Table 3: Key characteristics of IR

Characteristic	Description
Systematic	The systematic study of how evidence-based public health interventions are integrated and provided in specific settings, and how resulting health outcomes vary across communities. Balances relevance to real life situations with rigor, strictly adhering to the norms of scientific inquiry.
Multidisciplinary	Analysis of biological, social, economic, political, systemic and environmental factors that impact implementation of specific health interventions. Requires interdisciplinary collaborations between behavioural and social scientists, clinicians, epidemiologists, statisticians, engineers, business analysts, policy-makers, community leaders and key stakeholders.
Contextual	Demand-driven. Framing of research questions is based on needs identified by implementers and other stakeholders in the health system. Research is relevant to local specifics and needs, and aims to improve health care delivery in a given context. Generates generalizable knowledge and insights that can be applied across various settings. Mindful of cultural and community-based influences.
Complex	Dynamic and adaptive. Multi-scale: occurs at multiple levels of health systems and communities. Analyses multi-component programmes and policies. Non-linear, iterative, evolving process.
Real Life Situations	Takes place within real-life settings. There is no attempt to manipulate the setting within which the intervention is taking place. Engages with populations of interest including the actual implementers (e.g. health practitioners, policy-makers) and beneficiaries (communities, target population).

A simple paradox that IR acknowledges is that the more rigidly the implementation is controlled to ensure fidelity of a proven intervention, the more likely it is that local factors will reduce its effectiveness. Similarly, the more adapted an intervention is to local conditions the more effective it is likely will be.