A more practical guide to incorporating health equity domains in implementation determinant frameworks

Implementation Science Communications, Journal Year: 2021, Volume and Issue: 2(1)

Published: June 5, 2021

Due to striking disparities in the implementation of healthcare innovations, it is imperative that researchers and practitioners can meaningfully use determinant frameworks understand why exist access, receipt, use, quality, or outcomes healthcare. Our prior work documented piloted first published adaptation an existing framework with health equity domains create Health Equity Implementation Framework. We recommended integrating these three frameworks: (1) culturally relevant factors recipients, (2) clinical encounter patient-provider interaction, (3) societal context (including but not limited social determinants health). This was developed for practice settings. Some teams have begun using Framework their evaluations asked more guidance.

Language: Английский

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Buprenorphine dispensing in an epicenter of the U.S. opioid epidemic: A case study of the rural risk environment in Appalachian Kentucky

International Journal of Drug Policy, Journal Year: 2020, Volume and Issue: 85, P. 102701 - 102701

Published: March 26, 2020

Language: Английский

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Advancing health equity through a theoretically critical implementation science

Translational Behavioral Medicine, Journal Year: 2021, Volume and Issue: 11(8), P. 1617 - 1625

Published: April 27, 2021

Abstract While implementation science is driven by theory, most theories, models, and frameworks (TMF) do not address issues of power, inequality, reflexivity that are pivotal to achieving health equity. Theories used in anthropology these effectively could complement prevailing theories constructs. We propose three broad areas theory extend existing TMF advance First, postcoloniality foreground attention the role power knowledge production ways researchers interventionists may perpetuate inequalities shaping health. Second, structural violence intersectionality can help us better understand unequal burden disparities population, thereby encouraging think beyond single interventions initiate partnerships impact overlapping vulnerabilities influence upstream causes vulnerability. Finally, policy governance encourage examine social-political forces “outer context” crucial for sustainability. The incorporation critical enhance foster necessary among scientists. contend a theoretically will promote and, more importantly, support progress toward

Language: Английский

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Forms and functions of bridging factors: specifying the dynamic links between outer and inner contexts during implementation and sustainment

Implementation Science, Journal Year: 2021, Volume and Issue: 16(1)

Published: April 1, 2021

Abstract Background Bridging factors are relational ties, formal arrangements, and processes that connect outer system inner organizational contexts. They may be critical drivers of evidence-based practice (EBP) implementation sustainment. Yet, the complex interplay between contexts is often not considered. were recently defined in updated Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Further identification specification this construct will advance models, measures, methods. Our goal to bridging factor research by identifying relevant dimensions exemplifying these through illustrative case studies. Methods We used a multiple study design. Each ( n = 10) represented different contexts, EBPs, types. Inclusion criteria presence clearly distinguishable identifiable factor, sufficient information describe how affected implementation, variation from other cases. an iterative qualitative inquiry process develop refine list dimensions. Case data entered into matrix. Dimensions comprised rows details columns. After review all cases, we collectively considered independently coded each dimension as function or form. Results drew upon concepts functions forms, distinction originally proposed health intervention literature. Function help define illustrate its purpose it relates EBP implementation. Form specific structures activities why has been customized local experience. can researchers practitioners identify factors, whereas form us understand designed modified support context. propose five three Conclusions described many models studies, but without explicit reference investigation. understudied requires further attention facilitate practice. present recommendations for agenda.

Language: Английский

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Aligning dissemination and implementation science with health policies to improve children’s mental health.

American Psychologist, Journal Year: 2020, Volume and Issue: 75(8), P. 1130 - 1145

Published: Nov. 1, 2020

The prevalence of mental health problems among children (ages 0-21) in the United States remains unacceptably high and, post-COVID-19, is expected to increase dramatically. Decades psychological knowledge about effective treatments should inform delivery better services. Dissemination and implementation (D&I) science has been heralded as a solution persistent problem poor quality services has, some extent, improved our understanding contexts systems that implement practices. However, there are few studies demonstrating clear, population-level impacts interventions on children. Momentum growing communities, cities, states, federal agencies build "health all policies" address broad familial, social, economic factors known affect children's healthy development health. These policy initiatives offer rare opportunity repurpose D&I science, shifting it from primary focus evidence-based practice implementation, support child family well-being. This shift critical states develop responses COVID-19 pandemic already-vulnerable families. We provide typology for building research policy. (PsycInfo Database Record (c) 2020 APA, rights reserved).

Language: Английский

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Dissemination Strategies to Accelerate the Policy Impact of Children’s Mental Health Services Research

Psychiatric Services, Journal Year: 2020, Volume and Issue: 71(11), P. 1170 - 1178

Published: June 10, 2020

The United States is in the midst of a children’s mental health crisis, with rates depression, anxiety, and suicide increasing precipitously. Evidence produced by services research can help address this crisis informing public policy decisions about service delivery, system design, investments social determinants health. Unfortunately, impact limited because evidence often fails to reach makers, be responsive their needs, resonate worldview, or reflect contexts which they make decisions. Dissemination strategies—defined as development targeted distribution messages materials pertaining specific issue intervention—can these challenges. Yet, integrated guidance exists inform design such strategies. This article addresses need synthesizing results empirical studies provide how enhance dissemination makers. provides four recommendations content maker–focused materials, discusses strategic framing message tailoring increase chances that persuasive highlights strategies ensure reaches

Language: Английский

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How does the external context affect an implementation processes? A qualitative study investigating the impact of macro-level variables on the implementation of goal-oriented primary care

Implementation Science, Journal Year: 2024, Volume and Issue: 19(1)

Published: April 16, 2024

Abstract Background Although the importance of context in implementation science is not disputed, knowledge about actual impact external variables on processes remains rather fragmented. Current frameworks, models, and studies merely describe macro-level barriers facilitators, without acknowledging their dynamic character how they steer implementation. Including organizational theories frameworks could be a way tackling this problem. In study, we therefore investigate can contribute to our understanding ways which shape processes. We use process goal-oriented primary care Belgium as case. Methods A qualitative study using in-depth semi-structured interviews was conducted with actors from variety organizations. Data collected analyzed an iterative approach. assessed potential four enrich The are follows: institutional theory, resource dependency network contingency theory. analysis based combination inductive deductive thematic techniques NVivo 12. Results Institutional theory helps understand mechanisms that facilitate through regulatory policy measures. For example, Flemish government issued for facilitating more integrated, person-centered by means newly created institutions, incentives, expectations, other factors. three both counteracting or reinforcing mechanisms. financial system hampers interprofessional collaboration, key GOC. Networks between providers health and/or social organizations one hand GOC, while hand, technology support collaboration lacking. Contingent such aging population increasing workload complexity within create circumstances GOC presented possible answer. Conclusions Insights propositions derive utilized expand affect These insights combined integrated into existing models increase explanatory power.

Language: Английский

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Contracting as a bridging factor linking outer and inner contexts during EBP implementation and sustainment: a prospective study across multiple U.S. public sector service systems

Implementation Science, Journal Year: 2020, Volume and Issue: 15(1)

Published: June 11, 2020

Abstract Background Bridging factors are relational ties (e.g. partnerships), formal arrangements contracts or polices) and processes data sharing agreements) linking outer inner contexts a recent evolution of the Exploration-Preparation-Implementation-Sustainment (EPIS) framework. factor research can elucidate ways that service systems may influence and/or be influenced by organizations providing health services. This study used EPIS framework open resource dependence theoretical approaches to examine contracting in U.S. public sector systems. Contracting function as bridging through which communicate, interact, exchange resources with operating within them. Methods The sample included 17 community-based eight Longitudinal is derived from 113 contract documents 88 qualitative interviews focus groups involving system organizational stakeholders. Analyses consisted document review using content analysis focused coding transcripts groups. A multiple case was conducted identify patterns across organizations. dataset represented had sustained same EBP for between 2 10 years, allowed observation outer-inner context interactions over time. Results Service each other number arrangements. when resulted changes functioning, required responses insufficient funding, altered interorganizational network relationships. Organizations prompted organization-driven negotiation/tailoring, system-level processes, collaboration. were dependent on implementation progressed. Resources beyond funding emerged, including adequate numbers eligible clients, expertise evidence-based practice, training coaching capacity. Conclusion advances science expanding range definition illustrating specific bi-directional influences also identifies dependencies course sustainment. An influence, dependencies, exchanged has direct implications selecting tailoring strategies, especially those require coordination change.

Language: Английский

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What Gets Measured Gets Done: How Mental Health Agencies can Leverage Measurement-Based Care for Better Patient Care, Clinician Supports, and Organizational Goals

Administration and Policy in Mental Health and Mental Health Services Research, Journal Year: 2020, Volume and Issue: 48(2), P. 250 - 265

Published: July 12, 2020

Language: Английский

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Review: Structural Racism, Children’s Mental Health Service Systems, and Recommendations for Policy and Practice Change

Journal of the American Academy of Child & Adolescent Psychiatry, Journal Year: 2021, Volume and Issue: 61(9), P. 1087 - 1105

Published: Dec. 28, 2021

Language: Английский

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