Causal pathway diagrams to understand how implementation strategies work

Implementation strategies are intended to drive change in the complex environments within which implementation occurs, but how they work and under what conditions they work remain poorly understood. This chapter focuses on clarifying how implementation strategies work, using causal pathway diagrams. Causal pathway diagrams provide a structure for articulating the causal theory of how implementation strategies are hypothesized to function. This chapter describes the use of causal pathway diagrams for theorizing, the challenges in theorizing about implementation strategy functioning and how such theorizing can lead to theoretically informative research. As these causal theories are developed, tested and refined, they can have downstream improvements in the precision with which implementation strategies are designed, selected and deployed.