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Standards for Reporting Implementation Studies (StaRI): explanation and elaboration document
  1. Hilary Pinnock1,
  2. Melanie Barwick2,3,
  3. Christopher R Carpenter4,
  4. Sandra Eldridge5,
  5. Gonzalo Grandes6,
  6. Chris J Griffiths7,
  7. Jo Rycroft-Malone8,
  8. Paul Meissner9,
  9. Elizabeth Murray10,
  10. Anita Patel7,
  11. Aziz Sheikh1,
  12. Stephanie J C Taylor7
  13. for the StaRI Group
    1. 1Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
    2. 2Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
    3. 3Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
    4. 4Division of Emergency Medicine, Washington University School of Medicine in St Louis, St Louis, USA
    5. 5Pragmatic Clinical Trials Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
    6. 6Primary Care Research Unit of Bizkaia, Basque Health Service, Bilbao, Spain
    7. 7Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
    8. 8Bangor Institute for Health and Medical Research, Bangor University, Bangor, UK
    9. 9Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, New York, USA
    10. 10Department of Primary Care and Population Health, University College London, London, UK
    1. Correspondence to Professor Hilary Pinnock; hilary.pinnock{at}


    Objectives Implementation studies are often poorly reported and indexed, reducing their potential to inform the provision of healthcare services. The Standards for Reporting Implementation Studies (StaRI) initiative aims to develop guidelines for transparent and accurate reporting of implementation studies.

    Methods An international working group developed the StaRI guideline informed by a systematic literature review and e-Delphi prioritisation exercise. Following a face-to-face meeting, the checklist was developed iteratively by email discussion and critical review by international experts.

    Results The 27 items of the checklist are applicable to the broad range of study designs employed in implementation science. A key concept is the dual strands, represented as 2 columns in the checklist, describing, on the one hand, the implementation strategy and, on the other, the clinical, healthcare or public health intervention being implemented. This explanation and elaboration document details each of the items, explains the rationale and provides examples of good reporting practice.

    Conclusions Previously published reporting statements have been instrumental in improving reporting standards; adoption by journals and authors may achieve a similar improvement in the reporting of implementation strategies that will facilitate translation of effective interventions into routine practice.

    • Dissemination and implementation research
    • EQUATOR Network
    • Implementation Science
    • Reporting standards
    • Organisational innovation

    This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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    • Collaborators The StaRI Group includes: MB, CRC, Peter Craig, SE, Eleni Epiphaniou, GG, JR-M, PM, Brian Mittman, EM, AP, Gemma Pearce, HP, AS and SJCT.

    • Contributors HP initiated the idea for the study and with SJCT led the development of the protocol, securing of funding, study administration, workshop and writing of the paper. AS, CJG and SE advised on the development of the protocol, and data analysis. All authors participated in the StaRI international working group along with GP, BM and MG. HP wrote the initial draft of the paper, to which all the authors contributed. HP is the study guarantor.

    • Funding The StaRI initiative and workshop was funded by contributions from the Asthma UK Centre for Applied Research (AC-2012-01); Chief Scientist Office, Scottish Government Health and Social Care Directorates (PCRCA_08_01); the Centre for Primary Care and Public Health, Queen Mary University of London; and with contributions in kind from the PRISMS team (NIHR HS&DR Grant ref: 11/1014/04). SJCT was (in part) supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart's Health NHS Trust. AS is supported by the Farr Institute.

    • Disclaimer The funding bodies had no role in the design, in the collection, analysis, and interpretation of data; in the writing of the manuscript; nor in the decision to submit the manuscript for publication. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

    • Competing interests All authors have completed the ICMJE uniform disclosure form at and declare: research grants from Chief Scientist Office (HP), Asthma UK (AS, HP, SJCT), Farr Institute (AS), NIHR HS&DR (HP, SJCT), NIHR CLAHRC (SJCT) for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; CRC is the Deputy Editor-in-Chief for Academic Emergency Medicine and on the editorial boards for the Journal of the American Geriatrics Society and Annals of Internal Medicine's ACP Journal Club and serves as paid faculty for Emergency Medical Abstracts, JR-M is the Director of the NIHR HS&DR Programme, no other relationships or activities that could appear to have influenced the submitted work.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.