasibility? Where in an implementation research proposal can investigators demonstrate their capacity to conduct a study as proposed?

The Importance of the Question

A significant and innovative research question is the first and primary ingredient in a successful proposal. A competitive implementation research application needs to pursue scientific questions that remain unanswered, questions whose answers advance knowledge of implementation with generalizability beyond a given setting. By definition, implementation research in health focuses on a health condition or disease, healthcare settings, and particular evidence-based interventions and programs with promise of reducing a gap in quality of care. It is conducted in usual care settings with practical quality gaps that stakeholders want to reduce.

However, to make a compelling argument for scientific innovation and public health significance, a research grant application must have potential beyond reducing a quality gap and implementing a particular evidence-based healthcare practice. The application must have potential to advance the science of implementation by yielding generalizable knowledge. With only one journal devoted solely to implementation science, researchers must be aware of implementation literature that is scattered across a host of discipline-specific journals. Implementation researchers – akin to students with multiple majors – must demonstrate their grounding in implementation science, health diseases, disorders and their treatments, and real-world healthcare delivery.

Although implementation science is often characterized as an emerging field, its bar for scientifically important questions is rising rapidly. Descriptive studies of barriers have dominated implementation science for too long, and the field is urged to 'move on' to questions of how and why implementation processes are effective. Accordingly, the Institute of Medicine has identified studies comparing the effectiveness of alternative dissemination and implementation strategies as a top-quartile priority for comparative effectiveness research. But experimental studies testing implementation strategies need to be informed by systematic background research on the contexts and processes of implementation. While investigators must demonstrate their understanding of these complexities, their grant proposals must balance feasibility with scientific impact. This paper addresses the challenges of preparing grant applications that succeed on these fronts. Though this article focuses on U.S. funding sources and grant mechanisms, the principles that are discussed should be relevant to implementation researchers internationally.

Guidance from Grant Program Announcements

Grant review focuses on the significance of proposed aims, impact and innovation, investigator capacity to conduct the study as proposed, and support for the study hypotheses and research design. The entire application should address these issues. Investigators early in their research careers or new to implementation science often struggle to demonstrate their capacity to conduct the proposed study and the feasibility of the proposed methods. Not all National Institutes of Health (NIH) program announcements require preliminary data. However, those that do are clear that applications must convey investigator training and experience, capacity to conduct the study as proposed, and support for the study hypotheses and research design. The more complex the project, the more important it is to provide evidence of capacity and feasibility.

The R01grant mechanism is typically large in scope compared to the R03, R21 and R34 a . Program announcements for grant mechanisms that are preliminary to R01 studies give important clues as to how to set the stage for an R01 and demonstrate feasibility. Investigator capacity can be demonstrated by describing prior work, experience, and training relevant to the application's setting, substantive issues, and methodology – drawing on prior employment and research experience. For example, the NIH R03 small grant mechanism is often used to establish the feasibility of procedures, pilot test instruments, and refine data management procedures to be employed in a subsequent R01.

The NIH R21 and the R34 mechanisms support the development of new tools or technologies; proof of concept studies; early phases of research that evaluate the feasibility, tolerability, acceptability and safety of novel treatments; demonstrate the feasibility of recruitment protocols; and support the development of assessment protocols and manuals for programs and treatments to be tested in subsequent R01 studies. These exploratory grants do not require extensive background material or preliminary information, but rather serve as sources for gathering data for subsequent R01 studies. These grant program announcements provide a long list of how pre-R01 mechanisms can be used, and no single application can or should provide all the stage-setting work exemplified in these descriptions.

Review criteria, typically available on funding agency web sites or within program announcements, may vary slightly by funding mechanism. However, grants are typically reviewed and scored according to such criteria as: significance, approach (feasibility, appropriateness, robustness), impact, innovation, investigator team, and research environment.

Table 1 summarizes the ten ingredients, provides a checklist for reviewing applications prior to submission, and ties each ingredient to one or more of the typical grant review criteria.

Table 1 Ten Key ingredients for Implementation Research Proposals

The literature does not provide a '. . . a comprehensive, prescriptive, and robust-yet practical-model to help…researchers understand (the) factors need to be considered and addressed' in an R01 study. Therefore we examined a variety of sources to identify recommendations and examples of background work that can strengthen implementation research proposals. This paper reflects our team's experience with early career implementation researchers, specifically through training programs in implementation science and our work to provide technical assistance in implementation research through our university's Clinical and Translational Science Award CTSA program. We also studied grant program announcements, notably the R03, R21, R18, and R01 program announcements in implementation science. We studied how successful implementation research R01 grant applications 'set the stage' for the proposed study in various sections of the proposal. We conducted a literature search using combinations of the following key words: 'implementation research', 'implementation studies', 'preliminary studies', 'preliminary data', 'pilot studies', 'pilot data', 'pilot', 'implementation stages', 'implementation phases', and 'feasibility'. We also drew on published studies describing the introduction and testing of implementation strategies and those that characterize key elements and phases of implementation research.

From these reviews, we identified ten ingredients that are important in all implementation research grants: the gap between usual care and evidence-based care; the background of the evidence-based treatment to be implemented, its empirical base, and requisites; the theoretical framework for implementation and explicit theoretical justification for the choice of implementation strategies; information about stakeholders' (providers, consumers, policymakers) treatment priorities; the setting's (and providers') readiness to adopt new treatments; the implementation strategies planned or considered in order to implement evidence-based care; the study team's experience with the setting, treatment, or implementation process and the research environment; the feasibility and requisites of the proposed methods; the measurement and analysis of study variables; and the health delivery setting's policy/funding environment, leverage or support for sustaining change.

Given the sparse literature on the importance of preliminary studies for implementation science grant applications, we 'vetted' our list of grant application components with a convenience sample of experts. Ultimately, nine experts responded to our request, including six members of the Implementation Science editorial board. We asked the experts to rate the importance of each of the ten elements, rating them as '1: Very important to address this is the application', '2: Helpful but not necessary to the application', or '3: Not very important to address' within the context of demonstrating investigator capacity and study feasibility. Respondents were also asked whether there are any additional factors that were not listed.

While all the ten ingredients below were considered important for a successful application, several experts noted that their importance varies according to the aims of the application. For example, one expert affirmed the importance of the settings' readiness to change, but noted that it may not be crucial to address in a given proposal: 'the setting's readiness may be unimportant to establish or report prior to the study, because the study purpose may be to establish an answer to this question'. However, another maintained, 'in a good grant application, you have to dot all the 'I's' and cross all the 'T's'. I consider all these important'.

One expert noted that applications might need to argue the importance of implementation research itself, including the importance of closing or reducing gaps in the quality of care. This was viewed as particularly important when the study section to review the grant may not understand or appreciate implementation research. In these cases, it may be important to define and differentiate implementation research from other types of clinical and health services research.

For example, it may be useful to situate one's proposal within the Institute of Medicine's 'prevention research cycle', which demonstrates the progression from pre-intervention, efficacy, and effectiveness research to dissemination and implementation studies that focus on the adoption, sustainability, and scale-up of interventions. It may also be important to convey that implementation research is very complex, necessitating the use of multiple methods, a high degree of stakeholder involvement, and a fair amount of flexibility in order to ensure that implementers will be able to respond appropriately to unforeseen barriers.

Ten Key Ingredients of a Competitive Implementation Research Grant Application

As emphasized at the beginning of this article, the essential ingredient in a successful implementation science proposal is a research question that is innovative and, when answered, can advance the field of implementation science. Assuming that an important question has been established to potential reviewers, we propose that the following ten ingredients can help investigators demonstrate their capacity to conduct the study and to demonstrate the feasibility of completing the study as proposed. For each ingredient, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.

1. The Care Gap, or Quality Gap, Addressed in the Application

The primary rationale for all implementation efforts, and thus a key driver in implementation science, is discovering how to reduce gaps in healthcare access, quality, or, from a public health perspective, reducing the gap between Healthy People 2020 goals and current health status. Accordingly, implementation research proposals should provide clear evidence that gaps exists and that there is room for improvement and impact through the proposed implementation effort. This is a primary way of demonstrating the public health significance of the proposed work.

Gaps in the quality of programs, services, and healthcare can be measured and documented at the population-, organization-, and provider-levels. Several kinds of preliminary data can demonstrate the quality gap to be reduced through the proposed implementation effort. For example, investigators can emphasize the burden of disease through data that reflect its morbidity, mortality, quality of life, and cost. An implementation research grant should cite service system research that demonstrates unmet need, the wide variation in the use of evidence-based treatments in usual care, or the association between the burden of disease and variations in the use of guidelines.

Investigators can also document that few providers adopt evidence-based treatments, that evidence-based treatments or programs have limited reach, or that penetration into a system of care can be addressed by the implementation study. Regardless of the specific approach to documenting a quality gap, investigators should use rigorous methods and involve all relevant stakeholders. In fact, stakeholders can demonstrate their involvement and endorse quality gaps through letters of support attesting to the lack of evidence-based services in usual care.

2. The Evidence-Based Treatment to be Implemented

A second key ingredient in implementation research proposals is the evidence-based program, treatment, policies, or set of services whose implementation will be studied in the proposed research. The research 'pipeline' contains many effective programs and treatments in a backlog, waiting to be implemented. Moreover, many health settings experience a huge demand for better care. An appropriate evidence-based treatment contributes to the project's public health significance and practical impact, presuming of course that it will be studied in a way that contributes to implementation science.

Implementation research proposals must demonstrate that the evidence-based service is ready for implementation. The strength of the empirical evidence for a given guideline or treatment, a key part of 'readiness', can be demonstrated in a variety of ways; in some fields, specific thresholds must be met before an intervention is deemed 'evidence-based' or 'empirically-supported'. For example, Chambless et al.  suggest that interventions should demonstrate efficacy by being shown to be superior to placebos or to another treatment in at least two between group design experiments; or by showing efficacy in a large series of single case design experiments. Further, Chambless et al.  note that the experiments must have been conducted with treatment manuals, the characteristics of the samples must have been clearly specified, and the effects must have been demonstrated by at least two different investigators or investigative teams.

The strength of evidence for a given treatment can also be classified using the Cochrane EPOC's criteria for levels of evidence, which considers randomized controlled trials, controlled clinical trials, time series designs, and controlled before-and-after studies as appropriate. Researchers who come to implementation research as effectiveness researchers or as program or treatment developers are well positioned, because they can point to their prior research as part of their own background work. Other researchers can establish readiness for implementation by reviewing evidence for the treatment or program as part of the background literature review, preferably relying on well-conducted systematic reviews and meta-analyses of randomized-controlled trials (if available). At a minimum, 'evaluability assessment'  can help reflect what changes or improvements are needed to optimize effectiveness given the context of the implementation effort.

3. Conceptual Model and Theoretical Justification

Any research striving for generalizable knowledge should be guided by and propose to test conceptual frameworks, models, and theories. Yet, theory has been drastically underutilized and underspecified in implementation research. For example, in a review of 235 implementation studies, less than 25% of the studies employed theory in any way, and only 6% were explicitly theory-based. While translating theory into research design is not an easy task, the absence of theory in implementation research has limited our ability to specify key contextual variables and to identify the precise mechanisms by which implementation strategies exert their effects.

McDonald et al.  present a useful hierarchy of theories and models, which serves to organize the different levels of theory and specify the ways in which they can be useful in implementation research. They differentiate between conceptual models, frameworks, and systems, which are used to represent global ideas about a phenomenon and theory, which is an 'organized, heuristic, coherent, and systematic set of statements related to significant questions that are communicated in a meaningful whole'. Within the realm of theory, they differentiate between grand or macro theories ( e.g. , Rogers' Diffusion of Innovations theory, mid-range theories ( e.g. , transtheoretical model of change), and micro-theories ( e.g. , feedback intervention theory). Though models, frameworks, and systems are generally at a higher level of abstraction than theories, it is important to note that the level of abstraction varies both between and within the categories of the hierarchy. The thoughtful integration of both conceptual models and theories can substantially strengthen an application.

Conceptual models, frameworks, and systems can play a critical role in anchoring a research study theoretically by portraying the key variables and relationships to be tested. Even studies that address only a subset of variables within a conceptual model need to be framed conceptually, so that reviewers perceive the larger context (and body of literature) that a particular study proposes to inform. Given the confusion surrounding definitions and terminology within the still-evolving field of dissemination and implementation, grant proposals need to employ consistent language, clear definitions for constructs, and the most valid and reliable measures for the constructs that correspond to the guiding conceptual framework or theoretical model.

Proposal writers should be cautioned that the theory or conceptual model used to frame the study must be used within the application. A mere mention will not suffice. A conceptual model can help frame study questions and hypotheses, anchor the background literature, clarify the constructs to be measured, and illustrate the relationships to be evaluated or tested. The application must also spell out how potential findings will inform the theory or model.

Numerous models and frameworks can inform implementation research. For example, Glasgow et al.  RE-AIM framework can inform evaluation efforts in the area of implementation science. Similarly, Proctor et al.  have proposed a model that informs evaluation by differentiating implementation, service system, and clinical outcomes, and identifying a range of implementation outcomes that can be assessed. Damschroder et al. 's Consolidated Framework for Implementation Research identifies five domains that are critical to successful implementation:  

• Intervention characteristics (evidentiary support, relative advantage, adaptability, trialability, and complexity);
• The outer setting (patient needs and resources, organizational connectedness, peer pressure, external policy and incentives);
• The inner setting (structural characteristics, networks and communications, culture, climate, readiness for implementation);
• The characteristics of the individuals involved (knowledge, self-efficacy, stage of change, identification with organization, etc.); and
• The process of implementation (planning, engaging, executing, reflecting, evaluating).

Others have published stage or phase models of implementation. For example, the Department of Veteran Affairs' QUERI initiative specifies a four-phase model spanning pilot projects, small clinical trials, regional implementation, and implementation on the national scale; and Aarons, Hurlburt and Horwitz  developed a four phase model of exploration, adoption/preparation, active implementation, and sustainment. Magnabosco delineates between pre-implementation, initial implementation, and sustainability planning phases.

McDonald et al.  note that grand theories are similar to conceptual models, and that they generally represent theories of change. They differentiate between classical models of change that emphasize natural or passive change processes, such as Rogers' diffusion of innovations theory, and planned models of change that specify central elements of active implementation efforts. Investigators may find it more helpful to draw from mid-range theories because they discuss the mechanisms of change at various levels of the implementation context.

For example, social psychological theories, organizational theories, cognitive psychology theories, educational theories, and a host of others may be relevant to the proposed project. While conceptual models are useful in framing a study theoretically and providing a 'big picture' of the hypothesized relationships between variables, mid-range theories can be more helpful in justifying the selection of specific implementation strategies specifying the mechanisms by which they may exert their effects. Given the different roles that theory can play in implementation research, investigators would be wise to consider relevant theories at multiple levels of the theoretical hierarchy when preparing their proposals. It is far beyond the scope of this article to review conceptual models and theories in detail; however, several authors have produced invaluable syntheses of conceptual models and theories that investigators may find useful.

4. Stakeholder Priorities and Engagement in Change

Successful implementation of evidence-based interventions largely depends on their fit with the preferences and priorities of those who shape, deliver, and participate in healthcare. Stakeholders in implementation, and thus in implementation research, include treatment or guideline developers, researchers, administrators, providers, funders, community-based organizations, consumers, families, and perhaps legislators who shape reimbursement policies (see Mendel et al. ' article for a framework that outlines different levels of stakeholders). These stakeholders are likely to vary in their knowledge, perceptions, and preferences for healthcare. Their perspectives contribute substantially to the context of implementation and must be understood and addressed if the implementation effort is to succeed.

A National Institute of Mental Health Council workgroup report calls for the engagement of multiple stakeholder perspectives, from concept development to implementation, in order to improve the sustainability of evidence-based services in real-world practice. The engagement of key stakeholders in implementation research affects both the impact of proposed implementation efforts, the sustainability of the proposed change, and the feasibility and ultimate success of the proposed research project. Thus, implementation research grant proposals should convey the extent and manner in which key stakeholders are engaged in the project.

Stakeholders and researchers can forge different types of collaborative relationships. Lindamer et al.  describe three different approaches researchers and stakeholders can take that vary with respect to the level of participation of the stakeholders and community in decisions about the research. In the 'community-targeted' approach, stakeholders are involved in recruitment and in the dissemination of the results. In the 'community-based' approach, stakeholders participate in the selection of research topics, but the researcher makes the final decision on the study design, methodology, and analysis of data. Finally, the 'community-driven' approach or community-based participatory research (CBPR) approach entails participation of the stakeholders in all aspects of the research. Some authors advocate for the CBPR model as a strategy to decrease the gap between research and practice because it addresses some of the barriers to implementation and dissemination by enhancing the external validity of the research and promoting the sustainability of the intervention. Kerner et al.  note:

'When community-based organizations are involved as full partners in study design, implementation, and evaluation of study findings, these organizations may be more amenable to adopting the approaches identified as being effective, as their tacit knowledge about 'what works' would have been evaluated explicitly through research'.

Stakeholder analysis can be carried out to evaluate and understand stakeholders' interests, interrelations, influences, preferences, and priorities. The information gathered from stakeholder analysis can then be used to develop strategies for collaborating with stakeholders, to facilitate the implementation of decisions or organizational objectives, or to understand the future of policy directions.

Implementation research grant applications are stronger when preliminary data, qualitative or quantitative, reflect stakeholder preferences around the proposed change. Engagement is also reflected in publications that the principal investigator (PI) and key stakeholders have shared in authorship, or methodological details that reflect stakeholder priorities. Letters of support are a minimal reflection of stakeholder investment in the proposed implementation project.

5. Context: Setting's Readiness to Adopt New Services, Treatments, Programs

Implementation research proposals are strengthened by information that reflects the setting's readiness, capacity, or appetite for change, specifically around adoption of the proposed evidence-based treatment. This is not to say that all implementation research should be conducted in settings with high appetite for change. Implementation research is often criticized for disproportionate focus on settings that are eager and ready for change. 'Cherry picking' sites, where change is virtually guaranteed, or studying implementation only with eager and early adopters, does not produce knowledge that can generalize to usual care, where change is often challenging. The field of implementation science needs information about the process of change where readiness varies, including settings where change is resisted.

Preliminary data on the organizational and policy context and its readiness for change can strengthen an application. Typically viewed as 'nuisance' variance to be controlled in efficacy and effectiveness research, contextual factors are key in implementation research. The primacy of context is reflected in the choice of 'it's all about context' as a theme at the 2011 NIH Training Institute in Dissemination and Implementation Research in Health. Because organization, policy, and funding context may be among the strongest influences on implementation outcomes, context needs to be examined front and center in implementation research. A number of scales are available to capture one key aspect of context, the setting's readiness or capacity for change. Weiner et al.  extensive review focusing on the conceptualization and measurement of organizational readiness for change identified 43 different instruments; though, they acknowledged substantial problems with the reliability and validity of many of the measures. Due in part to issues with reliability and validity of the measures used in the field, work in this area is ongoing.

Other approaches to assessing readiness have focused on organizational culture, climate, and work attitudes, and on providers' attitudes towards evidence-based practices. Furthermore, a prospective identification of implementation barriers and facilitators can be helpful in demonstrating readiness to change, increasing reviewers' confidence that the PI has thoroughly assessed the implementation context, and informing the selection of implementation strategies (discussed in the following section). An evaluation of barriers and facilitators can be conducted through qualitative or survey methodology. In fact, a number of scales for measuring implementation barriers have been developed . Letters from agency partners or policy makers, while weaker than data, can also be used to convey the setting's readiness and capacity for change. Letters are stronger when they address the alignment of the implementation effort to setting or organizational priorities or to current or emergent policies.

6. Implementation Strategy/Process

Though the assessment of implementation barriers can play an important role in implementation research, the 'rising bar' in the field demands that investigators move beyond the study of barriers to research that generates knowledge about the implementation processes and strategies that can overcome them. Accordingly, the NIH has prioritized efforts to 'identify, develop, and refine effective and efficient methods, structures, and strategies to disseminate and implement' innovations in healthcare.

A number of implementation strategies have been identified and discussed in the literature. However, as the Improved Clinical Effectiveness through Behavioural Research Group notes, the most consistent finding from systematic reviews of implementation strategies is that most are effective some, but not all of the time, and produce effect sizes ranging from no effect to a large effect. Our inability to determine how, why, when, and for whom these strategies are effective is hampered in large part by the absence of detailed descriptions of implementation strategies, the use of inconsistent language, and the lack of clear theoretical justification for the selection of specific strategies.

Thus, investigators should take great care in providing detailed descriptions of implementation strategies to be observed or empirically tested. Implementation Science has endorsed the use of the WIDER Recommendations to Improve Reporting of the Content of Behaviour Change Interventions as a means of improving the conduct and reporting of implementation research, and these recommendations will undoubtedly be useful to investigators whose proposals employ implementation strategies.

Investigators may also find the Standards for Quality Improvement Reporting Excellence (SQUIRE) helpful. Additional design specific reporting guidelines can be found on the Equator Network website. The selection of strategies must be justified conceptually by drawing upon models and frameworks that outline critical implementation elements. Theory should be used to explain the mechanisms through which implementation strategies are proposed to exert their effects, and it may be helpful to clarify the proposed mechanisms of change through the development of a logic model and illustrate the model through a figure.

According to Brian Mittman, in addition to being theory-based, implementation strategies should be: multifaceted or multilevel (if appropriate); robust or readily adaptable; feasible and acceptable to stakeholders; compelling, saleable, trialable, and observable; sustainable; and scalable . We therefore emphasize taking stock of the budget impact of implementation strategies as well as any cost and cost-effectiveness data related to the implementation strategies. Although budget impact is a key concern to administrators and some funding agencies require budget impact analysis, implementation science to date suffers a dearth of economic evaluations from which to draw.

The empirical evidence for the effectiveness of multifaceted strategies has been mixed, because early research touted the benefits of multifaceted strategies, while a systematic review of 235 implementation trials by Grimshaw et al. found no relationship between the number of component interventions and the effects of multifaceted interventions. However, Wensing et al.  note that while multifaceted interventions were assumed to address multiple barriers to change, many focus on only one barrier.

For example, providing training and consultation is a multifaceted implementation strategy; however, it primarily serves to increase provider knowledge, and does not address other implementation barriers. Thus, Wensing et al.  argue that multifaceted interventions could be more effective if they address different types of implementation barriers ( e.g. , provider knowledge and the organizational context). While the methods for tailoring clinical interventions and implementation strategies to local contexts need to be improved, intervention mapping and a recently developed 'behaviour change wheel' are two promising approaches.

Proposals that employ multifaceted and multilevel strategies that address prospectively identified implementation barriers may be more compelling to review committees, but mounting complex experiments may be beyond the reach of many early-stage investigators and many grant mechanisms. However, it is within the scope of R03, R21, and R34 supported research to develop implementation strategies and to conduct pilot tests of their feasibility and acceptability – work that can strengthen the case for sustainability and scalability. Proposal writers should provide preliminary work for implementation strategies in much the same way that intervention developers do, such as by providing manuals or protocols to guide their use, and methods to gauge their fidelity. Such work is illustrated in the pilot study conducted by Kauth et al. , which demonstrated that an external facilitation strategy intended to increase the use of cognitive behavioral therapy within Veteran Affairs clinics was a promising and low-cost strategy; such pilot data would likely bolster reviewers' confidence that the strategy is feasible, scalable, and ultimately, sustainable. Investigators should also make plans to document any modifications to the intervention and, if possible, incorporate adaptation models to the implementation process, because interventions are rarely implemented without being modified.

While providing detailed specification of theory-based implementation strategies is critical, it is also imperative that investigators acknowledge the complexity of implementation processes. Aarons and Palinkas comment:

'It is unrealistic to assume that implementation is a simple process, that one can identify all of the salient concerns, be completely prepared, and then implement effectively without adjustments. It is becoming increasingly clear that being prepared to implement EBP means being prepared to evaluate, adjust, and adapt in a continuing process that includes give and take between intervention developers, service system researchers, organizations, providers, and consumers'.

Ultimately, proposals that reflect the PI's understanding of the complexity of the process of implementing evidence-based practices and that provide supporting detail about strategies and processes will be perceived as more feasible to complete through the proposed methods.

7. Team Experience with the Setting, Treatment, Implementation Process, and Research Environment

Grant reviewers are asked to specifically assess a PI's capacity to successfully complete a proposed study. Grant applications that convey the team's experience with the study setting, the treatment whose implementation is being studied, and implementation processes help convey capacity and feasibility to complete an implementation research project.

The reader should observe that NIH gives different scores for the team experience with the setting and for the research environment (http://grants.nih.gov/grants/writing_application.htm) but the purpose of both sections is demonstrating capacity to successfully carry out the study as proposed. Investigators can convey capacity through a variety of ways. Chief among them is building a strong research team, whose members bring depth and experience in areas the PI does not yet have. Implementation research exemplifies multidisciplinary team science, informed by a diverse range of substantive and methodological fields.

A team that brings the needed disciplines and skill sets directly to the project enhances the project's likelihood of success. Early-stage implementation researchers who collaborate or partner with senior investigators reassure reviewers that the proposed work will benefit from the senior team member's experience and expertise. Similarly, collaborators play important roles in complementing, or rounding out, the PI's disciplinary perspective and methodological skill set. Early career investigators, therefore, should surround themselves with more established colleagues who bring knowledge and experience in areas key to the study aims and methods.  The narrative should cite team members' relevant work, and their prior work can be addressed in a discussion of preliminary studies. Additionally, the new formats for NIH biosketches and budget justifications enable a clear portrayal of what each team member brings to the proposed study.

For the NIH applications, the research environment is detailed in the resources and environment section of a grant application. Here, an investigator can describe the setting's track record in implementation research; research centers, labs, and offices that the PI can draw on; and structural and historic ties to healthcare settings. For example, a PI can describe how their project will draw upon the University's CTSA program, statistics or design labs, established pools of research staff, and health services research centers. Preliminary studies and biosketches provide additional ways to convey the strengths of the environment and context within which an investigator will launch a proposed study.

In summary, researchers need to detail the strengths of the research environment, emphasizing in particular the resources, senior investigators, and research infrastructure that can contribute to the success of the proposed study. A strong research environment is especially important for implementation research, which is typically team-based, requires expertise of multiple disciplines, and requires strong relationships between researchers and community based health settings. Investigators who are surrounded by experienced implementation researchers, working in a setting with strong community ties, and drawing on experienced research staff can inspire greater confidence in the proposed study's likelihood of success.

8. Feasibility of Proposed Research Design and Methods

One of the most important functions of preliminary work is to demonstrate the feasibility of the proposed research design and methods. Landsverk  urges PIs to consider every possible question reviewers might raise, and to explicitly address those issues in the application. Data from small feasibility studies or pilot work around referral flow; participant entry into the study; participant retention; and the extent to which key measures are understood by participants, acceptable for use, and capture variability can demonstrate that the proposed methods are likely to work.

The methods section should contain as much detail as possible, as well as lay out possible choice junctures and contingencies, should methods not work as planned. It is not only important to justify methodological choices, but also to discuss why potential alternatives were not selected. For example, if randomization is not feasible or acceptable to stakeholders, investigators should make that clear. Letters from study site collaborators can support, but should not replace, the narrative's detail on study methods. For example, letters attesting the willingness of study sites to be randomized or to support recruitment for the proposed timeframe can help offset reviewer concerns about some of the real-world challenges of launching implementation studies.

9. Measurement and Analysis

A grant application must specify a measurement plan for each construct in the study's overarching conceptual model or guiding theory, whether those constructs pertain to implementation strategies, the context of implementation, stakeholder preferences and priorities, and implementation outcomes. Yet, crafting the study approach section is complicated by the current lack of consensus on methodological approaches to the study of implementation processes, measuring implementation context and outcomes, and testing implementation strategies.

Measurement is a particularly important aspect of study methods, because it determines the quality of data. Unlike efficacy and effectiveness studies, implementation research often involves some customization of an intervention to fit local context; accordingly, measurement plans need to address the intervention's degree of customization versus fidelity. Moreover, implementation science encompasses a broad range of constructs, from a variety of disciplines, with little standardization of measures or agreement on definitions of constructs across different studies, fields, authors, or research groups, further compounding the burden to present a clear and robust measurement plan along with its rationale.

Two current initiatives seek to advance the harmonization, standardization, and rigor of measurement in implementation science, the U.S. National Cancer Institute's (NCI) Grid-Enabled Measures (GEM) portal and the Comprehensive Review of Dissemination and Implementation Science Instruments efforts supported by the Seattle Implementation Research Conference (SIRC) at the University of Washington. Both initiatives engage the implementation science research community to enhance the quality and harmonization of measures. Their respective web sites are being populated with measures and ratings, affording grant writers an invaluable resource in addressing a key methodological challenge.

Key challenges in crafting the analysis plan for implementation studies include: determining the unit of analysis, given the 'action' at individual, team, organizational, and policy environments; shaping meditational analyses given the role of contextual variables; and developing and using appropriate methods for characterizing the speed, quality, and degree of implementation. The proposed study's design, assessment tools, analytic strategies, and analytic tools must address these challenges in some manner. Grant applications that propose the testing of implementation strategies or processes often provide preliminary data from small-scale pilot studies to examine feasibility and assess sources of variation. However, the magnitude of effects in small pilots should be determined by clinical relevance, given the uncertainty of power calculations from small scale studies.

10. Policy/Funding Environment; Leverage or Support for Sustaining Change

PIs should ensure that grant applications reflect their understanding of the policy and funding context of the implementation effort. Health policies differ in many ways that impact quality, and legal, reimbursement, and regulatory factors affect the adoption and sustainability of evidence-based treatments. Raghavan et al.  discuss the policy ecology of implementation, and emphasize that greater attention should be paid to marginal costs associated with implementing evidence-based treatments, including expenses for provider training, supervision, and consultation. Glasgow et al.  recently extended their heretofore behaviorally focused RE-AIM framework for public health interventions to health policies, revealing the challenges associated with policy as a practice-change lever.

PIs can address the policy context of the implementation initiative through the narrative, background literature, letters of support, and the resource and environment section. Proposals that address how the implementation initiative aligns with policy trends enhance their likelihood of being viewed as having high public health significance, as well as greater practical impact, feasibility, and sustainability. It is important to note that it may behoove investigators to address the policy context within a proposal even if it is not likely to be facilitative of implementation, because it demonstrates to reviewers that the investigator is not naïve to the challenges and barriers that exist at this level.

We identify and discuss ten key ingredients in implementation research grant proposals. The paper reflects the team's experience and expertise: writing for federal funding agencies in the United States. We acknowledge that this will be a strength for some readers and a limitation for international readers, whom we encourage to contribute additional perspectives. Setting the stage with careful background detail and preliminary data may be more important for implementation research, which poses a unique set of challenges that investigators should anticipate and demonstrate their capacity to manage. Data to set the stage for implementation research may be collected by the study team through preliminary, feasibility, or pilot studies, or the team may draw on others' work, citing background literature to establish readiness for the proposed research.

Every PI struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project's feasibility and likelihood of success. The relative emphasis on, and thus length of text addressing, the various sections of a grant proposal varies with the program mechanism, application 'call', and funding source. For NIH applications, most attention and detail should be allocated to the study method because the 'approach' section is typically weighted most heavily in scoring.

Moreover, the under-specification or lack of detail in study methodology usually receives the bulk of reviewer criticism. Well-constructed, parsimonious tables, logic models, and figures reflecting key concepts and the analytic plan for testing their relationships all help add clarity, focus reviewers, and prevent misperceptions. All implementation research grants need to propose aims, study questions, or hypotheses whose answers will advance implementation science. Beyond this fundamental grounding, proposed implementation studies should address most, if not all, of the ingredients identified here. While no application can include a high level of detail about every ingredient, addressing these components can help assure reviewers of the significance, feasibility, and impact of the proposed research.

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Writing implementation research grant proposals: ten key ingredients

BackgroundAll investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers.DiscussionThis article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the applic...

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Concocting that Magic Elixir: Successful Grant Application writing in Dissemination and Implementation Research by Ross Brownson, Graham Colditz, Maureen Dobbins, Karen Emmons, Jon Kerner, Margaret Padek, Enola Proctor and Kurt Stange.

This article explores the core competencies of dissemination and implementation (D&I) grant writing. It also includes a compilation of tips for writing a successful D&I proposal. While geared toward the US NIH funding processes, the competencies and tips should prove useful for other funding agencies & mechanisms.

Tips for Getting Funded from the Users’ Guide to Dissemination and Implementation in Health for Researchers and Practitioners

Checklists, tools, self-ratings and guides for successful proposals in dissemination and implementation (D&I) research developed by Enola Proctor, Ross Brownson, Byron Powell, Ana Baumann, Ashley Hamilton and Ryan Santens; and adapted for the internet by Amy Huebschmann, Chase Cameron, Demetria McNeal and Russell Glasgow.

Writing Implementation Research Grant Proposals: Ten Key Ingredients by Enola Proctor, Byron Powell, Ana Bauman, Ashley Hamilton and Ryan Santens

This article summarizes the key ingredients of an implementation research grant application with examples of how preliminary data, background literature and narrative details can strengthen the application.

Dissemination and Implementation Research at the National Cancer Institute : A Review of Funded Studies (2006–2019) and Opportunities to Advance the Field presents an analysis of NCI-funded DIRH grants and highlights areas in need of more research.

A review of policy dissemination and implementation research funded by the National Institutes of Health, 2007-2014 by Jonathan Purtle, Rachel Peters and Ross C. Brownson.

Implementation science in cancer prevention and control: a decade of grant funding by the National Cancer Institute and future directions by Gila Neta, Michael A. Sanchez, David A. Chambers, Siobhan M. Phillips, Bryan Leyva, Laurie Cynkin, Margaret M. Farrell, Suzanne Heurtin-Roberts and Cynthia Vinson.

The Science of Implementation in Health and Healthcare (SIHH) Study Section reviews applications that identify, develop, and evaluate dissemination and implementation theories, strategies and methods designed to integrate evidence-based health interventions into public health, clinical, and community settings. Applications reviewed in SIHH should have a major methods, strategy, or theoretical development component in implementation science in order to understand how interventions are implemented and measure implementation outcomes in public health, clinical, and community settings.

Sample Grants

Get Funding

Implementation science grant writing

Implementation science grant proposals require specific elements that are not common features in other grant types. Thankfully for those new to implementation science, to grant writing, or both, Dr. Enola Proctor and colleagues published an incredibly useful resource.

✪ Writing implementation research grant proposals: Ten key ingredients was published in the journal Implementation Science in 2012, and is a rich source of expert knowledge on writing successful grants in this young field.

Below you will find a high level overview of this article, to serve as an introduction to thinking about this type of grant. The full article linked above is available open source - be sure to read it!

Don’t miss the video adaptation of “10 Key Ingredients”, produced by the Colorado Clinical and Translational Sciences Institute .

Doing research, frame your question, pick a theory, model, or framework, identify implementation strategies, select research method, select study design, choose measures, ⇥ get funding, report results, key considerations.

Access/quality gap: It is not enough to simply document the burden of disease. Proposals need to demonstrate an unmet need, underuse or poor reach in the targeted population or low adoption, wide variation, or poor penetration of evidence based practices in usual care settings.

Evidence Based Practice: Must clearly establish that the evidence based practice is ready to implement. Strength of empirical evidence is key part of determining readiness, yet how much evidence is necessary is socially determined. Note the importance of evidence of effectiveness in targeted settings and populations. How much adaptation will be needed?

Conceptual model: Active and intentional use of theory is needed to produce generalizable knowledge and situate the study within larger body of knowledge. This is particularly needed for specifying key contextual variables that influence implementation and the mechanisms by which strategies have their effects. A theoretically based conceptual model helps to frame study questions and hypotheses, clarify the constructs to be measured, and specify the relationships to be evaluated or tested.

Stakeholder priorities and engagement: Engagement affects the impact of the proposed implementation effort, the sustainability of the proposed change, and the feasibility and ultimate success of the proposed project. Varying levels and forms of engagement are possible. The key is, have they demonstrated its impact?

Setting readiness: Stronger proposals include information that reflects the setting’s readiness for change. This is especially true regarding the adoption and implementation of the proposed evidence based practice. Conducting a formal readiness assessment, formative evaluation of implementation facilitators and barriers, and letters of support from the setting that address the alignment of the proposed implementation effort with organizational priorities, policy, and funding context.

Implementation strategy: Describe the strategy in detail (see our page Identify Implementation Strategies for more on this topic). Strategy selection should be justified conceptually and matched to known barriers (determinants) in the setting. Theory should be used to explain the mechanisms of action. The strategy should be robust, adaptable, feasible, acceptable, scalable and sustainable. It is important to know the cost and budget impact of selecting a particular strategy.

Team experience: Does the research team possess all of the relevant expertise? Does the team have experience with the study setting, the evidence based practice, and the strategy?

Feasibility of the proposed research design and methods: Is there preliminary or pilot data? Is the approach well described? Have potential problems and alternative approaches been described?

Measurement and analysis: Does the conceptual framework inform the measures? Does the analysis plan align with the research questions? How well is the speed, quality, or degree of implementation captured? Is there appropriate attention to implementation outcomes not just clinical effectiveness outcomes?

Policy/funding environment: Proposals that address how the implementation effort aligns with policy trends enhance their likelihood of being perceived as having high public health significance, as well as greater practical impact, feasibility, and sustainability.

Open Access articles will be marked with ✪ Please note some journals will require subscriptions to access a linked article.

Learn more:.

An Evidence-Based Guide to Writing Grant Proposals for Clinical Research ( Annals of Internal Medicine , 2005)

✪ How research funding agencies support science integration into policy and practice: An international overview ( Implementation Science , 2014)

✪ Implementation science in cancer prevention and control: A decade of grant funding by the National Cancer Institute and future directions ( Implementation Science , 2015)

✪ Concocting that Magic Elixir: Successful Grant Application Writing in Dissemination and Implementation Research ( Clinical and Translational Science , 2015)

✪ A review of policy dissemination and implementation research funded by the National Institutes of Health, 2007–2014 ( Implementation Science , 2016)

✪ A methodology for enhancing implementation science proposals: comparison of face-to-face versus virtual workshops ( Implementation Science , 2016)

✪ Standardizing an approach to the evaluation of implementation science proposals ( Implementation Science , 2018)

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Dissemination and Implementation Research in Health (R01 Clinical Trial Optional)

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Dissemination and Implementation Research in Health (R03)

Targeted Implementation Science to Achieve 90/90/90 Goals for HIV/AIDS Prevention and Treatment (R21 Clinical Trial Optional)

Strengthening the HIV Pre-Exposure Prophylaxis (PrEP) Care Continuum through Behavioral, Social, and Implementation Science (R01 Clinical Trial Optional)

Multi-Site Studies for System-Level Implementation of Substance Use Prevention and Treatment Services (R01 Clinical Trial Optional)

Agency for Healthcare Research and Quality

Funding Announcements Overview

Improving Management of Opioids and Opioid Use Disorder (OUD) in Older Adults (R18)

Patient-Centered Outcomes Research Institute

PCORI: Funding Opportunities

Example Funded Grants

Selection of NCI-Funded Implementation Science Grants

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The Ultimate Grant Writing Guide (and How to Find and Apply for Grants)

Securing grants requires strategic planning. Identifying relevant opportunities, building collaborations, and crafting a comprehensive grant proposal are crucial steps. Read our ultimate guide on grant writing, finding grants, and applying for grants to get the funding for your research.

Updated on February 22, 2024

Embarking on a journey of groundbreaking research and innovation always requires more than just passion and dedication, it demands financial support. In the academic and research domains, securing grants is a pivotal factor for transforming these ideas into tangible outcomes. 

Grant awards not only offer the backing needed for ambitious projects but also stand as a testament to the importance and potential impact of your work. The process of identifying, pursuing, and securing grants, however, is riddled with nuances that necessitate careful exploration. 

Whether you're a seasoned researcher or a budding academic, navigating this complex world of grants can be challenging, but we’re here to help. In this comprehensive guide, we'll walk you through the essential steps of applying for grants, providing expert tips and insights along the way.

Finding grant opportunities 

Prior to diving into the application phase, the process of finding grants involves researching and identifying those that are relevant and realistic to your project. While the initial step may seem as simple as entering a few keywords into a search engine, the full search phase takes a more thorough investigation.

By focusing efforts solely on the grants that align with your goals, this pre-application preparation streamlines the process while also increasing the likelihood of meeting all the requirements. In fact, having a well thought out plan and a clear understanding of the grants you seek both simplifies the entire activity and sets you and your team up for success.

Apply these steps when searching for appropriate grant opportunities:

1. Determine your need

Before embarking on the grant-seeking journey, clearly articulate why you need the funds and how they will be utilized. Understanding your financial requirements is crucial for effective grant research.

2. Know when you need the money

Grants operate on specific timelines with set award dates. Align your grant-seeking efforts with these timelines to enhance your chances of success.

3. Search strategically

Build a checklist of your most important, non-negotiable search criteria for quickly weeding out grant options that absolutely do not fit your project. Then, utilize the following resources to identify potential grants:

• Online directories
• Small Business Administration (SBA)
• Foundations

4. Develop a tracking tool

After familiarizing yourself with the criteria of each grant, including paperwork, deadlines, and award amounts, make a spreadsheet or use a project management tool to stay organized. Share this with your team to ensure that everyone can contribute to the grant cycle.

Here are a few popular grant management tools to try: 

• Jotform : spreadsheet template
• Airtable : table template
• Instrumentl : software
• Submit : software

Tips for Finding Research Grants

Consider large funding sources : Explore major agencies like NSF and NIH.

Reach out to experts : Consult experienced researchers and your institution's grant office.

Stay informed : Regularly check news in your field for novel funding sources.

Know agency requirements : Research and align your proposal with their requisites.

Ask questions : Use the available resources to get insights into the process.

Demonstrate expertise : Showcase your team's knowledge and background.

Neglect lesser-known sources : Cast a wide net to diversify opportunities.

Name drop reviewers : Prevent potential conflicts of interest.

Miss your chance : Find field-specific grant options.

Forget refinement : Improve proposal language, grammar, and clarity.

Ignore grant support services : Enhance the quality of your proposal.

Overlook co-investigators : Enhance your application by adding experience.

Grant collaboration 

Now that you’ve taken the initial step of identifying potential grant opportunities, it’s time to find collaborators. The application process is lengthy and arduous. It requires a diverse set of skills. This phase is crucial for success.

With their valuable expertise and unique perspectives, these collaborators play instrumental roles in navigating the complexities of grant writing. While exploring the judiciousness that goes into building these partnerships, we will underscore why collaboration is both advantageous and indispensable to the pursuit of securing grants.

Why is collaboration important to the grant process?

Some grant funding agencies outline collaboration as an outright requirement for acceptable applications. However, the condition is more implied with others. Funders may simply favor or seek out applications that represent multidisciplinary and multinational projects.

To get an idea of the types of collaboration major funders prefer, try searching “collaborative research grants” to uncover countless possibilities, such as:

• National Endowment for the Humanities
• American Brain Tumor Association

For exploring grants specifically for international collaboration, check out this blog:

• 30+ Research Funding Agencies That Support International Collaboration

Either way, proposing an interdisciplinary research project substantially increases your funding opportunities. Teaming up with multiple collaborators who offer diverse backgrounds and skill sets enhances the robustness of your research project and increases credibility.

This is especially true for early career researchers, who can leverage collaboration with industry, international, or community partners to boost their research profile. The key lies in recognizing the multifaceted advantages of collaboration in the context of obtaining funding and maximizing the impact of your research efforts.

How can I find collaborators?

Before embarking on the search for a collaborative partner, it's essential to crystallize your objectives for the grant proposal and identify the type of support needed. Ask yourself these questions: 

1)Which facet of the grant process do I need assistance with:

2) Is my knowledge lacking in a specific: 

• Population?

3) Do I have access to the necessary:

Use these questions to compile a detailed list of your needs and prioritize them based on magnitude and ramification. These preliminary step ensure that search for an ideal collaborator is focused and effective.

Once you identify targeted criteria for the most appropriate partners, it’s time to make your approach. While a practical starting point involves reaching out to peers, mentors, and other colleagues with shared interests and research goals, we encourage you to go outside your comfort zone.

Beyond the first line of potential collaborators exists a world of opportunities to expand your network. Uncover partnership possibilities by engaging with speakers and attendees at events, workshops, webinars, and conferences related to grant writing or your field.

Also, consider joining online communities that facilitate connections among grant writers and researchers. These communities offer a space to exchange ideas and information. Sites like Collaboratory , NIH RePorter , and upwork provide channels for canvassing and engaging with feasible collaborators who are good fits for your project. 

Like any other partnership, carefully weigh your vetted options before committing to a collaboration. Talk with individuals about their qualifications and experience, availability and work style, and terms for grant writing collaborations.

Transparency on both sides of this partnership is imperative to forging a positive work environment where goals, values, and expectations align for a strong grant proposal.

Putting together a winning grant proposal

It’s time to assemble the bulk of your grant application packet – the proposal itself. Each funder is unique in outlining the details for specific grants, but here are several elements fundamental to every proposal:

• Executive Summary
• Needs assessment
• Project description
• Evaluation plan
• Team introduction
• Sustainability plan 

This list of multi-faceted components may seem daunting, but careful research and planning will make it manageable. 

Start by reading about the grant funder to learn:

• What their mission and goals are,
• Which types of projects they have funded in the past, and
• How they evaluate and score applications.

Next, view sample applications to get a feel for the length, flow, and tone the evaluators are looking for. Many funders offer samples to peruse, like these from the NIH , while others are curated by online platforms , such as Grantstation.

Also, closely evaluate the grant application’s requirements. they vary between funding organizations and opportunities, and also from one grant cycle to the next. Take notes and make a checklist of these requirements to add to an Excel spreadsheet, Google smartsheet, or management system for organizing and tracking your grant process.

Finally, understand how you will submit the final grant application. Many funders use online portals with character or word limits for each section. Be aware of these limits beforehand. Simplify the editing process by first writing each section in a Word document to be copy and pasted into the corresponding submission fields.

If there is no online application platform, the funder will usually offer a comprehensive Request for Proposal (RFP) to guide the structure of your grant proposal. The RFP: 

• Specifies page constraints
• Delineates specific sections
• Outlines additional attachments
• Provides other pertinent details

Components of a grant proposal

Cover letter.

Though not always explicitly requested, including a cover letter is a strategic maneuver that could be the factor determining whether or not grant funders engage with your proposal. It’s an opportunity to give your best first impression by grabbing the reviewer’s attention and compelling them to read further. 

Cover letters are not the place for excessive emotion or detail, keep it brief and direct, stating your financial needs and purpose confidently from the outset. Also, try to clearly demonstrate the connection between your project and the funder’s mission to create additional value beyond the formal proposal.

Executive summary

Like an abstract for your research manuscript, the executive summary is a brief synopsis that encapsulates the overarching topics and key points of your grant proposal. It must set the tone for the main body of the proposal while providing enough information to stand alone if necessary.

Refer to How to Write an Executive Summary for a Grant Proposal for detailed guidance like:

• Give a clear and concise account of your identity, funding needs, and project roadmap.
• Write in an instructive manner aiming for an objective and persuasive tone
• Be convincing and pragmatic about your research team's ability.
• Follow the logical flow of main points in your proposal.
• Use subheadings and bulleted lists for clarity.
• Write the executive summary at the end of the proposal process.
• Reference detailed information explained in the proposal body.
• Address the funder directly.
• Provide excessive details about your project's accomplishments or management plans.
• Write in the first person.
• Disclose confidential information that could be accessed by competitors.
• Focus excessively on problems rather than proposed solutions.
• Deviate from the logical flow of the main proposal.
• Forget to align with evaluation criteria if specified

Project narrative

After the executive summary is the project narrative . This is the main body of your grant proposal and encompasses several distinct elements that work together to tell the story of your project and justify the need for funding. 

Include these primary components:

Introduction of the project team

Briefly outline the names, positions, and credentials of the project’s directors, key personnel, contributors, and advisors in a format that clearly defines their roles and responsibilities. Showing your team’s capacity and ability to meet all deliverables builds confidence and trust with the reviewers.

Needs assessment or problem statement

A compelling needs assessment (or problem statement) clearly articulates a problem that must be urgently addressed. It also offers a well-defined project idea as a possible solution. This statement emphasizes the pressing situation and highlights existing gaps and their consequences to illustrate how your project will make a difference.

To begin, ask yourself these questions:

• What urgent need are we focusing on with this project?
• Which unique solution does our project offer to this urgent need? 
• How will this project positively impact the world once completed?

Here are some helpful examples and templates.

Goals and objectives

Goals are broad statements that are fairly abstract and intangible. Objectives are more narrow statements that are concrete and measurable. For example :

• Goal : “To explore the impact of sleep deprivation on cognitive performance in college students.”
• Objective : “To compare cognitive test scores of students with less than six hours of sleep and those with 8 or more hours of sleep.”

Focus on outcomes, not processes, when crafting goals and objectives. Use the SMART acronym to align them with the proposal's mission while emphasizing their impact on the target audience.

Methods and strategies

It is vitally important to explain how you intend to use the grant funds to fulfill the project’s objectives. Detail the resources and activities that will be employed. Methods and strategies are the bridge between idea and action. They must prove to reviewers the plausibility of your project and the significance of their possible funding.

Here are some useful guidelines for writing your methods section that are outlined in " Winning Grants: Step by Step ."

• Firmly tie your methods to the proposed project's objectives and needs assessment.
• Clearly link them to the resources you are requesting in the proposal budget.
• Thoroughly explain why you chose these methods by including research, expert opinion, and your experience.
• Precisely list the facilities and capital equipment that you will use in the project.
• Carefully structure activities so that the program moves toward the desired results in a time-bound manner.

A comprehensive evaluation plan underscores the effectiveness and accountability of a project for both the funders and your team. An evaluation is used for tracking progress and success. The evaluation process shows how to determine the success of your project and measure the impact of the grant award by systematically gauging and analyzing each phase of your project as it compares to the set objectives.

Evaluations typically fall into two standard categories:

1. Formative evaluation : extending from project development through implementation, continuously provides feedback for necessary adjustments and improvements. 

2. Summative evaluation : conducted post-project completion, critically assesses overall success and impact by compiling information on activities and outcomes.

Creating a conceptual model of your project is helpful when identifying these key evaluation points. Then, you must consider exactly who will do the evaluations, what specific skills and resources they need, how long it will take, and how much it will cost.

Sustainability

Presenting a solid plan that illustrates exactly how your project will continue to thrive after the grant money is gone builds the funder's confidence in the project’s longevity and significance. In this sustainability section, it is vital to demonstrate a diversified funding strategy for securing the long-term viability of your program.

There are three possible long term outcomes for projects with correlated sustainability options:

• Short term projects: Though only implemented once, will have ongoing maintenance costs, such as monitoring, training, and updates.

(E.g., digitizing records, cleaning up after an oil spill)

• Projects that will generate income at some point in the future: must be funded until your product or service can cover operating costs with an alternative plan in place for deficits.

(E.g., medical device, technology, farming method)

• Ongoing projects: will eventually need a continuous stream of funding from a government entity or large organization.

(E.g., space exploration, hurricane tracking)

Along with strategies for funding your program beyond the initial grant,  reference your access to institutional infrastructure and resources that will reduce costs.

Also, submit multi-year budgets that reflect how sustainability factors are integrated into the project’s design.

The budget section of your grant proposal, comprising both a spreadsheet and a narrative, is the most influential component. It should be able to stand independently as a suitable representation of the entire endeavor. Providing a detailed plan to outline how grant funds will be utilized is crucial for illustrating cost-effectiveness and careful consideration of project expenses. 

A comprehensive grant budget offers numerous benefits to both the grantor , or entity funding the grant, and the grantee , those receiving the funding, such as:

• Grantor : The budget facilitates objective evaluation and comparison between multiple proposals by conveying a project's story through responsible fund management and financial transparency.
• Grantee : The budget serves as a tracking tool for monitoring and adjusting expenses throughout the project and cultivates trust with funders by answering questions before they arise.

Because the grant proposal budget is all-encompassing and integral to your efforts for securing funding, it can seem overwhelming. Start by listing all anticipated expenditures within two broad categories, direct and indirect expenses , where:

• Direct : are essential for successful project implementation, are measurable project-associated costs, such as salaries, equipment, supplies, travel, and external consultants, and are itemized and detailed in various categories within the grant budget.
• Indirect : includes administrative costs not directly or exclusively tied to your project, but necessary for its completion, like rent, utilities, and insurance, think about lab or meeting spaces that are shared by multiple project teams, or Directors who oversee several ongoing projects.

After compiling your list, review sample budgets to understand the typical layout and complexity. Focus closely on the budget narratives , where you have the opportunity to justify each aspect of the spreadsheet to ensure clarity and validity.

While not always needed, the appendices consist of relevant supplementary materials that are clearly referenced within your grant application. These might include: 

• Updated resumes that emphasize staff members' current positions and accomplishments. 
• Letters of support from people or organizations that have authority in the field of your research, or community members that may benefit from the project.
• Visual aids like charts, graphs, and maps that contribute directly to your project’s story and are referred to previously in the application. 

Finalizing your grant application

Now that your grant application is finished, make sure it's not just another document in the stack Aim for a grant proposal that captivates the evaluator. It should stand out not only for presenting an excellent project, but for being engaging and easily comprehended . 

Keep the language simple. Avoid jargon. Prioritizing accuracy and conciseness. Opt for reader-friendly formatting with white space, headings, standard fonts, and illustrations to enhance readability.

Always take time for thorough proofreading and editing. You can even set your proposal aside for a few days before revisiting it for additional edits and improvements. At this stage, it is helpful to seek outside feedback from those familiar with the subject matter as well as novices to catch unnoticed mistakes and improve clarity.

If you want to be absolutely sure your grant proposal is polished, consider getting it edited by AJE .

How can AI help the grant process?

When used efficiently, AI is a powerful tool for streamlining and enhancing various aspects of the grant process.

• Use AI algorithms to review related studies and identify knowledge gaps.
• Employ AI for quick analysis of complex datasets to identify patterns and trends.
• Leverage AI algorithms to match your project with relevant grant opportunities.
• Apply Natural Language Processing for analyzing grant guidelines and tailoring proposals accordingly.
• Utilize AI-powered tools for efficient project planning and execution.
• Employ AI for tracking project progress and generating reports.
• Take advantage of AI tools for improving the clarity, coherence, and quality of your proposal.
• Rely solely on manual efforts that are less comprehensive and more time consuming.
• Overlook the fact that AI is designed to find patterns and trends within large datasets.
• Minimize AI’s ability to use set parameters for sifting through vast amounts of data quickly.
• Forget that the strength of AI lies in its capacity to follow your prompts without divergence.
• Neglect tools that assist with scheduling, resource allocation, and milestone tracking.
• Settle for software that is not intuitive with automated reminders and updates.
• Hesitate to use AI tools for improving grammar, spelling, and composition throughout the writing process.

Remember that AI provides a diverse array of tools; there is no universal solution. Identify the most suitable tool for your specific task. Also, like a screwdriver or a hammer, AI needs informed human direction and control to work effectively.

Looking for tips when writing your grant application? 

Check out these resources:

• 4 Tips for Writing a Persuasive Grant Proposal
• Writing Effective Grant Applications
• 7 Tips for Writing an Effective Grant Proposal
• The best-kept secrets to winning grants
• The Best Grant Writing Books for Beginner Grant Writers
• Research Grant Proposal Funding: How I got $1 Million

Final thoughts

The bottom line – applying for grants is challenging. It requires passion, dedication, and a set of diverse skills rarely found within one human being.

Therefore, collaboration is key to a successful grant process . It encourages everyone’s strengths to shine. Be honest and ask yourself, “Which elements of this grant application do I really need help with?” Seek out experts in those areas.

Keep this guide on hand to reference as you work your way through this funding journey. Use the resources contained within. Seek out answers to all the questions that will inevitably arise throughout the process.

The grants are out there just waiting for the right project to present itself – one that shares the funder’s mission and is a benefit to our communities. Find grants that align with your project goals, tell your story through a compelling proposal, and get ready to make the world a better place with your research.

The AJE Team

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Home » Grant Proposal – Example, Template and Guide

Grant Proposal – Example, Template and Guide

Table of Contents

Grant Proposal

Grant Proposal is a written document that outlines a request for funding from a grant-making organization, such as a government agency, foundation, or private donor. The purpose of a grant proposal is to present a compelling case for why an individual, organization, or project deserves financial support.

Grant Proposal Outline

While the structure and specific sections of a grant proposal can vary depending on the funder’s requirements, here is a common outline that you can use as a starting point for developing your grant proposal:

• Brief overview of the project and its significance.
• Summary of the funding request and project goals.
• Key highlights and anticipated outcomes.
• Background information on the issue or problem being addressed.
• Explanation of the project’s relevance and importance.
• Clear statement of the project’s objectives.
• Detailed description of the problem or need to be addressed.
• Supporting evidence and data to demonstrate the extent and impact of the problem.
• Identification of the target population or beneficiaries.
• Broad goals that describe the desired outcomes of the project.
• Specific, measurable, achievable, relevant, and time-bound (SMART) objectives that contribute to the goals.
• Description of the strategies, activities, and interventions to achieve the objectives.
• Explanation of the project’s implementation plan, timeline, and key milestones.
• Roles and responsibilities of project staff and partners.
• Plan for assessing the project’s effectiveness and measuring its impact.
• Description of the data collection methods, tools, and indicators used for evaluation.
• Explanation of how the results will be used to improve the project.
• Comprehensive breakdown of project expenses, including personnel, supplies, equipment, and other costs.
• Clear justification for each budget item.
• Information about any matching funds or in-kind contributions, if applicable.
• Explanation of how the project will be sustained beyond the grant period.
• Discussion of long-term funding strategies, partnerships, and community involvement.
• Description of how the project will continue to address the identified problem in the future.
• Overview of the organization’s mission, history , and track record.
• Description of the organization’s experience and qualifications related to the proposed project.
• Summary of key staff and their roles.
• Recap of the project’s goals, objectives, and anticipated outcomes.
• Appreciation for the funder’s consideration.
• Contact information for further inquiries.

Grant Proposal Template

Here is a template for a grant proposal that you can use as a starting point. Remember to customize and adapt it based on the specific requirements and guidelines provided by the funding organization.

Dear [Grant-making Organization Name],

Executive Summary:

I. Introduction:

II. Needs Assessment:

III. Goals and Objectives:

IV. Project Methods and Approach:

V. Evaluation and Monitoring:

VI. Budget:

VII. Sustainability:

VIII. Organizational Capacity and Expertise:

IX. Conclusion:

Thank you for considering our grant proposal. We believe that this project will make a significant impact and address an important need in our community. We look forward to the opportunity to discuss our proposal further.

Grant Proposal Example

Here is an example of a grant proposal to provide you with a better understanding of how it could be structured and written:

Executive Summary: We are pleased to submit this grant proposal on behalf of [Your Organization’s Name]. Our proposal seeks funding in the amount of [Requested Amount] to support our project titled [Project Title]. This project aims to address [Describe the problem or need being addressed] in [Target Location]. By implementing a comprehensive approach, we aim to achieve [State the project’s goals and anticipated outcomes].

I. Introduction: We express our gratitude for the opportunity to present this proposal to your esteemed organization. At [Your Organization’s Name], our mission is to [Describe your organization’s mission]. Through this project, we aim to make a significant impact on [Describe the issue or problem being addressed] by [Explain the significance and relevance of the project].

II. Needs Assessment: After conducting thorough research and needs assessments in [Target Location], we have identified a pressing need for [Describe the problem or need]. The lack of [Identify key issues or challenges] has resulted in [Explain the consequences and impact of the problem]. The [Describe the target population or beneficiaries] are particularly affected, and our project aims to address their specific needs.

III. Goals and Objectives: The primary goal of our project is to [State the broad goal]. To achieve this, we have outlined the following objectives:

• [Objective 1]
• [Objective 2]
• [Objective 3] [Include additional objectives as necessary]

IV. Project Methods and Approach: To address the identified needs and accomplish our objectives, we propose the following methods and approach:

• [Describe the activities and strategies to be implemented]
• [Explain the timeline and key milestones]
• [Outline the roles and responsibilities of project staff and partners]

V. Evaluation and Monitoring: We recognize the importance of assessing the effectiveness and impact of our project. Therefore, we have developed a comprehensive evaluation plan, which includes the following:

• [Describe the data collection methods and tools]
• [Identify the indicators and metrics to measure progress]
• [Explain how the results will be analyzed and utilized]

VI. Budget: We have prepared a detailed budget for the project, totaling [Total Project Budget]. The budget includes the following key components:

• Personnel: [Salary and benefits for project staff]
• Supplies and Materials: [List necessary supplies and materials]
• Equipment: [Include any required equipment]
• Training and Capacity Building: [Specify any training or workshops]
• Other Expenses: [Additional costs, such as travel, marketing, etc.]

VII. Sustainability: Ensuring the sustainability of our project beyond the grant period is of utmost importance to us. We have devised the following strategies to ensure its long-term impact:

• [Describe plans for securing future funding]
• [Explain partnerships and collaborations with other organizations]
• [Outline community engagement and support]

VIII. Organizational Capacity and Expertise: [Your Organization’s Name] has a proven track record in successfully implementing projects of a similar nature. Our experienced team possesses the necessary skills and expertise to carry out this project effectively. Key personnel involved in the project include [List key staff and their qualifications].

IX. Conclusion: Thank you for considering our grant proposal. We firmly believe that [Project Title] will address a critical need in [Target Location] and contribute to the well-being of the [Target Population]. We are available to provide any additional information or clarification as required. We look forward to the

opportunity to discuss our proposal further and demonstrate the potential impact of this project.

Please find attached the required supporting documents, including our detailed budget, organizational information, and any additional materials that may be helpful in evaluating our proposal.

Thank you once again for considering our grant proposal. We appreciate your dedication to supporting projects that create positive change in our community. We eagerly await your response and the possibility of partnering with your esteemed organization to make a meaningful difference.

• Detailed Budget
• Organizational Information
• Additional Supporting Documents]

Grant Proposal Writing Guide

Writing a grant proposal can be a complex process, but with careful planning and attention to detail, you can create a compelling proposal. Here’s a step-by-step guide to help you through the grant proposal writing process:

• Carefully review the grant guidelines and requirements provided by the funding organization.
• Take note of the eligibility criteria, funding priorities, submission deadlines, and any specific instructions for the proposal.
• Familiarize yourself with the funding organization’s mission, goals, and previous projects they have supported.
• Gather relevant data, statistics, and evidence to support the need for your proposed project.
• Clearly define the problem or need your project aims to address.
• Identify the specific goals and objectives of your project.
• Consider how your project aligns with the mission and priorities of the funding organization.
• Organize your proposal by creating an outline that includes all the required sections.
• Arrange the sections logically and ensure a clear flow of ideas.
• Start with a concise and engaging executive summary to capture the reader’s attention.
• Provide a brief overview of your organization and the project.
• Present a clear and compelling case for the problem or need your project addresses.
• Use relevant data, research findings, and real-life examples to demonstrate the significance of the issue.
• Clearly articulate the overarching goals of your project.
• Define specific, measurable, achievable, relevant, and time-bound (SMART) objectives that align with the goals.
• Explain the strategies and activities you will implement to achieve the project objectives.
• Describe the timeline, milestones, and resources required for each activity.
• Highlight the uniqueness and innovation of your approach, if applicable.
• Outline your plan for evaluating the project’s effectiveness and measuring its impact.
• Discuss how you will collect and analyze data to assess the outcomes.
• Explain how the project will be sustained beyond the grant period, including future funding strategies and partnerships.
• Prepare a comprehensive budget that includes all the anticipated expenses and revenue sources.
• Clearly justify each budget item and ensure it aligns with the project activities and goals.
• Include a budget narrative that explains any cost assumptions or calculations.
• Review your proposal multiple times for clarity, coherence, and grammatical accuracy.
• Ensure that the proposal follows the formatting and length requirements specified by the funder.
• Consider seeking feedback from colleagues or experts in the field to improve your proposal.
• Gather all the necessary supporting documents, such as your organization’s background information, financial statements, resumes of key staff, and letters of support or partnership.
• Follow the submission instructions provided by the funding organization.
• Submit the proposal before the specified deadline, keeping in mind any additional submission requirements, such as online forms or hard copies.
• If possible, send a thank-you note or email to the funding organization for considering your proposal.
• Keep track of the notification date for the funding decision.
• In case of rejection, politely ask for feedback to improve future proposals.

Importance of Grant Proposal

Grant proposals play a crucial role in securing funding for organizations and projects. Here are some key reasons why grant proposals are important:

• Access to Funding: Grant proposals provide organizations with an opportunity to access financial resources that can support the implementation of projects and initiatives. Grants can provide the necessary funds for research, program development, capacity building, infrastructure improvement, and more.
• Project Development: Writing a grant proposal requires organizations to carefully plan and develop their projects. This process involves setting clear goals and objectives, identifying target populations, designing activities and strategies, and establishing timelines and budgets. Through this comprehensive planning process, organizations can enhance the effectiveness and impact of their projects.
• Validation and Credibility: Successfully securing a grant can enhance an organization’s credibility and reputation. It demonstrates to funders, partners, and stakeholders that the organization has a well-thought-out plan, sound management practices, and the capacity to execute projects effectively. Grant funding can provide validation for an organization’s work and attract further support.
• Increased Impact and Sustainability: Grant funding enables organizations to expand their reach and increase their impact. With financial resources, organizations can implement projects on a larger scale, reach more beneficiaries, and make a more significant difference in their communities. Additionally, grants often require organizations to consider long-term sustainability, encouraging them to develop strategies for continued project success beyond the grant period.
• Collaboration and Partnerships: Grant proposals often require organizations to form partnerships and collaborations with other entities, such as government agencies, nonprofit organizations, or community groups. These collaborations can lead to shared resources, expertise, and knowledge, fostering synergy and innovation in project implementation.
• Learning and Growth: The grant proposal writing process can be a valuable learning experience for organizations. It encourages them to conduct research, analyze data, and critically evaluate their programs and initiatives. Through this process, organizations can identify areas for improvement, refine their strategies, and strengthen their overall operations.
• Networking Opportunities: While preparing and submitting grant proposals, organizations have the opportunity to connect with funders, program officers, and other stakeholders. These connections can provide valuable networking opportunities, leading to future funding prospects, partnerships, and collaborations.

Purpose of Grant Proposal

The purpose of a grant proposal is to seek financial support from grant-making organizations or foundations for a specific project or initiative. Grant proposals serve several key purposes:

• Funding Acquisition: The primary purpose of a grant proposal is to secure funding for a project or program. Organizations rely on grants to obtain the financial resources necessary to implement and sustain their activities. Grant proposals outline the project’s goals, objectives, activities, and budget, making a compelling case for why the funding organization should invest in the proposed initiative.
• Project Planning and Development: Grant proposals require organizations to thoroughly plan and develop their projects before seeking funding. This includes clearly defining the problem or need the project aims to address, establishing measurable goals and objectives, and outlining the strategies and activities that will be implemented. Writing a grant proposal forces organizations to think critically about the project’s feasibility, anticipated outcomes, and impact.
• Communication and Persuasion: Grant proposals are persuasive documents designed to convince funding organizations that the proposed project is worthy of their investment. They must effectively communicate the organization’s mission, vision, and track record, as well as the specific problem being addressed and the potential benefits and impact of the project. Grant proposals use evidence, data, and compelling narratives to make a strong case for funding support.
• Relationship Building: Grant proposals serve as a platform for organizations to establish and strengthen relationships with funding organizations. Through the proposal, organizations introduce themselves, highlight their expertise, and demonstrate their alignment with the funding organization’s mission and priorities. A well-written grant proposal can lay the foundation for future collaborations and partnerships.
• Accountability and Evaluation: Grant proposals outline the expected outcomes, objectives, and evaluation methods for the proposed project. They establish a framework for accountability, as organizations are expected to report on their progress and outcomes if awarded the grant. Grant proposals often include plans for project evaluation and monitoring to assess the project’s effectiveness and ensure that the funding is being used appropriately.
• Sustainability and Long-Term Planning : Grant proposals often require organizations to consider the long-term sustainability of their projects beyond the grant period. This includes identifying strategies for continued funding, partnerships, and community involvement. By addressing sustainability in the proposal, organizations demonstrate their commitment to long-term impact and the responsible use of grant funds.

When to Write a Grant Proposal

Knowing when to write a grant proposal is crucial for maximizing your chances of success. Here are a few situations when it is appropriate to write a grant proposal:

• When There is a Funding Opportunity: Grants become available through various sources, including government agencies, foundations, corporations, and nonprofit organizations. Keep an eye out for grant announcements, requests for proposals (RFPs), or funding cycles that align with your organization’s mission and project goals. Once you identify a relevant funding opportunity, you can begin writing the grant proposal.
• When You Have a Well-Defined Project or Program: Before writing a grant proposal, it’s important to have a clearly defined project or program in mind. You should be able to articulate the problem or need you are addressing, the goals and objectives of your project, and the strategies and activities you plan to implement. Having a solid project plan in place will help you write a more compelling grant proposal.
• When You Have Conducted Research and Gathered Data: Grant proposals often require evidence and data to support the need for the project. Before writing the proposal, conduct thorough research to gather relevant statistics, studies, or community assessments that demonstrate the significance and urgency of the problem you aim to address. This data will strengthen your proposal and make it more persuasive.
• When You Have a Strong Organizational Profile: Funding organizations often consider the credibility and capacity of the applying organization. Before writing a grant proposal, ensure that your organization has a strong profile, including a clear mission statement, track record of accomplishments, capable staff or volunteers, and financial stability. These factors contribute to the overall credibility of your proposal.
• When You Have the Time and Resources to Dedicate to Proposal Writing: Writing a grant proposal requires time, effort, and resources. It involves conducting research, developing project plans, creating budgets, and crafting compelling narratives. Assess your organization’s capacity to commit to the grant proposal writing process. Consider the timeline, deadline, and any additional requirements specified by the funding organization before deciding to proceed.
• When You Have Identified Potential Partnerships or Collaborators: Some grant proposals may require or benefit from partnerships or collaborations with other organizations or stakeholders. If your project can be enhanced by partnering with other entities, it’s important to identify and secure these partnerships before writing the grant proposal. This demonstrates a collaborative approach and can strengthen your proposal.
• When You Are Committed to Project Evaluation and Accountability: Grant proposals often include requirements for project evaluation and reporting. If you are willing and able to commit to evaluating the project’s outcomes, tracking progress, and reporting on the use of funds, it is an appropriate time to write a grant proposal. This shows your dedication to transparency, accountability, and responsible use of grant funds.

Also see Proposal

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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What makes for a strong proposal? This webinar discusses " Writing Implementation Research Grant Proposals: Ten Key Ingredients ," published in the journal Implementation Science.

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Writing implementation research grant proposals: ten key ingredients.

Author information, affiliations.

• Proctor EK 1

ORCIDs linked to this article

• Powell BJ | 0000-0001-5245-1186
• Baumann AA | 0000-0002-4523-0147

Implementation Science : IS , 12 Oct 2012 , 7: 96 https://doi.org/10.1186/1748-5908-7-96   PMID: 23062065  PMCID: PMC3541090

Abstract 

Free full text .

Writing implementation research grant proposals: ten key ingredients

Enola k proctor.

1 Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA

Byron J Powell

Ana a baumann, ashley m hamilton, ryan l santens.

All investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Applicants need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, many investigators may not feel equipped to write competitive proposals, and this concern is pronounced among early stage implementation researchers.

This article addresses the challenges of preparing grant applications that succeed in the emerging field of dissemination and implementation. We summarize ten ingredients that are important in implementation research grants. For each, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.

Every investigator struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project’s feasibility and likelihood of success. While no application can include a high level of detail about every ingredient, addressing the ten ingredients summarized in this article can help assure reviewers of the significance, feasibility, and impact of the proposed research.

Investigators seeking funding to conduct implementation research face the challenges of preparing a high-quality proposal and demonstrating their capacity to conduct the proposed study. Researchers need to demonstrate the progressive nature of their research agenda and their ability to build cumulatively upon the literature and their own preliminary studies. Because implementation science is an emerging field involving complex and multilevel processes, most investigators may feel ‘new to the field.’ Furthermore, young investigators may have less preliminary data, and the path to successful proposal writing may seem less clear.

This article identifies ten of the important ingredients in well-crafted implementation proposals; in particular, it addresses how investigators can set the stage for proposed work through pilot data and a well-crafted and rationalized proposed study approach. It addresses questions such as: What preliminary work is important in the grant applications, and how can implementation researchers meet this challenge? How can investigators balance scientific impact with feasibility? Where in an implementation research proposal can investigators demonstrate their capacity to conduct a study as proposed?

The importance of the question

A significant and innovative research question is the first and primary ingredient in a successful proposal. A competitive implementation research application needs to pursue scientific questions that remain unanswered, questions whose answers advance knowledge of implementation with generalizability beyond a given setting. By definition, implementation research in health focuses on a health condition or disease, healthcare settings, and particular evidence-based interventions and programs with promise of reducing a gap in quality of care. It is conducted in usual care settings with practical quality gaps that stakeholders want to reduce. However, to make a compelling argument for scientific innovation and public health significance, a research grant application must have potential beyond reducing a quality gap and implementing a particular evidence-based healthcare practice. The application must have potential to advance the science of implementation by yielding generalizable knowledge. With only one journal devoted solely to implementation science [ 1 ], researchers must be aware of implementation literature that is scattered across a host of discipline-specific journals. Implementation researchers—akin to students with multiple majors—must demonstrate their grounding in implementation science, health diseases, disorders and their treatments, and real-world healthcare delivery.

Although implementation science is often characterized as an emerging field, its bar for scientifically important questions is rising rapidly. Descriptive studies of barriers have dominated implementation science for too long, and the field is urged to ‘move on’ to questions of how and why implementation processes are effective. Accordingly, the Institute of Medicine [ 2 ] has identified studies comparing the effectiveness of alternative dissemination and implementation strategies as a top-quartile priority for comparative effectiveness research. But experimental studies testing implementation strategies need to be informed by systematic background research on the contexts and processes of implementation. While investigators must demonstrate their understanding of these complexities, their grant proposals must balance feasibility with scientific impact. This paper addresses the challenges of preparing grant applications that succeed on these fronts. Though this article focuses on U.S. funding sources and grant mechanisms, the principles that are discussed should be relevant to implementation researchers internationally.

Guidance from grant program announcements

Grant review focuses on the significance of proposed aims, impact and innovation, investigator capacity to conduct the study as proposed, and support for the study hypotheses and research design. The entire application should address these issues. Investigators early in their research careers or new to implementation science often struggle to demonstrate their capacity to conduct the proposed study and the feasibility of the proposed methods. Not all National Institutes of Health (NIH) program announcements require preliminary data. However, those that do are clear that applications must convey investigator training and experience, capacity to conduct the study as proposed, and support for the study hypotheses and research design [ 3 ]. The more complex the project, the more important it is to provide evidence of capacity and feasibility [ 4 ].

The R01grant mechanism is typically large in scope compared to the R03, R21 and R34 a . Program announcements for grant mechanisms that are preliminary to R01 studies give important clues as to how to set the stage for an R01 and demonstrate feasibility. Investigator capacity can be demonstrated by describing prior work, experience, and training relevant to the application’s setting, substantive issues, and methodology—drawing on prior employment and research experience. For example, the NIH R03 small grant mechanism is often used to establish the feasibility of procedures, pilot test instruments, and refine data management procedures to be employed in a subsequent R01. The NIH R21 and the R34 mechanisms support the development of new tools or technologies; proof of concept studies; early phases of research that evaluate the feasibility, tolerability, acceptability and safety of novel treatments; demonstrate the feasibility of recruitment protocols; and support the development of assessment protocols and manuals for programs and treatments to be tested in subsequent R01 studies. These exploratory grants do not require extensive background material or preliminary information, but rather serve as sources for gathering data for subsequent R01 studies. These grant program announcements provide a long list of how pre-R01 mechanisms can be used, and no single application can or should provide all the stage-setting work exemplified in these descriptions.

Review criteria, typically available on funding agency web sites or within program announcements, may vary slightly by funding mechanism. However grants are typically reviewed and scored according to such criteria as: significance, approach (feasibility, appropriateness, robustness), impact, innovation, investigator team, and research environment. Table ​ Table1 1 summarizes the ten ingredients, provides a checklist for reviewing applications prior to submission, and ties each ingredient to one or more of the typical grant review criteria.

Ten key ingredients for implementation research proposals

The literature does not provide a ‘. . . a comprehensive, prescriptive, and robust-yet practical-model to help…researchers understand (the) factors need to be considered and addressed’ in an R01 study [ 5 ]. Therefore we examined a variety of sources to identify recommendations and examples of background work that can strengthen implementation research proposals. This paper reflects our team’s experience with early career implementation researchers, specifically through training programs in implementation science and our work to provide technical assistance in implementation research through our university’s Clinical and Translational Science Award CTSA program. We also studied grant program announcements, notably the R03, R21, R18, and R01 program announcements in implementation science [ 6 - 9 ]. We studied how successful implementation research R01 grant applications ‘set the stage’ for the proposed study in various sections of the proposal. We conducted a literature search using combinations of the following key words: ‘implementation research,’ ‘implementation studies,’ ‘preliminary studies,’ ‘preliminary data,’ ‘pilot studies,’ ‘pilot data,’ ‘pilot,’ ‘implementation stages,’ ‘implementation phases,’ and ‘feasibility.’ We also drew on published studies describing the introduction and testing of implementation strategies and those that characterize key elements and phases of implementation research [ 10 , 11 ].

From these reviews, we identified ten ingredients that are important in all implementation research grants: the gap between usual care and evidence-based care; the background of the evidence-based treatment to be implemented, its empirical base, and requisites; the theoretical framework for implementation and explicit theoretical justification for the choice of implementation strategies; information about stakeholders’ (providers, consumers, policymakers) treatment priorities; the setting’s (and providers’) readiness to adopt new treatments; the implementation strategies planned or considered in order to implement evidence-based care; the study team’s experience with the setting, treatment, or implementation process and the research environment; the feasibility and requisites of the proposed methods; the measurement and analysis of study variables; and the health delivery setting’s policy/funding environment, leverage or support for sustaining change.

Given the sparse literature on the importance of preliminary studies for implementation science grant applications, we ‘vetted’ our list of grant application components with a convenience sample of experts. Ultimately, nine experts responded to our request, including six members of the Implementation Science editorial board. We asked the experts to rate the importance of each of the ten elements, rating them as ‘1: Very important to address this is the application,’ ‘2: Helpful but not necessary to the application,’ or ‘3: Not very important to address’ within the context of demonstrating investigator capacity and study feasibility. Respondents were also asked whether there are any additional factors that were not listed.

While all the ten ingredients below were considered important for a successful application, several experts noted that their importance varies according to the aims of the application. For example, one expert affirmed the importance of the settings’ readiness to change, but noted that it may not be crucial to address in a given proposal: ‘the setting’s readiness may be unimportant to establish or report prior to the study, because the study purpose may be to establish an answer to this question.’ However, another maintained, ‘in a good grant application, you have to dot all the ‘I’s’ and cross all the ‘T’s.’ I consider all these important.’ One expert noted that applications might need to argue the importance of implementation research itself, including the importance of closing or reducing gaps in the quality of care. This was viewed as particularly important when the study section to review the grant may not understand or appreciate implementation research. In these cases, it may be important to define and differentiate implementation research from other types of clinical and health services research. For example, it may be useful to situate one’s proposal within the Institute of Medicine’s ‘prevention research cycle,’ which demonstrates the progression from pre-intervention, efficacy, and effectiveness research to dissemination and implementation studies that focus on the adoption, sustainability, and scale-up of interventions [ 12 ]. It may also be important to convey that implementation research is very complex, necessitating the use of multiple methods, a high degree of stakeholder involvement, and a fair amount of flexibility in order to ensure that implementers will be able to respond appropriately to unforeseen barriers.

Ten key ingredients of a competitive implementation research grant application

As emphasized at the beginning of this article, the essential ingredient in a successful implementation science proposal is a research question that is innovative and, when answered, can advance the field of implementation science. Assuming that an important question has been established to potential reviewers, we propose that the following ten ingredients can help investigators demonstrate their capacity to conduct the study and to demonstrate the feasibility of completing the study as proposed. For each ingredient, we provide examples of how preliminary data, background literature, and narrative detail in the application can strengthen the application.

The care gap, or quality gap, addressed in the application

The primary rationale for all implementation efforts, and thus a key driver in implementation science, is discovering how to reduce gaps in healthcare access, quality, or, from a public health perspective, reducing the gap between Healthy People 2020 [ 13 ] goals and current health status. Accordingly, implementation research proposals should provide clear evidence that gaps exists and that there is room for improvement and impact through the proposed implementation effort. This is a primary way of demonstrating the public health significance of the proposed work.

Gaps in the quality of programs, services, and healthcare can be measured and documented at the population-, organization-, and provider-levels [ 14 ]. Several kinds of preliminary data can demonstrate the quality gap to be reduced through the proposed implementation effort. For example, investigators can emphasize the burden of disease through data that reflect its morbidity, mortality, quality of life, and cost [ 14 ]. An implementation research grant should cite service system research that demonstrates unmet need [ 15 ], the wide variation in the use of evidence-based treatments in usual care [ 16 - 19 ], or the association between the burden of disease and variations in the use of guidelines [ 20 ]. Investigators can also document that few providers adopt evidence-based treatments [ 21 , 22 ], that evidence-based treatments or programs have limited reach [ 23 ], or that penetration [ 24 ] into a system of care can be addressed by the implementation study. Regardless of the specific approach to documenting a quality gap, investigators should use rigorous methods and involve all relevant stakeholders [ 14 ]. In fact, stakeholders can demonstrate their involvement and endorse quality gaps through letters of support attesting to the lack of evidence-based services in usual care.

The evidence-based treatment to be implemented

A second key ingredient in implementation research proposals is the evidence-based program, treatment, policies, or set of services whose implementation will be studied in the proposed research [ 25 - 27 ]. The research ‘pipeline’ [ 28 - 30 ] contains many effective programs and treatments in a backlog, waiting to be implemented. Moreover, many health settings experience a huge demand for better care. An appropriate evidence-based treatment contributes to the project’s public health significance and practical impact, presuming of course that it will be studied in a way that contributes to implementation science.

Implementation research proposals must demonstrate that the evidence-based service is ready for implementation. The strength of the empirical evidence for a given guideline or treatment [ 31 , 32 ], a key part of ‘readiness,’ can be demonstrated in a variety of ways; in some fields, specific thresholds must be met before an intervention is deemed ‘evidence-based’ or ‘empirically-supported’ [ 33 - 35 ]. For example, Chambless et al. [ 35 ] suggest that interventions should demonstrate efficacy by being shown to be superior to placebos or to another treatment in at least two between group design experiments; or by showing efficacy in a large series of single case design experiments. Further, Chambless et al. [ 35 ] note that the experiments must have been conducted with treatment manuals, the characteristics of the samples must have been clearly specified, and the effects must have been demonstrated by at least two different investigators or investigative teams.

The strength of evidence for a given treatment can also be classified using the Cochrane EPOC’s criteria for levels of evidence, which considers randomized controlled trials, controlled clinical trials, time series designs, and controlled before-and-after studies as appropriate [ 36 ]. Researchers who come to implementation research as effectiveness researchers or as program or treatment developers are well positioned, because they can point to their prior research as part of their own background work. Other researchers can establish readiness for implementation by reviewing evidence for the treatment or program as part of the background literature review, preferably relying on well-conducted systematic reviews and meta-analyses of randomized-controlled trials (if available). At a minimum, ‘evaluability assessment’ [ 37 ] can help reflect what changes or improvements are needed to optimize effectiveness given the context of the implementation effort.

Conceptual model and theoretical justification

Any research striving for generalizable knowledge should be guided by and propose to test conceptual frameworks, models, and theories [ 38 ]. Yet, theory has been drastically underutilized and underspecified in implementation research [ 38 - 40 ]. For example, in a review of 235 implementation studies, less than 25% of the studies employed theory in any way, and only 6% were explicitly theory-based [ 39 ]. While translating theory into research design is not an easy task [ 36 ], the absence of theory in implementation research has limited our ability to specify key contextual variables and to identify the precise mechanisms by which implementation strategies exert their effects.

McDonald et al. [ 41 ] present a useful hierarchy of theories and models, which serves to organize the different levels of theory and specify the ways in which they can be useful in implementation research. They differentiate between conceptual models, frameworks, and systems, which are used to represent global ideas about a phenomenon and theory, which is an ‘organized, heuristic, coherent, and systematic set of statements related to significant questions that are communicated in a meaningful whole’ [ 41 ]. Within the realm of theory, they differentiate between grand or macro theories ( e.g. , Rogers’ Diffusion of Innovations theory [ 26 ]), mid-range theories ( e.g. , transtheoretical model of change [ 42 ]), and micro-theories ( e.g. , feedback intervention theory [ 43 ]). Though models, frameworks, and systems are generally at a higher level of abstraction than theories, it is important to note that the level of abstraction varies both between and within the categories of the hierarchy. The thoughtful integration of both conceptual models and theories can substantially strengthen an application.

Conceptual models, frameworks, and systems can play a critical role in anchoring a research study theoretically by portraying the key variables and relationships to be tested. Even studies that address only a subset of variables within a conceptual model need to be framed conceptually, so that reviewers perceive the larger context (and body of literature) that a particular study proposes to inform. Given the confusion surrounding definitions and terminology within the still-evolving field of dissemination and implementation [ 44 , 45 ], grant proposals need to employ consistent language, clear definitions for constructs, and the most valid and reliable measures for the constructs that correspond to the guiding conceptual framework or theoretical model. Proposal writers should be cautioned that the theory or conceptual model used to frame the study must be used within the application. A mere mention will not suffice. A conceptual model can help frame study questions and hypotheses, anchor the background literature, clarify the constructs to be measured, and illustrate the relationships to be evaluated or tested. The application must also spell out how potential findings will inform the theory or model.

Numerous models and frameworks can inform implementation research. For example, Glasgow et al. [ 23 ] RE-AIM framework can inform evaluation efforts in the area of implementation science. Similarly, Proctor et al. [ 46 ] have proposed a model that informs evaluation by differentiating implementation, service system, and clinical outcomes, and identifying a range of implementation outcomes that can be assessed [ 24 ]. Damschroder et al. ’s [ 10 ] Consolidated Framework for Implementation Research identifies five domains that are critical to successful implementation: intervention characteristics (evidentiary support, relative advantage, adaptability, trialability, and complexity); the outer setting (patient needs and resources, organizational connectedness, peer pressure, external policy and incentives); the inner setting (structural characteristics, networks and communications, culture, climate, readiness for implementation); the characteristics of the individuals involved (knowledge, self-efficacy, stage of change, identification with organization, etc.); and the process of implementation (planning, engaging, executing, reflecting, evaluating). Others have published stage or phase models of implementation. For example, the Department of Veteran Affairs’ QUERI initiative [ 47 ] specifies a four-phase model spanning pilot projects, small clinical trials, regional implementation, and implementation on the national scale; and Aarons, Hurlburt and Horwitz [ 48 ] developed a four phase model of exploration, adoption/preparation, active implementation, and sustainment. Magnabosco [ 49 ] delineates between pre-implementation, initial implementation, and sustainability planning phases.

McDonald et al. [ 41 ] note that grand theories are similar to conceptual models, and that they generally represent theories of change. They differentiate between classical models of change that emphasize natural or passive change processes, such as Rogers’ diffusion of innovations theory [ 26 ], and planned models of change that specify central elements of active implementation efforts. Investigators may find it more helpful to draw from mid-range theories because they discuss the mechanisms of change at various levels of the implementation context [ 26 ]. For example, social psychological theories, organizational theories, cognitive psychology theories, educational theories, and a host of others may be relevant to the proposed project. While conceptual models are useful in framing a study theoretically and providing a ‘big picture’ of the hypothesized relationships between variables, mid-range theories can be more helpful in justifying the selection of specific implementation strategies specifying the mechanisms by which they may exert their effects. Given the different roles that theory can play in implementation research, investigators would be wise to consider relevant theories at multiple levels of the theoretical hierarchy when preparing their proposals. It is far beyond the scope of this article to review conceptual models and theories in detail; however, several authors have produced invaluable syntheses of conceptual models and theories that investigators may find useful [ 10 , 41 , 50 - 56 ].

Stakeholder priorities and engagement in change

Successful implementation of evidence-based interventions largely depends on their fit with the preferences and priorities of those who shape, deliver, and participate in healthcare. Stakeholders in implementation, and thus in implementation research, include treatment or guideline developers, researchers, administrators, providers, funders, community-based organizations, consumers, families, and perhaps legislators who shape reimbursement policies (see Mendel et al. ’ article [ 57 ] for a framework that outlines different levels of stakeholders). These stakeholders are likely to vary in their knowledge, perceptions, and preferences for healthcare. Their perspectives contribute substantially to the context of implementation and must be understood and addressed if the implementation effort is to succeed. A National Institute of Mental Health Council workgroup report [ 58 ] calls for the engagement of multiple stakeholder perspectives, from concept development to implementation, in order to improve the sustainability of evidence-based services in real-world practice. The engagement of key stakeholders in implementation research affects both the impact of proposed implementation efforts, the sustainability of the proposed change, and the feasibility and ultimate success of the proposed research project. Thus, implementation research grant proposals should convey the extent and manner in which key stakeholders are engaged in the project.

Stakeholders and researchers can forge different types of collaborative relationships. Lindamer et al. [ 59 ] describe three different approaches researchers and stakeholders can take that vary with respect to the level of participation of the stakeholders and community in decisions about the research. In the ‘community-targeted’ approach, stakeholders are involved in recruitment and in the dissemination of the results. In the ‘community-based’ approach, stakeholders participate in the selection of research topics, but the researcher makes the final decision on the study design, methodology, and analysis of data. Finally, the ‘community-driven’ approach or community-based participatory research (CBPR) approach entails participation of the stakeholders in all aspects of the research. Some authors advocate for the CBPR model as a strategy to decrease the gap between research and practice because it addresses some of the barriers to implementation and dissemination [ 60 - 62 ] by enhancing the external validity of the research and promoting the sustainability of the intervention. Kerner et al. [ 62 ] note:

‘When community-based organizations are involved as full partners in study design, implementation, and evaluation of study findings, these organizations may be more amenable to adopting the approaches identified as being effective, as their tacit knowledge about ‘what works’ would have been evaluated explicitly through research.’

Stakeholder analysis can be carried out to evaluate and understand stakeholders’ interests, interrelations, influences, preferences, and priorities. The information gathered from stakeholder analysis can then be used to develop strategies for collaborating with stakeholders, to facilitate the implementation of decisions or organizational objectives, or to understand the future of policy directions [ 63 , 64 ].

Implementation research grant applications are stronger when preliminary data, qualitative or quantitative, reflect stakeholder preferences around the proposed change. Engagement is also reflected in publications that the principal investigator (PI) and key stakeholders have shared in authorship, or methodological details that reflect stakeholder priorities. Letters of support are a minimal reflection of stakeholder investment in the proposed implementation project.

Context: Setting’s readiness to adopt new services/ treatments/ programs

Implementation research proposals are strengthened by information that reflects the setting’s readiness, capacity, or appetite for change, specifically around adoption of the proposed evidence-based treatment. This is not to say that all implementation research should be conducted in settings with high appetite for change. Implementation research is often criticized for disproportionate focus on settings that are eager and ready for change. ‘Cherry picking’ sites, where change is virtually guaranteed, or studying implementation only with eager and early adopters, does not produce knowledge that can generalize to usual care, where change is often challenging. The field of implementation science needs information about the process of change where readiness varies, including settings where change is resisted.

Preliminary data on the organizational and policy context and its readiness for change can strengthen an application. Typically viewed as ‘nuisance’ variance to be controlled in efficacy and effectiveness research, contextual factors are key in implementation research [ 65 - 67 ]. The primacy of context is reflected in the choice of ‘it’s all about context’ as a theme at the 2011 NIH Training Institute in Dissemination and Implementation Research in Health [ 68 ]. Because organization, policy, and funding context may be among the strongest influences on implementation outcomes, context needs to be examined front and center in implementation research [ 69 ]. A number of scales are available to capture one key aspect of context, the setting’s readiness or capacity for change. Weiner et al. [ 70 ] extensive review focusing on the conceptualization and measurement of organizational readiness for change identified 43 different instruments; though, they acknowledged substantial problems with the reliability and validity of many of the measures. Due in part to issues with reliability and validity of the measures used in the field, work in this area is ongoing [ 71 , 72 ].

Other approaches to assessing readiness have focused on organizational culture, climate, and work attitudes [ 73 ], and on providers’ attitudes towards evidence-based practices [ 21 , 22 , 74 ]. Furthermore, a prospective identification of implementation barriers and facilitators can be helpful in demonstrating readiness to change, increasing reviewers’ confidence that the PI has thoroughly assessed the implementation context, and informing the selection of implementation strategies (discussed in the following section) [ 75 - 77 ]. An evaluation of barriers and facilitators can be conducted through qualitative [ 78 - 80 ] or survey [ 81 , 82 ] methodology. In fact, a number of scales for measuring implementation barriers have been developed [ 74 , 83 , 84 ]. Letters from agency partners or policy makers, while weaker than data, can also be used to convey the setting’s readiness and capacity for change. Letters are stronger when they address the alignment of the implementation effort to setting or organizational priorities or to current or emergent policies.

Implementation strategy/process

Though the assessment of implementation barriers can play an important role in implementation research, the ‘rising bar’ in the field demands that investigators move beyond the study of barriers to research that generates knowledge about the implementation processes and strategies that can overcome them. Accordingly, the NIH has prioritized efforts to ‘identify, develop, and refine effective and efficient methods, structures, and strategies to disseminate and implement’ innovations in healthcare [ 7 ].

A number of implementation strategies have been identified and discussed in the literature [ 36 , 85 - 87 ]. However, as the Improved Clinical Effectiveness through Behavioural Research Group notes [ 38 ], the most consistent finding from systematic reviews of implementation strategies is that most are effective some, but not all of the time, and produce effect sizes ranging from no effect to a large effect. Our inability to determine how, why, when, and for whom these strategies are effective is hampered in large part by the absence of detailed descriptions of implementation strategies [ 40 ], the use of inconsistent language [ 44 ], and the lack of clear theoretical justification for the selection of specific strategies [ 39 ]. Thus, investigators should take great care in providing detailed descriptions of implementation strategies to be observed or empirically tested. Implementation Science has endorsed [ 40 ] the use of the WIDER Recommendations to Improve Reporting of the Content of Behaviour Change Interventions [ 88 ] as a means of improving the conduct and reporting of implementation research, and these recommendations will undoubtedly be useful to investigators whose proposals employ implementation strategies. Investigators may also find the Standards for Quality Improvement Reporting Excellence (SQUIRE) helpful [ 89 ]. Additional design specific reporting guidelines can be found on the Equator Network website [ 90 ]. The selection of strategies must be justified conceptually by drawing upon models and frameworks that outline critical implementation elements [ 10 ]. Theory should be used to explain the mechanisms through which implementation strategies are proposed to exert their effects [ 39 ], and it may be helpful to clarify the proposed mechanisms of change through the development of a logic model and illustrate the model through a figure [ 91 ].

According to Brian Mittman, in addition to being theory-based, implementation strategies should be: multifaceted or multilevel (if appropriate); robust or readily adaptable; feasible and acceptable to stakeholders; compelling, saleable, trialable, and observable; sustainable; and scalable [ 92 , 93 ]. We therefore emphasize taking stock of the budget impact of implementation strategies [ 94 ] as well as any cost and cost-effectiveness data related to the implementation strategies [ 95 ]. Although budget impact is a key concern to administrators and some funding agencies require budget impact analysis, implementation science to date suffers a dearth of economic evaluations from which to draw [ 96 , 97 ].

The empirical evidence for the effectiveness of multifaceted strategies has been mixed, because early research touted the benefits of multifaceted strategies [ 98 , 99 ], while a systematic review of 235 implementation trials by Grimshaw et al. found no relationship between the number of component interventions and the effects of multifaceted interventions [ 100 ]. However, Wensing et al. [ 101 ] note that while multifaceted interventions were assumed to address multiple barriers to change, many focus on only one barrier. For example, providing training and consultation is a multifaceted implementation strategy; however, it primarily serves to increase provider knowledge, and does not address other implementation barriers. Thus, Wensing et al. [ 101 ] argue that multifaceted interventions could be more effective if they address different types of implementation barriers ( e.g. , provider knowledge and the organizational context). While the methods for tailoring clinical interventions and implementation strategies to local contexts need to be improved [ 102 ], intervention mapping [ 103 ] and a recently developed ‘behaviour change wheel’ [ 104 ] are two promising approaches.

Proposals that employ multifaceted and multilevel strategies that address prospectively identified implementation barriers [ 102 ] may be more compelling to review committees, but mounting complex experiments may be beyond the reach of many early-stage investigators and many grant mechanisms. However, it is within the scope of R03, R21, and R34 supported research to develop implementation strategies and to conduct pilot tests of their feasibility and acceptability—work that can strengthen the case for sustainability and scalability. Proposal writers should provide preliminary work for implementation strategies in much the same way that intervention developers do, such as by providing manuals or protocols to guide their use, and methods to gauge their fidelity. Such work is illustrated in the pilot study conducted by Kauth et al. [ 105 ], which demonstrated that an external facilitation strategy intended to increase the use of cognitive behavioral therapy within Veteran Affairs clinics was a promising and low-cost strategy; such pilot data would likely bolster reviewers’ confidence that the strategy is feasible, scalable, and ultimately, sustainable. Investigators should also make plans to document any modifications to the intervention and, if possible, incorporate adaptation models to the implementation process, because interventions are rarely implemented without being modified [ 67 , 106 ].

While providing detailed specification of theory-based implementation strategies is critical, it is also imperative that investigators acknowledge the complexity of implementation processes. Aarons and Palinkas [ 107 ] comment:

‘It is unrealistic to assume that implementation is a simple process, that one can identify all of the salient concerns, be completely prepared, and then implement effectively without adjustments. It is becoming increasingly clear that being prepared to implement EBP means being prepared to evaluate, adjust, and adapt in a continuing process that includes give and take between intervention developers, service system researchers, organizations, providers, and consumers.’

Ultimately, proposals that reflect the PI’s understanding of the complexity of the process of implementing evidence-based practices and that provide supporting detail about strategies and processes will be perceived as more feasible to complete through the proposed methods.

Team experience with the setting, treatment, implementation process, and research environment

Grant reviewers are asked to specifically assess a PI’s capacity to successfully complete a proposed study. Grant applications that convey the team’s experience with the study setting, the treatment whose implementation is being studied, and implementation processes help convey capacity and feasibility to complete an implementation research project [ 108 ].

The reader should observe that NIH gives different scores for the team experience with the setting and for the research environment ( http://grants.nih.gov/grants/writing_application.htm ) but the purpose of both sections is demonstrating capacity to successfully carry out the study as proposed. Investigators can convey capacity through a variety of ways. Chief among them is building a strong research team, whose members bring depth and experience in areas the PI does not yet have. Implementation research exemplifies multidisciplinary team science, informed by a diverse range of substantive and methodological fields [ 96 , 109 ]. A team that brings the needed disciplines and skill sets directly to the project enhances the project’s likelihood of success. Early-stage implementation researchers who collaborate or partner with senior investigators reassure reviewers that the proposed work will benefit from the senior team member’s experience and expertise. Similarly, collaborators play important roles in complementing, or rounding out, the PI’s disciplinary perspective and methodological skill set. Early career investigators, therefore, should surround themselves with more established colleagues who bring knowledge and experience in areas key to the study aims and methods. The narrative should cite team members’ relevant work, and their prior work can be addressed in a discussion of preliminary studies. Additionally, the new formats for NIH biosketches and budget justifications enable a clear portrayal of what each team member brings to the proposed study.

For the NIH applications, the research environment is detailed in the resources and environment section of a grant application. Here, an investigator can describe the setting’s track record in implementation research; research centers, labs, and offices that the PI can draw on; and structural and historic ties to healthcare settings. For example, a PI can describe how their project will draw upon the University’s CTSA program [ 110 ], statistics or design labs, established pools of research staff, and health services research centers. Preliminary studies and biosketches provide additional ways to convey the strengths of the environment and context within which an investigator will launch a proposed study.

In summary, researchers need to detail the strengths of the research environment, emphasizing in particular the resources, senior investigators, and research infrastructure that can contribute to the success of the proposed study. A strong research environment is especially important for implementation research, which is typically team-based, requires expertise of multiple disciplines, and requires strong relationships between researchers and community based health settings. Investigators who are surrounded by experienced implementation researchers, working in a setting with strong community ties, and drawing on experienced research staff can inspire greater confidence in the proposed study’s likelihood of success.

Feasibility of proposed research design and methods

One of the most important functions of preliminary work is to demonstrate the feasibility of the proposed research design and methods. Landsverk [ 108 ] urges PIs to consider every possible question reviewers might raise, and to explicitly address those issues in the application. Data from small feasibility studies or pilot work around referral flow; participant entry into the study; participant retention; and the extent to which key measures are understood by participants, acceptable for use, and capture variability can demonstrate that the proposed methods are likely to work. The methods section should contain as much detail as possible, as well as lay out possible choice junctures and contingencies, should methods not work as planned. It is not only important to justify methodological choices, but also to discuss why potential alternatives were not selected. For example, if randomization is not feasible or acceptable to stakeholders, investigators should make that clear. Letters from study site collaborators can support, but should not replace, the narrative’s detail on study methods. For example, letters attesting the willingness of study sites to be randomized or to support recruitment for the proposed timeframe can help offset reviewer concerns about some of the real-world challenges of launching implementation studies.

Measurement and analysis

A grant application must specify a measurement plan for each construct in the study’s overarching conceptual model or guiding theory, whether those constructs pertain to implementation strategies, the context of implementation, stakeholder preferences and priorities, and implementation outcomes [ 111 ]. Yet, crafting the study approach section is complicated by the current lack of consensus on methodological approaches to the study of implementation processes, measuring implementation context and outcomes, and testing implementation strategies [ 112 , 113 ]. Measurement is a particularly important aspect of study methods, because it determines the quality of data. Unlike efficacy and effectiveness studies, implementation research often involves some customization of an intervention to fit local context; accordingly, measurement plans need to address the intervention’s degree of customization versus fidelity [ 97 ]. Moreover, implementation science encompasses a broad range of constructs, from a variety of disciplines, with little standardization of measures or agreement on definitions of constructs across different studies, fields, authors, or research groups, further compounding the burden to present a clear and robust measurement plan along with its rationale. Two current initiatives seek to advance the harmonization, standardization, and rigor of measurement in implementation science, the U.S. National Cancer Institute’s (NCI) Grid-Enabled Measures (GEM) portal [ 114 ] and the Comprehensive Review of Dissemination and Implementation Science Instruments efforts supported by the Seattle Implementation Research Conference (SIRC) at the University of Washington [ 115 ]. Both initiatives engage the implementation science research community to enhance the quality and harmonization of measures. Their respective web sites are being populated with measures and ratings, affording grant writers an invaluable resource in addressing a key methodological challenge.

Key challenges in crafting the analysis plan for implementation studies include: determining the unit of analysis, given the ‘action’ at individual, team, organizational, and policy environments; shaping meditational analyses given the role of contextual variables; and developing and using appropriate methods for characterizing the speed, quality, and degree of implementation. The proposed study’s design, assessment tools, analytic strategies, and analytic tools must address these challenges in some manner [ 113 ]. Grant applications that propose the testing of implementation strategies or processes often provide preliminary data from small-scale pilot studies to examine feasibility and assess sources of variation. However, the magnitude of effects in small pilots should be determined by clinical relevance [ 113 ], given the uncertainty of power calculations from small scale studies [ 116 ].

Policy/funding environment; leverage or support for sustaining change

PIs should ensure that grant applications reflect their understanding of the policy and funding context of the implementation effort. Health policies differ in many ways that impact quality [ 117 ], and legal, reimbursement, and regulatory factors affect the adoption and sustainability of evidence-based treatments [ 118 ]. Raghavan et al. [ 119 ] discuss the policy ecology of implementation, and emphasize that greater attention should be paid to marginal costs associated with implementing evidence-based treatments, including expenses for provider training, supervision, and consultation. Glasgow et al. [ 120 ] recently extended their heretofore behaviorally focused RE-AIM framework for public health interventions to health policies, revealing the challenges associated with policy as a practice-change lever.

PIs can address the policy context of the implementation initiative through the narrative, background literature, letters of support, and the resource and environment section. Proposals that address how the implementation initiative aligns with policy trends enhance their likelihood of being viewed as having high public health significance, as well as greater practical impact, feasibility, and sustainability. It is important to note that it may behoove investigators to address the policy context within a proposal even if it is not likely to be facilitative of implementation, because it demonstrates to reviewers that the investigator is not naïve to the challenges and barriers that exist at this level.

We identify and discuss ten key ingredients in implementation research grant proposals. The paper reflects the team’s experience and expertise: writing for federal funding agencies in the United States. We acknowledge that this will be a strength for some readers and a limitation for international readers, whom we encourage to contribute additional perspectives. Setting the stage with careful background detail and preliminary data may be more important for implementation research, which poses a unique set of challenges that investigators should anticipate and demonstrate their capacity to manage. Data to set the stage for implementation research may be collected by the study team through preliminary, feasibility, or pilot studies, or the team may draw on others’ work, citing background literature to establish readiness for the proposed research.

Every PI struggles with the challenge of fitting into a page-limited application the research background, methodological detail, and information that can convey the project’s feasibility and likelihood of success. The relative emphasis on, and thus length of text addressing, the various sections of a grant proposal varies with the program mechanism, application ‘call,’ and funding source. For NIH applications, most attention and detail should be allocated to the study method because the ‘approach’ section is typically weighted most heavily in scoring. Moreover, the under-specification or lack of detail in study methodology usually receives the bulk of reviewer criticism. Well-constructed, parsimonious tables, logic models, and figures reflecting key concepts and the analytic plan for testing their relationships all help add clarity, focus reviewers, and prevent misperceptions. All implementation research grants need to propose aims, study questions, or hypotheses whose answers will advance implementation science. Beyond this fundamental grounding, proposed implementation studies should address most, if not all, of the ingredients identified here. While no application can include a high level of detail about every ingredient, addressing these components can help assure reviewers of the significance, feasibility, and impact of the proposed research.

a For more information regarding different grant mechanisms, please see: http://grants.nih.gov/grants/funding/funding_program.htm .

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

EKP conceived the idea for this paper and led the writing. BJP, AAB, AMH, and RLS contributed to the conceptualization, literature review, and the writing of this manuscript. All authors read and approved the final manuscript.

Authors’ information

EKP directs the Center for Mental Health Services Research at Washington University in St. Louis (NIMH P30 MH085979), the Dissemination and Implementation Research Core (DIRC) of the Washington University Institute of Clinical and Translational Sciences (NCRR UL1RR024992), and the Implementation Research Institute (NIMH R25 MH080916).

Acknowledgements

Preparation of this paper was supported in part by National Center for Research Resources through the Dissemination and Implementation Research Core of Washington University in St. Louis’ Institute of Clinical and Translational Sciences (NCRR UL1 RR024992) and the National Institute of Mental Health through the Center for Mental Health Services Research (NIMH P30 MH068579), the Implementation Research Institute (NIMH R25 MH080916), and a Ruth L. Kirschstein National Research Service Award (NIMH T32 RR024992). An earlier version of this paper was an invited presentation at an early investigator workshop, held at the 4 th Annual National Institutes of Health Conference on Advancing the Science of Dissemination and Implementation on March 22, 2011 in Bethesda, Maryland.

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How to write a successful grant application: guidance provided by the European Society of Clinical Pharmacy

Anita e. weidmann.

1 Department of Clinical Pharmacy, Innsbruck University, Innsbruck, Austria

Cathal A. Cadogan

2 School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland

Daniela Fialová

3 Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic

4 Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic

Ankie Hazen

5 Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

Martin Henman

6 Trinity College Dublin, Dublin, Ireland

Monika Lutters

7 Kantonsspital Aarau, Aarau, Switzerland

Betul Okuyan

8 Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Turkey

Vibhu Paudyal

9 University of Birmingham, Birmingham, United Kingdom

Francesca Wirth

10 Department of Pharmacy, University of Malta, Msida, Malta

Considering a rejection rate of 80–90%, the preparation of a research grant is often considered a daunting task since it is resource intensive and there is no guarantee of success, even for seasoned researchers. This commentary provides a summary of the key points a researcher needs to consider when writing a research grant proposal, outlining: (1) how to conceptualise the research idea; (2) how to find the right funding call; (3) the importance of planning; (4) how to write; (5) what to write, and (6) key questions for reflection during preparation. It attempts to explain the difficulties associated with finding calls in clinical pharmacy and advanced pharmacy practice, and how to overcome them. The commentary aims to assist all pharmacy practice and health services research colleagues new to the grant application process, as well as experienced researchers striving to improve their grant review scores. The guidance in this paper is part of ESCP’s commitment to stimulate “ innovative and high-quality research in all areas of clinical pharmacy ”.

Writing research grants is a central part of any good quality research. Once a detailed research proposal has been submitted, it is subjected to an expert peer review process. Such reviews are designed to reach a funding decision, with feedback provided to improve the study for this and any future submissions. Depending on the length of the proposal, complexity of the research and experience of the research team, a proposal can take between six to twelve months to write [ 1 ]. Ample time must be given to the writing of hypothesis/research aim, budgeting, discussion with colleagues and several rounds of feedback [ 2 ]. The draft research proposal should always be completed well before the deadline to allow for last minute delays. An application which is not fully developed should not be submitted since it will most likely be rejected [ 3 ].

Despite the large effort that goes into each grant application, success rates are low. Application success rates for Horizon 2020 were < 15% [ 4 ] and < 20% for the National Institute of Health (NIH) [ 5 – 8 ]. With these statistics in mind, it is evident that often repeated submissions are required before securing funding. Due to a paucity of specific clinical pharmacy grant awarding bodies, writing a grant application for a clinical pharmacy or pharmacy practice research project often involves multidisciplinary collaborations with other healthcare professions and focus on a specific patient population or condition. There is no guarantee of success when trying to secure funding for research. Even the most seasoned researchers will have applications rejected. The key is to never give up. This commentary provides useful pointers for the planning and execution of grant writing.

Conceptualising your research idea

Before writing a research grant proposal/application, consider what the research should achieve in the short, medium, and long term, and how the research goals will serve patients, science and society [ 9 , 10 ]. Practical implications of research, policy impact or positive impact on society and active patient/public involvement are highly valued by many research agencies as research should not be conducted “only for research”, serving the researchers’ interests. EU health policy and action strategies (CORDIS database) and other national strategies, such as national mental health strategy for grants within mental disorders, should be considered, as well as dissemination strategies, project deliverables, outcomes and lay public invitations to participate. The Science Community COMPASS has developed a useful “Message Box Tool” that can help in the identification of benefits and solutions, as well as the all-important “So What?” of the research [ 11 ]. Clearly determine what the lead researcher’s personal and professional strengths, expertise and past experiences are, and carefully select the research team to close these gaps [ 12 – 14 ].

How to find the right funding call

When trying to identify the right type of grant according to the research ambitions, one should be mindful that several types of grants exist, including small project grants (for equipment, imaging costs), personal fellowships (for salary costs, sometimes including project costs), project grants (for a combination of salary and project costs), programme grants (for comprehensive project costs and salary for several staff members), start-up grants and travel grants [ 15 ]. Types of grants include EU grants (e.g. Horizon, Norway Grant), commercial grants (e.g. healthcare agencies and insurance companies), New Health Program grants ideal for new, reimbursed clinical pharmacy service projects and national grants (e.g. FWF (Austria), ARRS (Slovenia), NKFIH (Hungary), NCN (Poland), FWO (Belgium), HRZZ (Croatia), GAČR (Czech Republic), SNSF (Switzerland), SSF (Sweden). It is worth remembering that early career researchers, normally within ten years of finishing a PhD, have a particular sub-category within most grants.

Many national agencies only have one “Pharmacy” category. This results in clinical pharmacy and advanced clinical pharmacy practice projects competing with pharmaceutical chemistry, pharmaceutical biology and pharmacy technology submissions, thereby reducing the success rate as these research areas can often be very advanced in most EU countries compared to clinical and advanced pharmacy practice. A second possible submission category is “Public Health”. Several essential factors can impact the grant selection, such as research field, budget capacity, leading researcher’s experience and bilateral grants. Examples of successful clinical pharmacy funded research studies can be found in the published literature [ 16 – 20 ].

Plan, plan, plan

One key element of successful grant writing is the ability to plan and organise time. In order to develop a realistic work plan and achieve milestones, it is imperative to note deadlines and to be well-informed about the details of what is required. The development of a table or Gantt Chart that notes milestones, outcomes and deliverables is useful [ 21 ].

All funders are quite specific about what they will and will not fund. Research your potential funders well in advance. It is vital to pay attention to the aims, ambitions and guidelines of the grant awarding bodies and focus your proposal accordingly. Submitting an application which does not adhere to the guidelines may lead to very early rejection. It is helpful to prepare the grant application in such a way that the reviewers can easily find the information they are looking for [ 15 , 22 ]. This includes checking the reviewers’ reports and adding “bolded” sentences into the application to allow immediate emphasis. Reviewers’ reports are often available on the agencies’ websites. It is extremely useful to read previously submitted and funded or rejected proposals to further help in the identification of what is required in each application. Most funding agencies publish a funded project list, and the ‘Centre for Open Science (COS) Database of Funded Research’ enables tracking of funding histories from leading agencies around the world [ 23 ]. Another useful recommendation is to talk to colleagues who have been successful when applying to that particular funder. Funding agency grant officers can provide advice on the suitability of the proposal and the application process.

It is important to pay particular attention to deadlines for the grant proposal and ensure that sufficient time is allocated for completion of all parts of the application, particularly those that are not fully within one’s own control, for example, gathering any required signatures/approvals. Funders will generally not review an application submitted beyond the deadline.

Lastly, it is important to obtain insight into the decision process of grants. Research applications are sent to several reviewers, who are either volunteers or receive a small compensation to judge the application on previously determined criteria. While the judging criteria may vary from funder to funder, the key considerations are:

• Is there a clear statement of the research aim(s)/research question(s)/research objective(s)?
• Is the proposed research “state-of-the-art” in its field and has all relevant literature been reviewed?
• Is the method likely to yield valid, reliable, trustworthy data to answer question 1.?
• If the answer to the second question is ’yes’, then what is the impact of financing this study on patient care, professional practice, society etc.?
• Is there sufficient confidence that the research team will deliver this study on time with expected quality outputs and on budget?
• Does the study provide value for money?

How to write

The key to good grant proposal writing is to be concise yet engaging. The use of colour and modern web-based tools such as #hashtags, webpage links, and links to YouTube presentations are becoming increasingly popular to improve the interest of a submission and facilitate a swift decision-making process. Ensure use of the exact section headings provided in the guidance, and use the keywords provided in the funding call documentation to reflect alignment with the funding bodies’ key interests. Attention to detail cannot be overstated; the quality and accuracy of the research proposal reflect the quality and accuracy of the research [ 24 ]. Try to adopt a clear, succinct, and simple writing style, making the grant easy to read. Having a clear focus can help to boost a grant to the top of a reviewer’s pile [ 25 , 26 ]. A clearly stated scientific question, hypothesis, and rationale are imperative. The reviewer should not have to work to understand the project [ 27 ]. Allow for plenty of time to incorporate feedback from trusted individuals with the appropriate expertise and consider having reviews for readability by non-experts.

What to write

Abstract, lay summary and background/rationale.

Take sufficient time to draft the scientific abstract and summary for the lay public. These should clearly state the long-term goal of the research, the aim and specific testable objectives, as well as the potential impact of the work. The research aim is a broad statement of research intent that sets out what the project hopes to achieve at the end. Research objectives are specific statements that define measurable outcomes of the project [ 28 , 29 ].

The lay summary is important for non-subject experts to quickly grasp the purpose and aims of the research. This is important in light of the increased emphasis on patient and public involvement in the design of the research. The abstract is often given little attention by the applicants, yet is essential. If reviewers have many applications to read, they may form a quick judgement when reading the abstract. The background should develop the argument for the study. It should flow and highlight the relevant literature and policy or society needs statements which support the argument, but at the same time must be balanced. It should focus on the need for the study at the local, national and international level, highlighting the knowledge gap the study addresses and what the proposed research adds. Ensure this section is well-referenced. The innovation section addresses the ‘‘So what?’’ question and should clearly explain how this research is important to develop an understanding in this field of practice and its potential impact. Will it change practice, or will it change the understanding of the disease process or its treatment? Will it generate new avenues for future scientific study? [ 30 ].

Hypothesis/aims and objectives

For the hypothesis, state the core idea of the grant in one or two sentences. It should be concise, and lead to testable specific aims. This section is fundamental; if it is unclear or poorly written, the reviewers may stop reading and reject the application. Do not attempt to make the aims overly complex. Well-written aims should be simply stated. Criteria such as PICO (population, intervention, comparison, outcomes) [ 31 ], and FINER (feasible, interesting, novel, ethical, relevant) [ 32 ], provide useful frameworks to help in writing aim(s), research question(s), objective(s) and hypotheses. Pay attention to the distinction between aim(s), research question(s), objective(s) and hypotheses. While it is tempting to want to claim that enormously complex problems can be solved in a single project, do not overreach. It is important to be realistic [ 25 ].

Experimental design, methods and expertise

The methodology is one of the most important parts of getting a grant proposal accepted. The reviewing board should be convinced that the relevant methodology is well within the research teams’ expertise. Any evidence of potential success, such as preliminary results or pilot studies strengthen the application significantly [ 33 ]. The methodology must relate directly to the aim. Structuring this section into specific activities/ set of activities that address each research question or objective should be considered. This clarifies how each question/ objective will be addressed. Each work-package should clearly define the title of the research question/objective to be addressed, the activities to be carried out including milestones and deliverables, and the overall duration of the proposed work-package. Deliverables should be presented in table format for ease of review. Each subsequent work-package should start once the previous one has been completed to provide a clear picture of timelines, milestones and deliverables which reflect stakeholder involvement and overall organisation of the proposed project. Using relevant EQUATOR Network reporting guidelines enhances the quality of detail included in the design [ 34 ]. Key elements of this methodology are detailed in Table  1 .

Summary of the key elements of the experimental design, methods and expertise

Proposed budget

The budget should be designed based on the needs of the project and the funding agency’s policies and instructions. Each aspect of the budget must be sufficiently justified to ensure accountability to the grant awarding body [ 35 ]. Costing and justification of the time of those involved, any equipment, consumables, travel, payment for participants, dissemination costs and other relevant costs are required. The funders will be looking for value for money and not necessarily a low-cost study. Ensure that the total budget is within the allocated funding frame.

Provide a breakdown of the key work packages and tasks to be completed, as well as an indication of the anticipated duration. Include a Gantt chart (A table detailing the most general project content milestones and activities) to demonstrate that all aspects of the proposal have been well thought through [ 21 ].

Critical appraisal, limitations, and impact of the proposed research

It is important to detail any strengths and limitations of the proposed project. Omitting these will present the reviewing board with sufficient grounds to reject the proposal [ 36 ]. Provide a clear statement about the short and long-term impact of the research [ 37 , 38 ]. The reviewers will pay particular attention to the differences the study can make and how potential impact aligns with the funding bodies goals as well as national policies. This statement is essential to make an informed decision whether or not to support the application. Useful diagrams summarise the different levels of impact [ 39 ].

Table  2 provides a summary of the key elements of project grants and key questions to ask oneself.

Summary of the key elements of project grants and key questions to ask oneself.

(Adapted from [ 5 ]: Koppelmann GH, Holloway JW. Successful grant writing. Paediatr Respir Rev. 2012; 13:63–66.)

Although the grant writing process is time-consuming and complex, support is widely available at each stage. It is important to involve colleagues and collaborators to improve the proposal as much as possible and invest time in the detailed planning and execution. Even if the grant is not awarded, do not be disheartened. Use the feedback for improvement and exercise resilience and persistence in pursuing your research ambition.

The guidance in this paper is part of ESCP’s commitment to stimulate “innovative and high-quality research in all areas of clinical pharmacy”. In a previous ESCP survey, it was found that few opportunities for collaboration (especially for grant applications) was one of the key barriers for members towards conducting research [ 40 ]. ESCP promotes networking, which is essential for multi-centre grant applications, both among ESCP members and with other organisations as it recognises the need for “multi-centre research in all areas of clinical pharmacy both within countries and between countries or differing healthcare delivery systems”. ESCP is planning to relaunch its own research grant which was paused during the pandemic, and it is also planning to provide ESCP members with information about the research grants offered by other organizations. ESCP is exploring partnering with other organisations to develop research proposals in areas of common interest and, in the near future, it will ask its members about their research priorities. Taken together, these initiatives will inform ESCP’s research strategy and help it to formulate policies to address the challenges its members face.

Acknowledgements

Research works of Assoc. Prof. Fialová were also supported by the institutional program Cooperation of the Faculty of Pharmacy, Charles University.

Open access funding provided by University of Innsbruck and Medical University of Innsbruck. This work was conducted without external funding.

Conflicts of interest

The authors have not disclosed any competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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DePaul University Research Services > Research Development > Grant Writing

​ORS offers grant writing support for the narrative portions of proposals to federal agencies and other governmental funders, with a special focus on projects that are multidisciplinary in nature or that involve partnerships between DePaul and other institutions. We directly support faculty to succeed in their efforts to acquire funding, and also work with Dean's Offices and other leaders to develop innovative program and proposal ideas, identify faculty for research initiatives, and offer targeted training.​​

• Edit part or all of a narrative before submission.
• Help you revise a proposal that was not successful to prepare for resubmission.
• Help you think through your project idea and decide how to structure your narrative.
• Draft select sections of your narrative.
• Provide project management for larger submissions, including hosting regular check-in meetings, coordinating letters of support and collaboration, and facilitating additional documents for the submission.

Interested in learning more about grant writing generally? The Grant Writer offers  trainings, lunch-and-learn sessions, and other events to support general faculty learning around the grant writing process. Check the ORS News & Events page​ for upcoming training sessions, or reach out directly to request assistance.

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