It was while doing his PhD in nursing that Ingram School of Nursing (ISoN) Assistant Professor Guillaume Fontaine, RN, PhD, first discovered the emerging field of implementation science (IS). The focus of his doctoral studies was on developing strategies to train nurses at the Montreal Heart Institute to counsel their patients to adopt behaviours such as exercising, healthy eating and quitting smoking. “Although still in its infancy, implementation science offered a wide range of tools and approaches to support changes in clinical practice and solve challenges within the healthcare system. It seemed like a natural fit for nursing and I was excited by its tremendous potential for change,” he recalls.
As Prof. Fontaine explains, implementation science is a field dedicated to the study of methods to promote the integration of evidence-based practices, programs, and policies into healthcare. Its primary goal is to find new solutions to pressing issues in healthcare by looking at the bigger picture. The approach is interdisciplinary, drawing on a wide variety of evidence from diverse fields such as organizational behaviour, psychology, sociology, political science, and anthropology. “The process is a bit like creating a new recipe. We look at the vast menu of possibilities and carefully select the best ingredients. Then we test the recipe to make sure it works,” he explains.
The process generally begins with reviewing the literature to identify best practices and understanding the gap between what research shows is best practice and what actually happens in healthcare settings. Then researchers interview all stakeholders to obtain their perspectives on the issue in order to identify barriers and enablers to the effective adoption of best practices. After analyzing the complex interplay between systemic, organizational and individual barriers and enablers, IS researchers design implementation strategies and test their effectiveness.
For example, in 2020, Prof. Fontaine was part of a group of investigators awarded a three-year Canadian Institutes of Health (CIHR) research grant titled Using Behavioural Science Approaches to Optimise Public Health and Social Measures That Prevent COVID-19 Transmission and Infection in Priority Populations in Diverse Urban Settings. Given the evidence that vaccines reduce the transmission and severity of the disease, the goal of the study was to improve COVID-19 vaccination uptake among populations prioritized by public health units in Ontario. The researchers identified barriers and enablers at the individual, organizational and systemic levels. Key barriers varied across populations, but often included individuals’ concerns about vaccine development, efficacy and side-effects, mistrust in government, public health, scientists, big pharma and politicians, as well as unfavourable social influences about vaccination from family, friends, community and religious leaders. The researchers then designed tailored COVID vaccine uptake strategies for public health units in Ontario, which will be able to assess how well these strategies work.
Prof. Fontaine, who joined the ISoN faculty last August, also serves as Principal Investigator at the Centre for Clinical Epidemiology of the Lady Davis Institute for Medical Research, Affiliate Investigator at the Centre for Implementation Research of the Ottawa Hospital Research Institute, Nurse Scientist at the Centre for Nursing Research of the Jewish General Hospital, and Visiting Fellow at the Kirby Institute of the University of New South Wales Sydney.
In addition to his expertise in IS, Prof. Fontaine has a keen interest in the application of digital technology in healthcare and its role in enhancing patient care and public health. To that end, he has designed a new course called Fundamentals of Digital Health which will be launched in Fall 2024. This fully online course will be open to all McGill health profession students at the undergraduate and graduate levels.
Asked what attracted him to the ISoN, Prof. Fontaine cited several factors, including McGill’s reputation as a leader in nursing and healthcare education, research and practice, the School’s commitment to innovation, the potential for close collaboration with first-class researchers, and the opportunity to expand the faculty’s expertise in implementation science. “From the moment I arrived here, I found an open door. I am really looking forward to sharing my knowledge with the faculty, supervising master’s and doctoral students who are interested in IS, and training a new generation of healthcare professionals from all disciplines who can confidently leverage the powerful set of tools offered by implementation science for improving clinical practice and public health.”
Students who are interested in working with Prof. Fontaine are invited to contact him directly via email: guil.fontaine [at] mcgill.ca