Closing the health equity gap: A role for implementation science?

Odeny, Beryne

doi:10.1371/journal.pmed.1003762

Cited by 27 publications

(21 citation statements)

References 12 publications

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“…*Definitions are adapted from the Proctor et al 2011 paper (6). **Team added constructs-availability (21)(22)(23)(24), health equity (25)(26)(27), and scale-up ( 28)-based on theoretical and practical application.…”

Section: Sustainability*mentioning

confidence: 99%

A Perspective on Implementation Outcomes and Strategies to Promote the Uptake of COVID-19 Vaccines

et al. 2022

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Recent articles have highlighted the importance of incorporating implementation science concepts into pandemic-related research. However, limited research has been documented to date regarding implementation outcomes that may be unique to COVID-19 vaccinations and how to utilize implementation strategies to address vaccine program-related implementation challenges. To address these gaps, we formed a global COVID-19 implementation workgroup of implementation scientists who met weekly for over a year to review the available literature and learn about ongoing research during the pandemic. We developed a hierarchy to prioritize the applicability of “lessons learned” from the vaccination-related implementation literature. We identified applications of existing implementation outcomes as well as identified additional implementation outcomes. We also mapped implementation strategies to those outcomes. Our efforts provide rationale for the utility of using implementation outcomes in pandemic-related research. Furthermore, we identified three additional implementation outcomes: availability, health equity, and scale-up. Results include a list of COVID-19 relevant implementation strategies mapped to the implementation outcomes.

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Section: Sustainability*mentioning

confidence: 99%

A Perspective on Implementation Outcomes and Strategies to Promote the Uptake of COVID-19 Vaccines

et al. 2022

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“…2 Implementation science is being increasingly recognised as an approach to reduce health inequities. [20][21][22][23][24][25][26] Implementation science is defined as the 'scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services and care'. 27 Implementation research seeks to understand the multi-level factors influencing health intervention design and delivery.…”

Section: Open Accessmentioning

confidence: 99%

“…Achieving equitable health outcomes requires approaches that recognise and account for the differences in levels of advantage between groups 2. Implementation science is being increasingly recognised as an approach to reduce health inequities 20–26. Implementation science is defined as the ‘scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services and care’ 27.…”

Section: Introductionmentioning

confidence: 99%

Supporting implementation of interventions to address ethnicity-related health inequities: frameworks, facilitators and barriers – a scoping review protocol

et al. 2023

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IntroductionHealth inequities are differences in health between groups of people that are avoidable, unfair and unjust. Achieving equitable health outcomes requires approaches that recognise and account for the differences in levels of advantage between groups. Implementation science, which studies how to translate evidence-based interventions into routine practice, is increasingly recognised as an approach to address health inequities by identifying factors and processes that enable equitable implementation of interventions. This article describes the protocol for a scoping review of the literature relating to the equitable implementation of interventions, focusing on ethnicity-related health inequities. The scoping review aims to identify equity-focused implementation science theories, models and frameworks (TMFs) and to synthesise and analyse the evidence relating to the factors that aid or inhibit equitable implementation of health interventions.Methods and analysisThe scoping review is guided by the methodology developed by Arksey and O’Malley and enhanced by Levac and colleagues. Relevant literature will be identified by searching electronic databases, grey literature, hand-searching key journals and searching the reference lists and citations of studies that meet the inclusion criteria. We will focus on literature published from 2011 to the present. Titles, abstracts and full-text articles will be screened independently by two researchers; any disagreements will be resolved through discussion with another researcher. Extracted data will be summarised and analysed to address the scoping review aims.Ethics and disseminationThe scoping review will map the available literature on equity-focused implementation science TMFs and the facilitators and barriers to equitable implementation of interventions. Ethical approval is not required. Dissemination of the results of the review will include publications in peer-review journals and conference and stakeholder presentations. Findings from the review will support those implementing interventions to ensure that the implementation pathway and processes are equitable, thereby improving health outcomes and reducing existing inequities.

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“…Approaches to evaluating a digital health technology' s impact on health disparities and/or equity can be effectively adapted from existing clinical, research, or industry models. For example, implementation science (sometimes known as knowledge translation science) frameworks such as "RE-AIM" (Reach, Effectiveness, Adoption, Implementation, and Maintenance) and Proctor' s Implementation Outcomes Framework (IOF) offer means to understand how evidence-based interventions are taken up in real-world contexts, and to optimize specific intervention goals such as adoption, sustainability, or cost (18); these frameworks can be applied to digital health technologies, and can be adapted to incorporate equity goals more explicitly (19)(20)(21). Similarly, business development approaches to product metrics such as the Pirate Metrics (acquisition, activation, retention, referral, and revenue) (22) can be repurposed to highlight equity-centered goals for digital health products -for example, redefining acquisition (how a company attains customers) to focus on the recruitment of diverse patient end-users and retention (how a company keeps customers) to focus on empowerment, representativeness, or enfranchisement.…”

Section: Building Equitable Digital Health Toolsmentioning

confidence: 99%

Digital Health Equity

Lawrence

2022

Digital Health

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Digital health technologies have the potential to improve healthcare access, utilization, and experience for patients; at the same time, their development and use can reinforce, exacerbate, and even create health disparities. Applying a health equity lens to digital health innovations can help inform the equitable design and development of digital health tools. Specifically, areas of health equity impact that can be targeted in the development of a digital health technology include: the tool itself, including its design, technical development, integration into the healthcare environment, and evaluation; the technology' s relationship to various end-users, including individuals, tech proprietors and developers, and the larger healthcare system; and its impact on identified health and social determinant outcomes. Targeting one or more of these areas can help support the design, development, and deployment of digital health tools that actively work to reduce health disparities and promote health equity for socially disadvantaged patient populations. More research is needed to understand the full effect of digital health technology on health disparities, and to develop best practices for equity-centered digital health implementation and evaluation.

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Closing the health equity gap: A role for implementation science?

Abstract: Beryne Odeny discusses strategies to improve equity in health care and health research.

Cited by 27 publications

References 12 publications

A Perspective on Implementation Outcomes and Strategies to Promote the Uptake of COVID-19 Vaccines

A Perspective on Implementation Outcomes and Strategies to Promote the Uptake of COVID-19 Vaccines

Supporting implementation of interventions to address ethnicity-related health inequities: frameworks, facilitators and barriers – a scoping review protocol

Digital Health Equity

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