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Implementation Science at UW

Keywords: Adaptation

✪ An integrative review of implementation science in climate change and health adaptation research

Authors:

Amber S Khan, Clare C McCarthy, Stefan Wheat, Kenneth Sherr, Jeremy J Hess & Nicole A Errett

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: April 2026

Read the full text in the open access Journal of Climate Change and Health

Abstract:

Introduction

As climate change accelerates, reducing associated health risks requires uptake of effective approaches to adaptation at scale. However, translating climate change and health adaptation (CCHA) interventions into practice remains a persistent challenge for both researchers and practitioners. Implementation science provides tools to study methods and strategies that facilitate the adoption and sustainability of interventions into practice, but its application in the CCHA domain has not yet been examined.

Methods

In response, this integrative literature review identifies how implementation science has been applied to assess determinants, strategies, and outcomes of CCHA interventions, and to evaluate gaps, strengths, and limitations in the existing literature. Nineteen articles were identified through systematic searches of four databases and expert recommendations. Discrete data domains, defined a priori, were extracted and synthesized across articles.

Results

Findings demonstrated wide variability in the use of implementation frameworks, the identification and assessment of implementation strategies and outcomes, and the overall conceptualization of CCHA interventions. Findings highlight a critical opportunity to leverage implementation science as a tool to strengthen the assessment and uptake of CCHA efforts in public health practice.

Conclusion

In the face of the accelerating climate crisis, there is an urgent need for implementation science and climate change and health experts to work together to overcome conceptual and operational challenges to the use of implementation science frameworks and methods to advance the field.

Highlights
  • The formal use of implementation science in published CCHA research is limited.
  • Opportunities exist to adapt implementation science frameworks to CCHA research.
  • Investing in these opportunities can improve uptake of CCHA interventions.

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**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ A cross-consortium, stakeholder-driven model for implementing a modern electronic data capture and submission system across the Alzheimer’s Disease Research Centers Program

Authors:

Sarah Biber, Sarah Gothard, Charles F Murchison, Laura McLeod, Kathryn Gauthreaux, Chandima HewaNadungodage, Emily Cheng, Jessica Welsch, Jessica E. Culhane, Sarah Yasuda, Hannah Stockwell, Shilpa Allimatti, Mark Bauer, Jonathan M. Reader, Walter Kukull, Meredith Zozus & Sudeshna Das

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: March 2026

Read the full text in the open access Alzheimer's & Dementia: The Journal of the Alzheimer's Association

Abstract:

INTRODUCTION

The National Alzheimer's Coordinating Center (NACC) and Alzheimer's Disease Research Center (ADRC) Program advances dementia research by collecting and sharing standardized, longitudinal data, including the Uniform Data Set with the global research community. To modernize workflow and accelerate the availability of analyzable data, we co-developed a consortium-wide Electronic Data Capture and Submission system.

METHODS

A cross-disciplinary workgroup of ADRC and NACC members co-developed the system using a stakeholder-centered sociotechnical implementation model. Subgroups focused on requirements, development, and training. Surveys and pilot testing across centers guided design and priorities.

RESULTS

Research Electronic Data Capture was selected as the foundational platform. Deliverables included modular UDS version 4 instruments, embedded logic and automated quality checks, dynamic training resources, and an API-based submission pipeline to NACC. The platform was adopted across all 36 ADRCs and surveys indicated high user satisfaction.

DISCUSSION

Beyond infrastructure, this initiative provides a scalable, stakeholder-driven implementation model that supports higher-quality, more timely multicenter data submission, accelerating biomarker validation, early detection studies, and precision-medicine analyses.

Highlights
  • A cross-disciplinary workgroup of ADRC and NACC members designed a stakeholder-centric sociotechnical implementation model.
  • The workgroup drove the adoption of a modernized data infrastructure across a national consortium.
  • Deployed a modern electronic data capture and submission system for the ADRC program.
  • Leveraged REDCap as a flexible, scalable tool for a large-scale EDCS system.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ Reciprocal innovation in implementation science and global health: reflections from the EXTRA-CVD (extending the HIV treatment cascade for cardiovascular disease prevention) study

Authors:

Claudia L. Leung, Hayden B. Bosworth, Allison R. Webel, Angela Aifah, Constantine Akwanalo, Gerald S. Bloomfield, Emily W. Choi, Barbara M. Gripshover, Corrilynn O. Hileman, Jemima Kamano, Virginie Lopez-Kidwell, Charles Muiruri, Benson Njuguna, Nwora Lance Okeke, Christopher T. Longenecker, & Rajesh Vedanthan

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: March 2026

Read the full text in the open access journal BMC Global Public Health

Abstract:

Reciprocal innovation, a model of sustained, multidirectional exchange in which health strategies are adapted, revisited, and refined across contexts, offers a compelling framework to rethink how implementation science can support global health equity by enabling dynamic, multidirectional learning across different contexts. Drawing on the EXTRA-CVD trial, a nurse-led cardiovascular disease prevention intervention designed to extend the HIV treatment cascade in United States (U.S.) HIV clinics, which adapted strategies informed by implementation research in Kenya and the U.S. Veterans Affairs health system, this perspective examines how reciprocal innovation can begin to emerge within existing research structures, as well as where opportunities for deeper exchange remain limited. We identify four operational domains of reciprocal innovation: care delivery strategies, end-user engagement, research methodologies, and research leadership and partnership. Across these domains, we describe how cross-context learning shaped intervention adaptation and site-level implementation in EXTRA-CVD, as well as missed opportunities where more intentional feedback, shared leadership, and methodological exchange could have strengthened multidirectional learning. Taken together, this work highlights both the potential and the practical challenges of reciprocal innovation in implementation research, emphasizing its role in moving beyond unidirectional knowledge transfer toward iterative, context-responsive learning. By embedding structures for iterative feedback, equity-centered governance, and multidirectional learning systems within research and implementation systems, future global partnerships can foster more inclusive, responsive, and sustainable health interventions.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ HIV Prevention for People Releasing from Incarceration: A Qualitative Pre-implementation Study

Authors:

Emily Callen, Susan M. Graham, Winter Forsyth, Nicola R. Gerbino, Zoë Senter, Brett Hauber, Bryan J. Weiner, Courtney Bagdon-Cox & Helen E. Jack

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: December 2025

Read the full text in the open access journal Journal of General Internal Medicine

Abstract:

Background

Release from prison or jail is a high-risk time for HIV acquisition, yet prior efforts to expand access to pre-exposure prophylaxis (PrEP) and other HIV prevention services for people releasing from jail or prison have faced substantial implementation barriers.

Objective

Characterize the implementation landscape for HIV prevention for people releasing from prison or jail in Washington State, gathering input from staff at carceral institutions and community-based organizations to inform implementation of evidence-based HIV prevention strategies.

Design

Qualitative study.

Participants

Healthcare and reentry staff in prisons and jails (n = 15) and staff at community-based organizations that may serve people releasing from jail or prison (n = 20), selected through chain referral sampling.

Approach

Semi-structured qualitative interviews were conducted to theoretical saturation, then coded using a mixed inductive-deductive approach, based on the Consolidated Framework for Implementation Research.

Key Results

Carceral institutions had few programs aimed specifically at HIV prevention. Carceral institutions had PrEP available but did not offer it widely, focusing on behavioral health or acute medical needs. Some community-based organizations offered PrEP or other forms of HIV prevention, but many focused on meeting basic needs or building community. Five themes characterized the implementation landscape for HIV prevention: 1) primacy of basic needs means HIV prevention is lower priority, 2) adding HIV prevention programming would require new funding, 3) differences in culture and philosophy influence interest in providing PrEP, 4) disconnection between carceral institutions and providers in the community limits linkage to care, 5) organizations balance protecting confidentiality while coordinating care.

Conclusion

Rather than directly focusing on HIV prevention, carceral institutions and community-based organizations often focused on substance use disorder treatment, and there are opportunities to integrate additional HIV prevention education and interventions into substance use care. Closer relationships between carceral institutions and community organizations may improve care coordination but would require staff capacity.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

From Tanzania to Washington, DC: Application of the Consolidated Framework for Implementation Research and ADAPT-ITT Model to Guide the Development of a Community-Based PrEP Intervention for Black Adults

Authors:

Waimar Tun, Jennifer Gomez-Berrospi, Samuel Janson, Demarc Hickson, Christian Morris, Julie Pulerwitz, Mamaswatsi Kopeka, Jesse Yao, Rikiyah Mixson, Amanda McHale, Rachel Macey, Christian Buchanan, Bukola Rinola, Naana Koranteng-Yorke, Deanna Kerrigan, Oluwaseun Adebayo Bamodu, Donaldson F. Conserve & BRIDGE Research Team

University of Washington affiliated authors are displayed in bold.

Subscription Required for Full Text Access

Published: October 2025

Read the full text in the subscription access journal AIDS and Behavior

✪ Environmental sustainability, an essential outcome for implementation scientists to improve health

Authors:

Virginia Mckay, Emmanuel Tetteh, Nicholas Wong, C Bradley Kramer & Jason Burnham

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: October 2025

Read the full text in the open access journal Frontiers in Health Services

Abstract:

While there is evidence of humans' harmful impact on the environment, translating such evidence into changes is challenging. Implementation science can facilitate a shift from a reactive to proactive approach in tackling environmental sustainability. This article aims to spur further discussion among implementation scientists to incorporate environmental sustainability within their research, while also offering concepts relevant to environmental science researchers seeking to apply implementation science principles.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ “Going above and beyond” for implementation in the education sector: extension and validation of the School Implementation Citizenship Behavior Scale (SICBS)

Authors:

Catherine M. Corbin, Mark G. Ehrhart, Eric C. Brown, Jill Locke, Clayton R. Cook, Gregory A. Aarons & Aaron R. Lyon

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: May 2025

Read the full text in the open access journal Implementation Science Communications

Abstract:

Background

Employee behaviors that strategically support implementation (i.e., implementation citizenship behavior [ICB]) theoretically promote the adoption and high-fidelity use of evidence-based practices (EBPs). ICB (e.g., helping colleagues overcome implementation barriers) may vary across contexts, including schools where children are most likely to access and receive mental and behavioral health services. Pragmatic measures are needed to advance nascent research on school-based ICB and inform how these behaviors can be used to support successful implementation. The current study expanded the Implementation Citizenship Behavior Scale (ICBS) to create and validate the School Implementation Citizenship Behavior Scale (SICBS) in a sample of elementary school teachers implementing evidence-based prevention programs to support children’s mental and behavioral health.

Methods

Based on subject matter expert feedback, items were refined from the original ICBS and items for two new subscales (taking initiative, advocacy) were created for the SICBS. A sample of 441 public school teachers from 52 elementary schools in the Midwest and Western United States of America completed a survey that included the SICBS and additional measures to assess convergent and divergent validity. SICBS was refined and validated via examination of item characteristics curves to reduce items and develop a pragmatic instrument, confirmatory factor analyses to evaluate the hypothesized measurement structure, and assessment of convergent and divergent validity.

Results

The original two ICBS subscales (helping others, keeping informed) were retained, and two new three-item subscales resulted from item reduction analyses (taking initiative, advocacy). The hypothesized second-order factor model was generally well fit to the data (CFI = .99, TLI = .99, RMSEA = .09), all first- (λs = .85-.96) and second-order factor loadings (λs = .93-.95) were high. All SICBS subscales demonstrated acceptable reliability (αs = .88-.92). Convergent validity was evidenced by moderate correlations with organizational citizenship behavior items (rs = .42-.49). Divergent validity was demonstrated by weak correlations with teachers’ beliefs about teaching (rs = .31-.38) and null correlations with most school demographics.

Conclusion

Results support the structural, convergent, and divergent validity of the 12-item, 4-factor SICBS. The SICBS provides a deeper understanding of individual implementer actions that may serve as implementation mechanisms or outcomes.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ Finding the balance between rigour and relevance: implementing adaptations to the implementation of a pragmatic randomised controlled trial of a two-way texting intervention for voluntary medical male circumcision in South Africa

Authors:

Geoffrey Setswe, Sarah Day, Felex Ndebele, Jacqueline Pienaar, Vuyolwethu Ncube, & Caryl Feldacker

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: April 2025

Read the full text in the open access journal BMJ Open

Abstract:

Objectives

To document adaptations that were made to the implementation of the two-way texting (2wT) randomised controlled trial (RCT) for voluntary medical male circumcision (VMMC) in South Africa and to provide a nuanced discussion on the differences between adaptations and fidelity in this context.

Design

We conducted a qualitative study using the Framework for Reporting Adaptations and Modifications in Evidence-based Implementation Strategies (FRAME-IS) to examine 2wT adaptations. We reported adaptations to the 2wT intervention using two steps. First, we categorised adaptations in a shared study-specific Google Docs that documented participant engagement with the 2wT system, tracked daily RCT implementation notes, reported software bugs and noted reminder emails about adaptations for the research team. Second, we conducted a qualitative assessment of the influence of adaptations on project outcomes via 10 periodic reflection meetings with VMMC implementers. Reflection documentation included notes from field observations, meeting minutes and informal partner check-ins to complete adaptation documentation. Using the FRAME-IS as a codebook, adaptations were categorised.

Settings

The RCT was conducted in rural and urban VMMC clinics in the North West and Gauteng districts of South Africa.

Participants

Implementation scientists and VMMC implementers who implemented the 2wT pragmatic randomised controlled trial (pRCT) were participants for the adaptation study.

Primary and secondary outcome measures

The primary outcome measure was the adaptations that were made during the implementation of the 2wT pRCT. The secondary outcome measures were fidelity and rigour of implementing adaptations to the 2wT pRCT.

Results

Between June 2021 and February 2022, 13 adaptations were identified in three phases during the implementation of the 2wT pRCT. The first phase of adaptations aimed to augment study recruitment, including conducting weekend VMMC recruitment camps, using mobile outreach services in the rural site, adding two urban sites to increase recruitment, using weekly WhatsApp calls for updates with all implementing teams, using virtual meetings to implement the 2wT strategy remotely during COVID-19 restrictions and allocating one clinician to work outside of normal working hours. The second phase of adaptations further enhanced enrolments, including adding two local language translations in the usability survey for 2wT men and contributing a portion towards the salary of the implementing staff by the research partner. The third phase included the exclusion of two rural clinics as recruitment sites due to inconsistent mobile phone networks, adding another layer of data quality checks to ensure data quality, training non-clinical counsellors to help with enrolling clients, retraining of staff in the rural site with high staff turnover and using both primary and alternative phone numbers for enrolment to reduce loss to follow-up.

Conclusions

This study made adaptations to the 2wT pRCT without compromising the fidelity of the study. The 2wT pRCT balances rigour (fidelity) and relevance (adaptation). Adaptations should not be confined by rigour but should also not go unchallenged or unverified. We conclude that fidelity can be maintained with adaptations that are implemented to close the gap between research in the laboratory and practice.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ Outcome preferences in fidelity-adaptation scenarios across evidence-based parenting programs: A discrete choice experiment

Authors:

Kristoffer Pettersson, Philip Millroth, Fabrizia Giannotta, Pernilla Liedgren, Aaron R. Lyon, Henna Hasson, and Ulrica von Thiele Schwarz

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: February 2025

Read the full text in the open access journal Implementation Science

Abstract:

Background

Implementing evidence-based parenting programs often involves navigating fidelity-adaptation decisions. While research has explored various aspects of this dilemma, little is known about how practitioners’ outcome preferences influence their decisions in real-world scenarios.

Methods

This study employed a discrete choice experiment (DCE) to investigate the relative importance of five outcomes (Relationship Quality, Satisfaction, Workload Strain, Value Conflict, and Reach) in fidelity-adaptation decisions among 209 practitioners delivering evidence-based parenting programs in Sweden. The DCE presented 25 choice sets across five contextual scenarios, analyzed using Bayesian hierarchical logistic regression.

Results

All five outcomes significantly influenced practitioners’ choices, with Relationship Quality emerging as the most impactful (log-odds: 4.56, 95% CI [4.16, 4.91]). Satisfaction and minimizing Value Conflict showed similar importance (log odds: 2.45 and -2.40, respectively), while Workload Strain and Reach had slightly less impact (log odds: -2.10 and 1.96, respectively).

Conclusions

This study offers a novel perspective on the role of outcome preference in navigating fidelity-adaptation decisions. The strong preference for improving parent-child relationships aligns with core parenting program goals, while consideration of other outcomes reflects practitioners’ holistic approach to implementation. These findings can inform the design of interventions and implementation strategies that balance effectiveness with real-world constraints, potentially enhancing parenting programs’ adoption, sustainability, and impact.

Contributions to the literature
  • This study pioneers the application of discrete choice experiments in exploring fidelity-adaptation decisions.
  • Quantifying practitioners’ outcome preferences provides empirical evidence of complex trade-offs in implementing evidence-based parenting programs.
  • The study’s results provide actionable insights for program developers, policymakers, and implementation scientists on designing interventions that resonate with practitioners’ priorities while maintaining program effectiveness.
  • This research bridges theoretical frameworks and real-world decision-making, advancing our understanding of how various factors influence intervention delivery in practice.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**