Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., & Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65–76. https://doi.org/10.1007/s10488-010-0319-7 (Paper)

As the field of implementation science began to emerge, this article by Proctor and colleagues was an early effort to define key constructs as implementation outcomes. Although they did not formally name this work, the field often refers to this Proctor et al. articles as the Implementation Outcomes Framework (IOF). Another key contribution is the theoretical differentiation of implementation outcomes from service outcomes and client outcomes.

Damschroder, L. J., Reardon, C. M., Opra Widerquist, M. A., & Lowery, J. (2022). Conceptualizing outcomes for use with the Consolidated Framework for Implementation Research (CFIR): The CFIR Outcomes Addendum. Implementation Science, 17(1), Article 7. https://doi.org/10.1186/s13012-021-01181-5 (Paper)

The original CFIR framework (1.0) did not provide details about measuring implementation outcomes, so when updating CFIR (2.0), Damschroder and colleagues have provided more details to delineate implementation outcomes from innovation outcomes, while also conceptualizing anticipated implementation outcomes from actual implementation outcomes. In contrast to Proctor et al.’s IOF, the CFIR Outcomes do not include attitudinal antecedents such as acceptability, appropriateness, or feasibility.

Glasgow, R. E., Vogt, T. M., & Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions: The RE‑AIM framework. American Journal of Public Health, 89(9), 1322–1327. https://doi.org/10.2105/AJPH.89.9.1322 (Paper)

RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) is a popular framework developed by Dr. Russell Glasgow and colleagues for measuring implementation outcomes. This seminal paper describes key features of this framework in a concise way. Researchers intending to use RE-AIM as an outcome framework are encouraged to examine more recent papers for resources regarding measurement.

Wesolowicz, D. M., Becker, W. C., Alegría, M., Chin-Purcell, L., Glass, J. E., Knudsen, H. K., Dow, P. M., Seal, K. H., & McGinty, E. B. (2025). Integrating implementation outcomes into effectiveness studies: A practical guide for clinical interventionists. Journal of General Internal Medicine, 40, 2376–2382. https://doi.org/10.1007/s11606-025-09551-1 (Paper)

This manuscript aims to encourage effectiveness studies to integrate implementation outcomes while defining key implementation outcomes and providing practical guidance around measurement.

The Implementation Outcomes Repository provides an archive of instruments that are available for measuring implementation outcomes, with an emphasis on constructs that map onto Proctor et al.’s Implementation Outcome Framework. Instruments have been rated for psychometric quality, validity, reliability, and usability.

The team behind RE-AIM has developed a website with ample resources related to measuring the dimensions of this outcome framework. Check out the “Resources and Tools” tab for insights into survey measures and planning tools as well as the “Papers, Talks, and Blogs” tab for manuscripts that utilized RE-AIM. (Note: This website also provides resources related to the PRISM determinants framework.)

Another resource for identifying measures is the ASSESS section of the D&I Models Webtool. There are a wide array of instruments in their repository, including both implementation outcomes and implementation determinants (see “Explore D&I Assessment Instruments). Watch webinar providing training on this section of the D&I Models Webtool.   

Lengnick-Hall, R., Gerke, D. R., Proctor, E. K., Bunger, A. C., Phillips, R. J., Martin, J. K., & Swanson, J. C. (2022). Six practical recommendations for improved implementation outcomes reporting. Implementation Science, 17(1), Article 16. https://doi.org/10.1186/s13012-021-01183-3 (Paper)

Despite widespread uptake of Proctor et al.’s (2011) IOF, many studies continue to report implementation outcomes inconsistently and do not provide enough specification to support rigor and reproducibility. In this article, Lengnick-Hall and colleagues articulate six concrete, practice‑oriented recommendations to improve rigor and transparency when reporting implementation outcomes. Using these recommendations when grant writing may also be helpful in convincing reviewers about the rigor of your approach.

Proctor, E. K., Bunger, A. C., Lengnick-Hall, R., Gerke, D. R., Martin, J. K., Phillips, R. J., & Swanson, J. C. (2023). Ten years of implementation outcomes research: A scoping review. Implementation Science, 18(1), Article 31. https://doi.org/10.1186/s13012-023-01286-z (Paper)

Proctor and colleagues provide the first comprehensive, field‑level assessment of how implementation outcomes have been studied during the decade following the introduction of the original IOF. Through a scoping review of 400 empirical studies, this article documents where the field has made progress—most notably in the widespread adoption of implementation outcomes—and where critical gaps remain.

Khadjesari, Z., Boufkhed, S., Vitoratou, S., Schatte, L., Ziemann, A., Daskalopoulou, C., Uglik-Marucha, E., Sevdalis, N., & Hull, L. (2020). Implementation outcome instruments for use in physical healthcare settings: A systematic review. Implementation Science, 15(1), Article 66. https://doi.org/10.1186/s13012-020-01027-6 (Paper)

Khadjesari and colleagues made an important measurement contribution by systematically reviewing and evaluating quantitative instruments used to assess implementation outcomes in healthcare settings. The study provided the first synthesis of psychometric and methodological quality of implementation outcome measures mapped to Proctor et al.’s IOF. demonstrating that while many instruments exist, many exhibit limited reliability, validity, and responsiveness. This review was foundational to the Implementation Outcomes Repository which linked under Measurement Resources.

Mettert, K., Lewis, C., Dorsey, C., Halko, H., & Weiner, B. (2020). Measuring implementation outcomes: An updated systematic review of measures’ psychometric properties. Implementation Research and Practice, 1, Article 2633489520936644. https://doi.org/10.1177/2633489520936644 (Paper)

In this systematic review, Mettert and colleagues reviewed the psychometric properties of 102 measures of implementation outcomes. These measures are largely focused on survey measures that can be administered to staff involved in implementing a new practice.