Gillings researcher authors one of three most accessed papers on implementation science

April 29, 2019

Dr. Sarah Birken, by UNC/Dr. Sarah Birkin

Dr. Sarah Birken

Sarah Birken, PhD, assistant professor of health policy and management at the UNC Gillings School of Global Public Health, is first author of an article that is currently among the three most-accessed papers in the journal Implementation Science.

The paper, titled “Middle managers’ role in implementing evidence-based practices in healthcare: a systematic review,” synthesizes the findings of 105 studies spanning several countries and health care settings. The researchers found that studies of middle managers’ role in health care evidence-based practices (EBP) implementation and its determinants substantially increased from 1996 to 2015; they also found evidence to suggest that middle managers significantly shape implementation climate.

Birken, who also is an alumna of the UNC Gillings School, conducted the review with help from several students in the health policy and management department (Alecia Clary, Amir Alishahi Tabriz, Kea Turner and Alexandra Zizzi), and with assistance from Jennifer Walker, liaison librarian at the UNC Health Sciences Library.

“Fundamentally, implementation science is about putting evidence-based practices into use,” Birken said. “Our review suggests that there’s ample evidence of what health care practitioners have always known based on experience: Middle managers and supervisors often are the lynchpins of successful implementation in health care organizations. In light of this, our most important finding is that there’s insufficient evidence of what we can do to support middle managers in promoting EBP implementation. I think the potential for us to narrow the knowledge-action gap by supporting middle managers’ role in EPB implementation made this a particularly popular paper.”

In addition to her extensive research on the implementation of innovations in cancer care and the selection and application of implementation theories, Birken is committed to the advancement of her fellow women scholars. She has published on the topic in the Chronicle of Higher Education and serves on the Committee on the Status of Women as well as the Women in Science Deserve Opportunities and Mentoring group at UNC. She also co-hosts AcaDames, a podcast about women in academia.

“It’s not a platitude to say that this paper was a team effort,” said Birken. “It is the product of several years of work by many dedicated and talented students. I’ve been inspired by mentors who believed that I had something to contribute — even before I believed it myself! It’s gratifying to be able to pay that forward now by engaging rising stars in my research.”

Another Implementation Science paper co-authored by Birken — “T-CaST: an implementation theory comparison and selection tool” — earned the second-highest Altmetric score for the journal in 2018.

Contact the Gillings School of Global Public Health communications team at

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