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Kemp CG, Edwards AJ, White L, Kore G, Thurman PJ, Gaines T, King PT, Cole M, Orellana ER. Implementation Science for HIV Prevention and Treatment in Indigenous Communities: a Systematic Review and Commentary. Curr HIV/AIDS Rep 2024:10.1007/s11904-024-00706-z. [PMID: 39120668 DOI: 10.1007/s11904-024-00706-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE OF REVIEW We systematically reviewed implementation research conducted in Indigenous communities in the Americas and the Pacific that focused on improving delivery of HIV preventive or treatment services. We highlight strengths and opportunities in the literature and outline principles for Indigenous-led, HIV-related implementation science. RECENT FINDINGS We identified 31 studies, revealing a consistent emphasis on cultural tailoring of services to Indigenous communities. Common barriers to implementation included stigma, geographic limitations, confidentiality concerns, language barriers, and mistrust. Community involvement in intervention development and delivery emerged as a key facilitator, and nearly half of the studies used community-based participatory research methods. While behavioral HIV prevention, especially among Indigenous youth, was a major focus, there was limited research on biomedical HIV prevention and treatment. No randomized implementation trials were identified. The findings underscore the importance of community engagement, the need for interventions developed within Indigenous communities rather than merely adapted, and the value of addressing the social determinants of implementation success. Aligned to these principles, an indigenized implementation science could enhance the acceptability and reach of critical HIV preventive and treatment services in Indigenous communities while also honoring their knowledge, wisdom, and strength.
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Affiliation(s)
- Christopher G Kemp
- Center for Indigenous Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Abagail J Edwards
- Center for Indigenous Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lauren White
- Joint Program for Social Work and Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Gauri Kore
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Tommi Gaines
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Paula Toko King
- Te Rōpū Rangahau Hauora a Eru Pōmare, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Marama Cole
- Te Rōpū Rangahau Hauora a Eru Pōmare, Department of Public Health, University of Otago, Wellington, New Zealand
| | - E Roberto Orellana
- Indigenous Wellness Research Institute, University of Washington, Seattle, WA, USA
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Villalobos A, Reynolds E, Halpin SN, Jacobs SR, Peay HL. Prioritizing research needs and opportunities at the intersection of implementation science and engagement science. Implement Sci Commun 2024; 5:78. [PMID: 39026346 PMCID: PMC11264720 DOI: 10.1186/s43058-024-00617-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/10/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND There has been increased attention to the need for, and the positive impact of, engaged or participatory science in recent years. Implementation scientists have an opportunity to leverage and contribute to engagement science (ES) through the systematic integration of engagement into implementation science (IS). The purpose of this study was to gather information from researchers and others to develop a prioritized list of research needs and opportunities at the intersection of IS and ES. METHODS We conducted three Zoom-based focus groups with 20 researchers to generate a list of unmet needs, barriers, and to describe normative themes about use of ES and IS. Then a panel of nine experts in IS and/or engagement ranked the needs and barriers using a survey and met via a Zoom meeting to discuss and generate research opportunities and questions, with reference to the focus group outputs. RESULTS Respondents and experts concurred on the importance of engagement in IS. Focus group participants reported 28 needs and barriers under the themes of 1) need for best practice guidance related to engagement processes and outcomes and 2) structural barriers to integrating ES in IS. The expert panel prioritized six structural barriers and four barriers related to generating best practice guidance, with corresponding recommendations on research opportunities. Example research opportunities related to engagement processes included: define "successful" engagement in IS contexts; adapt engagement tools and best practices from other disciplines into IS. Example research opportunities related to outcomes included: assess the impact of engagement on IS outcomes; examine engagement practices that lead to optimal engaged research. Example research opportunities related to structural barriers included: leverage research evidence to create structural changes needed to expand support for engaged IS; examine factors that influence institutional buy-in of engagement in IS. CONCLUSIONS Research needs exist that relate to engagement processes, outcomes, and structural barriers, even for scientists who value engaged research. Expert panelists recommended sequential and reinforcing research opportunities that implementation and engagement scientists can tackle together to advance both fields and health equity. Future work should assess insights from broader invested parties, particularly patients and community members.
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Affiliation(s)
- Aubrey Villalobos
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Dr., Bethesda, MD, 20892, USA.
| | - Elizabeth Reynolds
- RTI International, 3040 E Cornwallis Rd, Research Triangle Park, NC, 27709, USA
| | - Sean N Halpin
- RTI International, 3040 E Cornwallis Rd, Research Triangle Park, NC, 27709, USA
| | - Sara R Jacobs
- RTI International, 3040 E Cornwallis Rd, Research Triangle Park, NC, 27709, USA
| | - Holly L Peay
- RTI International, 3040 E Cornwallis Rd, Research Triangle Park, NC, 27709, USA
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Ridge MS, Statile AM. We Need It All in Quality Improvement: Local Change, Collaboration, and an Equity Lens. Pediatrics 2024; 153:e2024065653. [PMID: 38682246 DOI: 10.1542/peds.2024-065653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 05/01/2024] Open
Affiliation(s)
- Margaret S Ridge
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; and James M Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Angela M Statile
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; and James M Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital, Cincinnati, Ohio
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Swaithes L, Paskins Z, Finney A, Walsh N, Skrybant M, Mallen C, Dziedzic K. Optimising the implementation of evidence-based osteoarthritis guidelines in primary care: Development of a Knowledge Mobilisation Toolkit. Osteoarthritis Cartilage 2024; 32:612-629. [PMID: 38237760 DOI: 10.1016/j.joca.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/21/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Implementing clinical guidelines for osteoarthritis (OA) in primary care is complex. Whilst international guidelines detail what best practice for OA looks like, little is known about how this is best implemented. Limited resources are available to guideline developers, practitioners, researchers, or the public to facilitate implementation. Set in the context of a larger research project which sought to understand the factors that influence knowledge mobilisation (KM) in implementation for OA guidelines, this study reports the development of a toolkit to optimise KM for the implementation of evidence-based OA guidelines in primary care. DESIGN Triangulation of three qualitative data sets was conducted, followed by a stakeholder consensus exercise. Public contributors were involved in dedicated meetings (n = 3) to inform the content, design, and KM plans for the toolkit. RESULTS From data triangulation, 53 key findings were identified, which were refined into 30 draft recommendation statements, within six domains: approaches to KM; the knowledge mobiliser role; understanding context; implementation planning; the nature of the intervention; and appealing to a range of priorities. Stakeholder voting (n = 27) demonstrated consensus with the recommendations and informed the wording of the final toolkit. CONCLUSIONS Factors that optimise KM for OA guideline implementation in primary care were identified. Empirical data, practice-based evidence, implementation practice, and stakeholder (including patient and public) engagement have informed a toolkit comprising several overarching principles of KM, which are suitable for use in primary care. Consideration of equitable access when implementing evidence-based OA care among diverse populations is recommended when using the toolkit. Further research is needed to evaluate the toolkit's utility and transferability.
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Affiliation(s)
- Laura Swaithes
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire ST5 5BG, United Kingdom.
| | - Zoe Paskins
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire ST5 5BG, United Kingdom; Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, Staffordshire, United Kingdom.
| | - Andrew Finney
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine & School of Nursing and Midwifery, Keele University, Staffordshire ST5 5BG, United Kingdom.
| | - Nicola Walsh
- Centre for Health and Clinical Research, University of the West of England, Bristol, United Kingdom.
| | - Magdalena Skrybant
- Institute of Applied Health Research, University of Birmingham, Edgbaston B15 2TT, United Kingdom.
| | - Christian Mallen
- Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire ST5 5BG, United Kingdom.
| | - Krysia Dziedzic
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire ST5 5BG, United Kingdom.
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Mauricio AM, Garcia Y, Merelas S, Cioffi CC, McWhirter EH, Budd EL, Mueller MV, De Anda S, Rodriguez E, Leve LD. Community Partner Perceptions of Equitable Implementation Practices for a Promotores de Salud Intervention: A Qualitative Assessment. Am J Public Health 2024; 114:S377-S383. [PMID: 38776501 PMCID: PMC11111374 DOI: 10.2105/ajph.2024.307686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 05/25/2024]
Abstract
We conducted focus groups with staff from 5 community-based organizations (21 participants; 86% female, 52% Hispanic/Latino/a/x and 24% Mexican/Mexican American) between August and October 2021. Results highlighted community partner perceptions of practices congruent (e.g., communication that built trust and dismantled power dynamics, a shared mission) and incongruent (e.g., intervention-community misalignment, research driven decision-making) with equitable implementation in the development, implementation, and evaluation of a promotores de salud intervention to increase COVID-19 testing and preventive behaviors among Latinx communities in Oregon. (Am J Public Health. 2024;114(S5):S377-S383. https://doi.org/10.2105/AJPH.2024.307686).
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Affiliation(s)
- Anne Marie Mauricio
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Yahaira Garcia
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Sophia Merelas
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Camille C Cioffi
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Ellen Hawley McWhirter
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Elizabeth L Budd
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Maryanne V Mueller
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Stephanie De Anda
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Elaine Rodriguez
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
| | - Leslie D Leve
- Anne Marie Mauricio, Yahaira Garcia, Sophia Merelas, Camille C. Cioffi, Elizabeth L. Budd, Stephanie De Anda, Maryanne V. Mueller, Elaine Rodriguez, and Leslie D. Leve are with the University of Oregon, Prevention Science Institute, Eugene. Anne Marie Mauricio, Yahaira Garcia, Elizabeth L. Budd, and Leslie D. Leve are also with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene. Stephanie De Anda is also with the Department of Special Education and Clinical Sciences, University of Oregon, Eugene. Elaine Rodriguez is also with Mano Amiga, Roseburg, OR. Ellen Hawley McWhirter is with the Department of Counseling Psychology and Human Services, University of Oregon, Eugene
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Nitto AM, Crespo-Bellido M, Yenerall J, Anderson Steeves ET, Kersten SK, Vest D, Hill JL. Mixed methods evaluation of the COVID-19 changes to the WIC cash-value benefit for fruits and vegetables. Front Public Health 2024; 12:1371697. [PMID: 38741911 PMCID: PMC11089207 DOI: 10.3389/fpubh.2024.1371697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction Recent cash-value benefit (CVB) increases are a positive development to help increase WIC participant fruits and vegetables (FV) access. Little is known about the impacts of the CVB changes on FV redemptions or about implementation successes and challenges among WIC State and local agencies. This mixed method study aimed to evaluate (a) the CVB changes' impact on FV access among WIC child participants measured by CVB redemption rates, (b) facilitators and barriers to CVB changes' implementation, and (c) differences in FV redemption and facilitators and barriers by race/ethnicity. Methods We requested redemption data from all 89 State agencies for April 2020 to September 2022 and utilized descriptive statistics, interrupted time series analysis (ITS), and generalized linear regression analysis. Additionally, we recruited State agencies, local agencies, and caregivers across the U.S. for interviews and used rapid qualitative analysis to find emerging themes anchored in policy evaluation and implementation science frameworks. Results We received redemption data from 27 State agencies and interviewed 23 State agencies, 61 local agencies, and 76 caregivers of child WIC participants. CVB monthly redemptions increased at $35/child/month compared to $9/child/month; however, adjusted ITS analyses found a decrease in redemption rates at $35/child/month. The decrease was not significant when the transition/first implementation month was excluded with rates progressively increasing over time. Differences were found among racial/ethnic groups, with lower redemption rates observed for non-Hispanic Black caregivers. Overall, WIC caregivers reported high satisfaction and utilization at the $35/child/month. The frequent and quick turnaround CVB changes strained WIC agency resources with agencies serving higher caseloads of diverse racial and ethnic populations experiencing greater issues with implementing the CVB changes. Conclusion Despite implementation challenges, the increased CVB shows promise to improve WIC participant FV access and satisfaction with WIC. WIC agencies need adequate lead time to update the CVB amounts, and resources and support to help ensure equitable distribution and utilization of the FV benefits.
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Affiliation(s)
| | | | - Jackie Yenerall
- Department of Agricultural and Resource Economics, University of Tennessee, Knoxville, TN, United States
| | | | | | - Daniele Vest
- Gretchen Swanson Center for Nutrition, Omaha, NE, United States
| | - Jennie L. Hill
- Gretchen Swanson Center for Nutrition, Omaha, NE, United States
- Population Health Sciences, University of Utah, Salt Lake City, UT, United States
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Gustafson P, Lambert M, Bartholomew K, Ratima M, Aziz YA, Kremer L, Fusheini A, Carswell P, Brown R, Priest P, Crengle S. Adapting an equity-focused implementation process framework with a focus on ethnic health inequities in the Aotearoa New Zealand context. Int J Equity Health 2024; 23:15. [PMID: 38280997 PMCID: PMC10822165 DOI: 10.1186/s12939-023-02087-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/20/2023] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND Health intervention implementation in Aotearoa New Zealand (NZ), as in many countries globally, usually varies by ethnicity. Māori (the Indigenous peoples of Aotearoa) and Pacific peoples are less likely to receive interventions than other ethnic groups, despite experiencing persistent health inequities. This study aimed to develop an equity-focused implementation framework, appropriate for the Aotearoa NZ context, to support the planning and delivery of equitable implementation pathways for health interventions, with the intention of achieving equitable outcomes for Māori, as well as people originating from the Pacific Islands. METHODS A scoping review of the literature to identify existing equity-focused implementation theories, models and frameworks was undertaken. One of these, the Equity-based framework for Implementation Research (EquIR), was selected for adaptation. The adaptation process was undertaken in collaboration with the project's Māori and consumer advisory groups and informed by the expertise of local health equity researchers and stakeholders, as well as the international implementation science literature. RESULTS The adapted framework's foundation is the principles of Te Tiriti o Waitangi (the written agreement between Māori rangatira (chiefs) and the British Crown), and its focus is whānau (extended family)-centred implementation that meets the health and wellbeing aspirations, priorities and needs of whānau. The implementation pathway comprises four main steps: implementation planning, pathway design, monitoring, and outcomes and evaluation, all with an equity focus. The pathway is underpinned by the core constructs of equitable implementation in Aotearoa NZ: collaborative design, anti-racism, Māori and priority population expertise, cultural safety and values-based. Additionally, the contextual factors impacting implementation, i.e. the social, economic, commercial and political determinants of health, are included. CONCLUSIONS The framework presented in this study is the first equity-focused process-type implementation framework to be adapted for the Aotearoa NZ context. This framework is intended to support and facilitate equity-focused implementation research and health intervention implementation by mainstream health services.
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Affiliation(s)
- Papillon Gustafson
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin Campus, PO Box 56, Dunedin, Aotearoa, New Zealand, 9054
| | - Michelle Lambert
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin Campus, PO Box 56, Dunedin, Aotearoa, New Zealand, 9054
| | - Karen Bartholomew
- Te Whatu Ora Waitematā and Te Toka Tumai Auckland, Auckland, Aotearoa, New Zealand
| | - Mihi Ratima
- Taumata Associates, Hāwera, Aotearoa, New Zealand
| | - Yasmin Abdul Aziz
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin Campus, PO Box 56, Dunedin, Aotearoa, New Zealand, 9054
| | - Lisa Kremer
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin Campus, PO Box 56, Dunedin, Aotearoa, New Zealand, 9054
| | - Adam Fusheini
- Preventive and Social Medicine, University of Otago, Dunedin Campus, Dunedin, Aotearoa, New Zealand
| | | | - Rachel Brown
- National Hauora Coalition, Auckland, Aotearoa, New Zealand
| | - Patricia Priest
- Preventive and Social Medicine, University of Otago, Dunedin Campus, Dunedin, Aotearoa, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin Campus, PO Box 56, Dunedin, Aotearoa, New Zealand, 9054.
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Khan S, Lewis C, Zhang X, Ilias M, Mensah G. Charting the Future of Health Equity Research: Lessons Learned and Future Aspirations for NHLBI's DECIPHeR Alliance. Ethn Dis 2023; DECIPHeR:135-137. [PMID: 38846739 PMCID: PMC11099515 DOI: 10.18865/ed.decipher.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
The Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Risk (DECIPHeR) research program, supported by the National Heart, Lung, and Blood Institute (NHLBI), focuses on developing and testing sustainable interventions to reduce heart and lung disease disparities. This perspective piece reflects on lessons learned during the planning phase (UG3) and outlines the accomplishments of the DECIPHeR Alliance. The article emphasizes the importance of a biphasic (UG3/UH3) funding mechanism, technical assistance, and collaborative subcommittees in achieving success. As DECIPHeR enters phase 2 (UH3), the article anticipates rigorously planned studies addressing social determinants of health and emphasizes the need for effective implementation strategies and equitable research frameworks. The Alliance's contributions, such as the IM4Equity framework, offer novel approaches to community-engaged health equity and implementation science research. The article explores future opportunities, including dissemination strategies, community engagement, and collaboration with diverse partners, to maximize DECIPHeR's impact on health disparities beyond cardiovascular and pulmonary health.
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Affiliation(s)
- Shahnaz Khan
- National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Cara Lewis
- National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Xinzhi Zhang
- National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Maliha Ilias
- National Heart, Lung, and Blood Institute, Bethesda, MD
| | - George Mensah
- National Heart, Lung, and Blood Institute, Bethesda, MD
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