Context shapes the effectiveness of knowledge implementation and influences improvement. Context is defined as factors, varying by locality, that have been shown to influence improvement. Understanding and overcoming contextual barriers at the local level is crucial and is essential to implementing highly effective improvement strategies.

Research Theme Aims

The aim of the Context theme is to synthesise current evidence to produce a framework to guide the design of effective, affordable and sustainable novel improvement strategies and methods.

Within this research theme, we will explore three key issues relating to context:

  • Patient, service user and carer factors;
  • Capacity for organisational change;
  • Social and legal factors.

We will work closely with the Behaviour Change theme within SISCC, which explores the way in which individual/organisational factors and professional interactions shape improvement activity.

Our Current Focus

Building the evidence base:

A realist review will be undertaken to update the evidence base and support the initial development of the framework.  This framework will then be tested and refined through a series of:

  • Case studies of improvement/implementation projects across a range of contexts within our older people and maternal and child health work streams, representing different levels of complexity of contexts, different population groups and different levels of evidence availability.
  • Cross-sectoral workshops to gain clinical, policy and user expertise at local, regional and national (Scotland) levels.

Context Framework - Translating evidence into practice:  

The framework will be used to inform future development of interventions, to make them more amenable to implementation and scaling up in real-world contexts. It will also underpin future improvement strategies that are designed to implement existing evidence sustainably, affordably and at scale.

Examples of how the Context research theme is supporting the SISCC large-scale improvement programmes is summarised within the Context theme examples.

Key People








Dr Emma Coles


All outputs from the Context research theme can be accessed here