Open Access Open Badges Study protocol

Tailored implementation for chronic diseases (TICD): A project protocol

Michel Wensing1*, Andy Oxman2, Richard Baker3, Maciek Godycki-Cwirko4, Signe Flottorp2, Joachim Szecsenyi5, Jeremy Grimshaw6 and Martin Eccles7

Author Affiliations

1 Scientific Institute for Quality of Healthcare, Nijmegen, Radboud University Nijmegen Medical Centre, Geert Grooteplein, Nijmegen, the Netherlands

2 Global Health Unit, Norwegian Knowledge Centre for the Health Services, Olavsplass, Oslo, Norway

3 Department of Health Sciences, University of Leicester, Princess Road West, Leicester, UK

4 Department of Family and Community Medicine, Medical University of Lodz,, Kopcinskiego Lodz, Poland

5 Department of General Practice and Health Services Research, University of Heidelberg Hospital, Vossstrasse, Heidelberg, Germany

6 Clinical Epidemiology Program, Ottawa Health Research Institute, Carling Avenue, Administrative Building, Ottawa, Canada

7 Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK

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Implementation Science 2011, 6:103  doi:10.1186/1748-5908-6-103

Published: 7 September 2011



The assumption underlying tailoring is that implementation interventions are most helpful if these effectively address the most important determinants of practice for improvement in the targeted setting. The aim of the Tailored Implementation For Chronic Diseases (TICD) project is to develop valid and efficient methods of tailoring implementation interventions to determinants of practice for knowledge implementation in chronic illness care.


The TICD project has organized the planned empirical research in three work packages that follow the three main steps of tailoring: identification of determinants of healthcare practice, matching implementation interventions to identified determinants of practice, and applying and assessing the tailored implementation interventions. These three key steps of tailored implementation will be applied to targeted chronic conditions in five different healthcare systems: cardiovascular disease in the Netherlands, obesity in England, depression in Norway, chronic obstructive pulmonary disease in Poland, and multimorbidity in Germany. The design and interpretation of empirical research will be informed by systematic reviews of previous research on tailoring implementation interventions.


The TICD project will provide much needed evidence on the advantages and disadvantages of different methods of identifying important determinants of practice and selecting implementation strategies that take account of those. It will also provide five rigorous evaluations of tailored implementation interventions for five different chronic conditions.