Conclusions
Changing practice, whether in a research study or in the “real world”, is complex. Understanding the process of implementation is crucial to effective research delivery. Implementation frameworks facilitate understanding, and subsequently the systematic and iterative development of strategies for this to be addressed. How teams (rather than individuals) work together is central to how complex interventions are understood and implemented. It is possible that new complex interventions work best in contexts where there are ‘flexible’ cultures. Researchers should consider, and potentially measure this, before they can effectively implement and evaluate an intervention.