Enhancing Impact: A Call to Action for Equitable Implementation Science

Prevention Science, Год журнала: 2023, Номер 25(S1), С. 174 - 189

Опубликована: Окт. 25, 2023

Abstract Despite investments in evidence-based interventions and Implementation Science, most are not widely or routinely adopted, delivered, sustained many real-world community healthcare settings. This gap is even greater settings populations experiencing numerous social structural barriers to health, with important implications for persistent patterns health inequities. In this Viewpoint, as part of a Special Issue on Advancing the Adaptability Chronic Disease Prevention Management through Science , we outline seven calls action field goal encouraging researchers, practitioners, funders be more intentional accountable applying have impact promoting equity. Calls include (1) enhance public community, multi-sectoral partnerships promote equity equitable implementation; (2) revisit build evidence base needed at multiple levels; (3) prioritize focus policy development, dissemination, (4) agile responsive application frameworks, processes, methods; (5) identify redefine meaningful metrics impact; (6) disseminate scientific research diverse range partners potential beneficiaries; (7) extend de-implementation, mis-implementation, sustainability which central enhancing Additionally, why prevention essential making progress towards summarize advancements that has made foundational, pose questions work area.

Язык: Английский

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Digital Health for Asthma Management: Electronic Medication Monitoring for Adherence as a Case Example

The Journal of Allergy and Clinical Immunology In Practice, Год журнала: 2025, Номер unknown

Опубликована: Янв. 1, 2025

Язык: Английский

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Practical considerations for engaging staff in resource-constrained healthcare settings in implementation research: A qualitative focus group and consensus building study

Journal of Clinical and Translational Science, Год журнала: 2025, Номер 9(1)

Опубликована: Янв. 1, 2025

Abstract Background: The primary purpose of this study was to assess perceived burdens and benefits participating in implementation research among staff employed resource-constrained healthcare settings. Another objective use findings generate considerations for engaging across different phases research. Methods: This qualitative focus group consensus building involved researchers affiliated with the National Cancer Institute Implementation Science Centers Control program nine Community Health (CHCs) Massachusetts. Six groups (n = 3 CHC staff; n researchers) assessed barriers facilitators participation During discussions, we used develop as participants partners throughout Results: Sixteen 14 participated separate groups; seven discussions. Themes emerged participant three domains: (1) influences on participation; (2) benefits; (3) ways facilitate Practical included: (a) aligning organizational values priorities; (b) applying user-centered design methods; (c) individual capacity; (d) offering equitable incentives participation. Conclusions: Engaging requires knowledge about what contributes burden addressing context-specific benefits.

Язык: Английский

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A research agenda to advance the study of implementation mechanisms

Implementation Science Communications, Год журнала: 2024, Номер 5(1)

Опубликована: Сен. 16, 2024

Implementation science scholars have made significant progress identifying factors that enable or obstruct the implementation of evidence-based interventions, and testing strategies may modify those factors. However, little research sheds light on how why work, in what contexts, for whom. Studying mechanisms-the processes responsible change-is crucial advancing field enhancing its value facilitating equitable policy practice change. The Agency Healthcare Research Quality funded a conference series to achieve two aims: (1) develop agenda mechanisms, (2) actively disseminate research, policy, audiences. This article presents resulting agenda, including priorities actions encourage execution. Building prior concept mapping semi-structured, 3-day, in-person working meeting, 23 US-based researchers used modified nominal group process generate addressing challenges studying mechanisms. During each three 120-min sessions, small groups responded prompt: "What need be taken move this forward?" brainstormed actions, which were then shared with full discussed support facilitators trained structured processes. Facilitators grouped critical novel ideas into themes. Attendees voted six themes they prioritized discuss fourth, session, during operationalized actions. Subsequently, all collated, combined, revised clarity by subset authorship team. From multistep process, 150 emerged across 10 priority areas, together constitute agenda. Actions included discrete activities, projects, products, ways shift is conducted strengthen study elevates guide selection, design, evaluation By delineating recommended address facilitates expanding science, beyond works whom, interventions.

Язык: Английский

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Advancing implementation science in community settings: the implementation strategies applied in communities (ISAC) compilation

International Journal of Behavioral Nutrition and Physical Activity, Год журнала: 2024, Номер 21(1)

Опубликована: Ноя. 26, 2024

Abstract Background Implementation strategies have predominantly been operationalized and studied in clinical settings. are also needed to improve evidence-based intervention (EBI) integration community settings, but there is a lack of systematic characterization their use, which limits generalizability findings. The goals this study were determine implementation most used deliver primary prevention EBIs develop compilation pragmatic strategy selection process with accompanying guidance tools, understand practitioners’ preferences for dissemination. Methods Purposive snowball sampling was recruit setting researchers practitioners delivering (nutrition, physical activity, tobacco prevention) settings: education, social services, city planning transportation, workplaces, recreation/sport, faith-based, other public health organizations. Semi-structured interviews conducted using guide based on the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework. Participants asked describe barriers experienced overcome them within each RE-AIM dimension. Practitioners about preferred dissemination strategies, prompted by Diffusion Innovations theory concepts sources (who provides information) channels (how information provided). A rapid deductive approach analyze findings coding matrix aligned interview guide. Results Researchers ( n = 10) 8) across all targeted settings outcomes completed interviews. Interviewees shared unique N 40) related multiple dimensions, commonly 29) adoption 27). Most frequently mentioned conduct evaluation 31), provide training 26), change adaptable program components leverage funding 21). Webinars 6) listservs/newsletters 5) channels; national organizations 13) sources. Conclusions reflect (e.g., training, technical assistance) add novel not reflected current taxonomies. Dissemination suggest need involve broad-reaching resultant (Implementation Strategies Applied Communities) resources assist applying improving EBI delivery

Язык: Английский

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Advancing health equity through implementation science: Identifying and examining measures of the outer setting

Social Science & Medicine, Год журнала: 2023, Номер 331, С. 116095 - 116095

Опубликована: Июль 17, 2023

Язык: Английский

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A Hybrid Type III Effectiveness-Implementation Trial to Optimize Medication Safety With Oral Antitumor Therapy in Real-World: The AMBORA Competence and Consultation Center

JCO Oncology Practice, Год журнала: 2024, Номер 20(9), С. 1219 - 1230

Опубликована: Июнь 7, 2024

PURPOSE Implementation science endeavors to facilitate the translation of evidence-based research into clinical routine. The pharmacological/pharmaceutical care program evaluated in randomized AMBORA trial on medication safety with oral antitumor therapeutics (OAT) optimizes delivery and provides significant benefits for patients, treatment teams, health systems. Thus, we aimed investigate implementation this within Competence Consultation Center (AMBORA Center). METHODS a University Comprehensive Cancer offered several services (eg, patient consultations) was according RE-AIM framework. This multicenter hybrid type III focused outcomes recruitment, referring units, evaluation services) while concurrently investigating effectiveness side effects, errors). Quantitative qualitative assessments were combined. RESULTS conducted over 800 consultations 420 patients seven institutions. primary end point counseling 70% treated OAT not reached. Patients referred by 15 units compared 11 trial. On basis heterogeneous referral rates characteristics across institutions, barriers facilitators process derived. Several survey results stakeholder interviews, online/paper-based questionnaires) reflected high appreciation professionals. severity 60.1% (178 296) detected effects improved, 86.3% (297 344) errors resolved. CONCLUSION Despite reaching outcome, included more demonstrated benefit meeting all outcomes. We outlined quantitative enhance outreach foster further dissemination centers optimize OAT.

Язык: Английский

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Use of concept mapping to inform a participatory engagement approach for implementation of evidence-based HPV vaccination strategies in safety-net clinics

Implementation Science Communications, Год журнала: 2024, Номер 5(1)

Опубликована: Июнь 26, 2024

Abstract Background Multiple evidence-based strategies (EBS) for promoting HPV vaccination exist. However, adolescent rates remain below target levels in communities at high risk HPV-associated cancers and served by safety-net clinics. Participatory engaged approaches are needed to leverage the expertise of community clinical partners selecting EBS relevant their local context. We concept mapping as a method inform adoption adaptation that seeks empower implementation prioritize, select, ultimately implement context-relevant vaccination. Methods Using 38 statements generated from qualitative interviews national vaccine advocacy sources, we conducted modified activity with internal clinics external members two study sites larger (Greater Los Angeles New Jersey), sort into clusters rate each importance feasibility increasing within Concept findings (EBS statement ratings, ladder graphs go-zones) were shared leaders large federally qualified health center (FQHC) system (focusing on three clinic sites), select over 12 months. Results participants (n=23) sorted rated statements, resulting an eight-cluster solution: 1) Community education outreach; 2) Advocacy policy; 3) Data access/quality improvement monitoring; 4) Provider tracking/audit feedback; 5) recommendation/communication; 6) Expanding access; 7) Reducing missed opportunities; 8) Nurse/staff workflow training. The FQHC partner then selected intervene eight 17 “go-zone” action, “reducing opportunities,” “nurse/staff training,” one “provider feedback,” recommendation/communication,” “expanding access,” which research team addressed through multi-level intervention (e.g., physician communication training, staff training assessment, audit feedback processes). Conclusions provided powerful participatory approach identify multilevel context, particularly when several exist, prioritization is necessary. This demonstrates how benefited directly ratings broader context adapt prioritized solutions advance equity.

Язык: Английский

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Participatory logic modeling in a multi-site initiative to advance implementation science

Implementation Science Communications, Год журнала: 2023, Номер 4(1)

Опубликована: Авг. 29, 2023

Logic models map the short-term and long-term outcomes that are expected to occur with a program, thus an essential tool for evaluation. Funding agencies, especially in United States (US), have encouraged use of logic among their grantees. They also clarify expectations own funding initiatives. It is increasingly recognized should be developed through participatory approach which allows input from those who carry out program being evaluated. While there many positive examples modeling, funders generally not engaged grantees developing model associated This article describes instance where US funder multi-site initiative fully funded organizations model. The focus case study Implementation Science Centers Cancer Control (ISC

Язык: Английский

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Provision of colonoscopy in rural settings: A qualitative assessment of provider context, barriers, facilitators, and capacity

The Journal of Rural Health, Год журнала: 2023, Номер 40(2), С. 272 - 281

Опубликована: Сен. 7, 2023

Abstract Purpose Colonoscopy can prevent morbidity and mortality from colorectal cancer (CRC) is the most commonly used screening method in United States. Barriers to colonoscopy at multiple levels contribute disparities. Yet, rural settings, little known about who delivers facilitators barriers access through completion. Methods We conducted a qualitative study with providers Oregon worked endoscopy centers or primary care clinics. Semistructured interviews, July August, 2021, focused on clinician experiences providing Medicaid patients, including workflows, barriers, access. thematic analysis, immersion crystallization, analyze interview transcripts develop emergent themes. Findings interviewed 19 providers. found two categories of providers: (PCPs) doing their own patients ( n = 9; 47%) general surgeons referred services 10; 53%). Providers described provider, community, patient suggested supports could help overcome them. current capacity sufficient, but noted PCPs trained perform would be key continued accessibility. Finally, shared concerns shrinking number PCP endoscopists, especially anticipated increased demand related CRC guideline shift. Conclusions These themes reflect opportunities address multilevel improve access, capacity, education approaches. Our results highlight that are an essential part workforce provides areas.

Язык: Английский

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