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Adamu AA, Ndwandwe D, Jalo RI, Wiysonge CS. Positioning implementation science in national immunization programmes to improve coverage equity and advance progress toward Immunization Agenda 2030: An urgent global health imperative. Hum Vaccin Immunother 2024; 20:2331872. [PMID: 38556477 PMCID: PMC10984125 DOI: 10.1080/21645515.2024.2331872] [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: 02/14/2024] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
Despite the availability of effective vaccines for preventing common childhood infectious diseases, there is still significant disparities in access and utilization across many low- and middle-income countries (LMIC). The factors that drive these disparities are often multilevel, originating from individuals, health facilities, health systems and communities, and also multifaceted. Implementation science has emerged as a field to help address "know-do" gaps in health systems, and can play a significant role in strengthening immunization systems to understand and solve implementation barriers that limit access and uptake within their contexts. This article presents a reflexive perspective on how to position implementation research in immunization programmes to improve coverage equity. Furthermore, key points of synergy between implementation research and vaccination are highlighted, and some potential practice changes that can be applied within specific contexts were proposed. Using a human rights lens, it was concluded that the cost that is associated with implementation failure in immunization programmes is significant and unjust, and future directions for implementation research to optimize its application in practice settings have been recommended.
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Affiliation(s)
- Abdu A. Adamu
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Rabiu I. Jalo
- Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Vaccine-Preventable Diseases Programme, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Lewis CC, Frank HE, Cruden G, Kim B, Stahmer AC, Lyon AR, Albers B, Aarons GA, Beidas RS, Mittman BS, Weiner BJ, Williams NJ, Powell BJ. A research agenda to advance the study of implementation mechanisms. Implement Sci Commun 2024; 5:98. [PMID: 39285504 PMCID: PMC11403843 DOI: 10.1186/s43058-024-00633-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 08/30/2024] [Indexed: 09/20/2024] Open
Abstract
BACKGROUND Implementation science scholars have made significant progress identifying factors that enable or obstruct the implementation of evidence-based interventions, and testing strategies that may modify those factors. However, little research sheds light on how or why strategies work, in what contexts, and for whom. Studying implementation mechanisms-the processes responsible for change-is crucial for advancing the field of implementation science and enhancing its value in facilitating equitable policy and practice change. The Agency for Healthcare Research and Quality funded a conference series to achieve two aims: (1) develop a research agenda on implementation mechanisms, and (2) actively disseminate the research agenda to research, policy, and practice audiences. This article presents the resulting research agenda, including priorities and actions to encourage its execution. METHOD Building on prior concept mapping work, in a semi-structured, 3-day, in-person working meeting, 23 US-based researchers used a modified nominal group process to generate priorities and actions for addressing challenges to studying implementation mechanisms. During each of the three 120-min sessions, small groups responded to the prompt: "What actions need to be taken to move this research forward?" The groups brainstormed actions, which were then shared with the full group and discussed with the support of facilitators trained in structured group processes. Facilitators grouped critical and novel ideas into themes. Attendees voted on six themes they prioritized to discuss in a fourth, 120-min session, during which small groups operationalized prioritized actions. Subsequently, all ideas were collated, combined, and revised for clarity by a subset of the authorship team. RESULTS From this multistep process, 150 actions emerged across 10 priority areas, which together constitute the research agenda. Actions included discrete activities, projects, or products, and ways to shift how research is conducted to strengthen the study of implementation mechanisms. CONCLUSIONS This research agenda elevates actions to guide the selection, design, and evaluation of implementation mechanisms. By delineating recommended actions to address the challenges of studying implementation mechanisms, this research agenda facilitates expanding the field of implementation science, beyond studying what works to how and why strategies work, in what contexts, for whom, and with which interventions.
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Affiliation(s)
- Cara C Lewis
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA.
| | - Hannah E Frank
- The Warren Alpert Medical School, Brown University, Box G-BH, Providence, RI, 02912, USA
| | - Gracelyn Cruden
- Chestnut Health System, Lighthouse Institute - OR Group, 1255 Pearl St, Ste 101, Eugene, OR 97401, USA
| | - Bo Kim
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA, 02130, USA
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Aubyn C Stahmer
- UC Davis MIND Institute, 2825 50Th St, Sacramento, CA, 95819, USA
| | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 NE Pacific Street Box 356560, Seattle, WA, 98195-6560, USA
| | - Bianca Albers
- Institute for Implementation Science in Health Care, University of Zurich, Zürich, Switzerland
| | - Gregory A Aarons
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive La Jolla California, San Diego, 92093, CA, USA
| | - Rinad S Beidas
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Avenue, Evanston, IL, 60661, USA
| | - Brian S Mittman
- Division of Health Services Research & Implementation Science, Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S Los Robles Ave, Pasadena, CA, 91101, USA
| | - Bryan J Weiner
- Department of Global Health, School of Public Health, Box 357965, Seattle, WA, 98195, USA
| | - Nate J Williams
- School of Social Work, Boise State University, Boise, ID, 83725, USA
| | - Byron J Powell
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, St. Louis, MO, USA
- Center for Dissemination & Implementation, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA
- Division of Infectious Diseases, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Kang E, Chen J, Lipsey KL, Foster ER. Community-Engaged Implementation Strategies in Occupational Therapy: A Scoping Review. Am J Occup Ther 2024; 78:7805205030. [PMID: 39197014 DOI: 10.5014/ajot.2024.050526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2024] Open
Abstract
IMPORTANCE Despite the potential of community-engaged implementation research (CEIR) in developing strategies to accelerate the translation of evidence-based interventions (EBIs), there is a noticeable knowledge gap in the current state of CEIR in occupational therapy. A synthesis of the concept, purpose, and operationalization of CEIR is necessary. OBJECTIVE To identify the contexts, purposes, and operationalization of CEIR, focusing on implementation strategies in occupational therapy. DATA SOURCES PubMed/MEDLINE, Embase, CINAHL, Scopus, and Web of Science. STUDY SELECTION AND DATA COLLECTION We included studies that were explicit and intentional about CEIR and that focused on implementation strategies to support the translation of occupational therapy interventions, clinical guidelines, practice models, theories, or assessments. We extracted the research context (e.g., partners, recruitment), purpose (e.g., why community-engaged research was used), and operationalization (e.g., community engagement [CE] activities, how their findings inform the research) using thematic analysis. FINDINGS Of 3,219 records, 6 studies were included. Involved partners were mainly occupational therapy practitioners from existing networks. CEIR that focuses on implementation strategies informs various aspects of research design, ranging from study design to sustainability, by developing community-academia partnerships, building implementation capacity, and creating implementation strategies across diverse research areas. Current research has used various but mostly traditional CE activities (e.g., focus groups). CONCLUSIONS AND RELEVANCE We synthesized evidence on CEIR focused on implementation strategies in occupational therapy. Intentional efforts are needed to collaborate with diverse partners, explore innovative CE activities, produce equitable outputs, and develop multilevel implementation strategies to accelerate the translation of EBIs into practice. Plain-Language Summary: In this review, we synthesize evidence on the contexts, purposes, and operationalization of community-engaged implementation research (CEIR), focusing on implementation strategies in occupational therapy research. We found that current implementation efforts mainly rely on occupational therapy practitioners as community partners and use traditional recruitment methods and community engagement activities. In turn, they develop implementation strategies that mainly target practitioners without comprehensive, multilevel implementation support. We suggest more equitable collaboration with diverse partners to effectively promote the implementation and dissemination of evidence-based interventions in occupational therapy practice.
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Affiliation(s)
- Eunyoung Kang
- Eunyoung Kang, PhD, BOT, is Postdoctoral Research Fellow, Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO;
| | - Julie Chen
- Julie Chen, BS, is Occupational Therapy Student, Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Kim L Lipsey
- Kim L. Lipsey, MLS, is Medical Librarian, Bernard Becker Medical Library, School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Erin R Foster
- Erin R. Foster, PhD, OTD, OTR/L, is Associate Professor, Program in Occupational Therapy, Departments of Neurology and Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO
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Brownson RC, Cabassa LJ, Drake BF, Shelton RC. Closing the gap: advancing implementation science through training and capacity building. Implement Sci 2024; 19:46. [PMID: 38961482 PMCID: PMC11223366 DOI: 10.1186/s13012-024-01371-x] [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: 04/04/2024] [Accepted: 06/07/2024] [Indexed: 07/05/2024] Open
Abstract
In their article on "Navigating the Field of Implementation Science Towards Maturity: Challenges and Opportunities," Chambers and Emmons describe the rapid growth of implementation science along with remaining challenges. A significant gap remains in training and capacity building. Formats for capacity building include university degree programs, summer training institutes, workshops, and conferences. In this letter, we describe and amplify on five key areas, including the need to (1) identify advanced competencies, (2) increase the volume and reach of trainings, (3) sustain trainings, (4) build equity focused trainings, and (5) develop global capacity. We hope that the areas we highlight will aid in addressing several key challenges to prioritize in future efforts to build greater capacity in implementation science.
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Affiliation(s)
- Ross C Brownson
- Prevention Research Center, Brown School at Washington University in St. Louis, One Brookings Drive, Campus, Box 1196, St. Louis, MO, 63130, United States.
- Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, 63130, United States.
| | - Leopoldo J Cabassa
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, St. Louis, MO, 63130 63130, United States
| | - Bettina F Drake
- Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, 63130, United States
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, 10032, United States
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Dagenais C, Hot A, Bekelynck A, Villemin R, Mc Sween-Cadieux E, Ridde V. MOOC-based blended learning for knowledge translation capacity-building: A qualitative evaluative study. PLoS One 2024; 19:e0297781. [PMID: 38335193 PMCID: PMC10857586 DOI: 10.1371/journal.pone.0297781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/12/2024] [Indexed: 02/12/2024] Open
Abstract
This qualitative study investigated the effectiveness of blended learning using MOOCs (massive open online courses) for capacity-building in knowledge translation (KT). The evaluation followed Kirkpatrick's updated model. A total of 23 semi-directed interviews were conducted with participants working at a research centre in Côte d'Ivoire, with a first wave of interviews immediately post-training and a second wave after five months. Results showed that the training met learners' needs, with both the content and teaching format being deemed appropriate. Learners reacted positively to face-to-face activities and affirmed the importance of coaching for putting learning into practice. Specific KT skills and principles appeared to have been acquired, such as a procedure for structuring the KT process and improved skills for communicating and presenting scientific knowledge. Five months after the training, encouraging changes were reported, but the sustainability of the new KT practices remained uncertain. KT capacity-building initiatives in low- and middle-income countries struggle to meet demand. Little is known about effective KT training in that context, and even less in non-anglophone countries. The study presented here contributes to the understanding of success factors from the learners' standpoint.
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Affiliation(s)
- Christian Dagenais
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Aurélie Hot
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | | | - Romane Villemin
- Department of Psychology, Université du Québec à Montreal, Montreal, Quebec, Canada
| | - Esther Mc Sween-Cadieux
- Department of School and Social Adaptation Studies, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Valéry Ridde
- Université Paris Cité, IRD, Inserm, Ceped, Paris, France
- Institut de Santé et Développement, Université Cheikh Anta Diop, Dakar, Senegal
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Russell-Babin K, Friesen MA, O'Brien AM, McLaughlin MK, Messing J, Mowery B, Bettencourt AP, Graling PR. A Nurse-Led Implementation Science Specialist Program. Am J Nurs 2023; 123:38-45. [PMID: 37988023 DOI: 10.1097/01.naj.0000997228.84722.c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
ABSTRACT A well-known challenge in health care is integrating evidence into practice. Implementation science (IS) is a growing field that promotes the sustainable application of evidence-based practice (EBP) to clinical care. Health care organizations have an opportunity to support sustainable change by creating robust IS infrastructures that engage nurses in the clinical environment. Integrating IS into a nursing shared governance model is an ideal vehicle to empower direct care nurses to sustain EBP. Importantly, an IS infrastructure may also promote nurse retention and increase interdisciplinary collaboration. This article, the first in a series on applying IS, describes how a multisite health care organization developed a systemwide nurse-led IS Specialist program within a shared governance model.
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Affiliation(s)
- Kathleen Russell-Babin
- Kathleen Russell-Babin is vice president of professional practice at Inova Health System in Falls Church, VA, where Mary Ann Friesen and Bernice Mowery are nursing research scientists, Maureen Kirkpatrick McLaughlin is an implementation science consultant, Jonathan Messing is an advanced practice provider manager, and Paula R. Graling is vice president of nursing, perioperative services. Anne-Marie O'Brien is an associate professor of nursing at Sonoma State University in Rohnert Park, CA. Amanda P. Bettencourt is an assistant professor in the University of Pennsylvania School of Nursing in Philadelphia and an implementation science consultant. Contact author: Paula R. Graling, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Keim-Malpass J, Phillips J, Johnston KC. Disseminating for impact: creating curriculum activities for translational dissemination for the clinical and translational research workforce. Front Pharmacol 2023; 14:1284662. [PMID: 38026997 PMCID: PMC10663226 DOI: 10.3389/fphar.2023.1284662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
There has been an increased focus on the practices associated with dissemination for the translation of research to clinical practice and ultimately, policy. Simultaneously, there has been attention placed on the role of the clinical research workforce in supporting optimal dissemination efforts for impact and societal benefit. Curriculums focused on education opportunities for dissemination for translational scientists have been under-reported. The Translational Science Benefits Model (TSBM) is a framework that has been developed to support assessment of clinical and translational research outcomes that measure impact (both in the clinical and community setting) beyond traditional citations in academic journals/bibliometric activities. The TSBM framework outlines more than 30 different facets of impact and can provide a basis for operationalizing broad impacts of research for translational and clinical scientists. Engagement science offers methods and modalities to work with individual stakeholders, and collaborators in a team science model, and engagement with external scholars and society. This article will describe the use of the TSBM framework and engagement science strategies to develop a translational dissemination framework with novel components for evaluation of dissemination and implementation activities. We propose using the translational dissemination framework to guide the development of an educational curriculum for the clinical research workforce. We outline the educational domains and proposed evaluation criteria essential in implementing this innovative translational dissemination educational content for the clinical and translational research workforce.
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Affiliation(s)
- Jessica Keim-Malpass
- Division of Pediatric Hematology-Oncology, University of Virginia School of Medicine, Charlottesville, VA, United States
- Integrated Translational Health Research Institute of Virginia (iTHRIV), University of Virginia, Charlottesville, VA, United States
| | - Jennifer Phillips
- Integrated Translational Health Research Institute of Virginia (iTHRIV), University of Virginia, Charlottesville, VA, United States
| | - Karen C. Johnston
- Integrated Translational Health Research Institute of Virginia (iTHRIV), University of Virginia, Charlottesville, VA, United States
- Department of Neurology, University of Virginia School of Medicine, Charlottesville, VA, United States
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