An intervention may be internally developed as a good idea, solution to a problem, or other grass-roots effort, or may be developed by an external entity (e.g., vendor or research group) . Perception of key stakeholders about whether the intervention is externally or internally developed may influence success of implementation . The legitimacy of the source may also influence implementation.
An externally developed intervention coupled with lack of transparency in the decision-making process may lead to implementation failure . Dissemination, “whose main mechanism of spread is centrally driven and controlled” is negatively associated with implementation [1 pg. 604]. Though there is empirical evidence of a positive association with an authoritative decision to use the intervention, there is a negative relationship with fully implementing or routinizing the intervention . On the other hand, key ideas that come from outside the organization and are effectively tailored to the organization can result in successful implementation  (See Adaptability). Sometimes, internal decisions to adopt or implement an intervention may be perceived as externally driven. If the decision to adopt and implement is made by leaders higher in the hierarchy who edict change with little user input in the decision to implement an intervention, implementation is less likely to be effective .
Include statements about the source of the innovation and the extent to which interviewees viewed the change as internal to the organization, e.g., an internally developed program, or external to the organization, e.g., a program coming from the outside. Note: May code and rate as “I” for internal or “E” for external.
- External Source: “Wow. Well there’s nothing like an unfunded mandate you know to get … their blood boiling around here where workloads are so high.”
- Internal Source: “We all got together and decided to create a new process to fix the problem.”
Exclude or double code statements related to who participated in the decision process to implement the innovation to Engaging, as an indication of early (or late) engagement. Participation in decision-making is an effective engagement strategy to help people feel ownership of the innovation.
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