Canada Archives - Implementation Science at UW

✪ Towards a decolonising implementation science: principles from Indigenous leadership

Abstract:

Summary

Implementation science is a diverse and evolving field that draws on multiple epistemologies and methods. However, the dominant foundations of implementation science remain settler colonial, biomedical, and positivist. In Indigenous and other marginalised settings, these foundations can result in poor epistemological, ethical, and practical fit. We argue that a paradigm shift that is grounded in Indigenous values, sovereignty, relationality, and epistemologies is needed. We propose seven guiding principles for a decolonising implementation science. Drawing from emerging scholarship and innovative Indigenous-led frameworks from the USA, Aotearoa New Zealand, and Australia, these principles centre sovereignty, strengths-based approaches, and relational accountability. These principles also offer a roadmap to redefine rigour, expand what counts as evidence, and ensure genuine community control over the research process. Although born from Indigenous experience, these principles provide a framework for transforming implementation science to be more just, equitable, and effective for marginalised communities globally.

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

✪ How integrated knowledge translation worked to reduce federal policy barriers to the implementation of medication abortion in Canada: a realist evaluation

Abstract:

Background

Initial Canadian federal regulations for the abortion pill, mifepristone, had the potential to impede safe and equitable access to this medication. To catalyze evidence-based regulatory change, we engaged health policy, health system, and health services decision makers, and health professional organizations in integrated knowledge translation (iKT), a research approach that engages the users of research as equal partners.

Methods

We conducted a realist evaluation of what iKT strategies worked, for whom, and in what context to impact federal mifepristone regulations. We constructed initial program theories (if–then statements about how iKT worked). We tested the initial program theories using interviews with researchers and knowledge partners and triangulated with analysis of research programme documents. We configured the evidence in relation to the initial program theories, and refined program theories into causal explanatory configurations.

Results

We analyzed 38 interviews with researchers, health professional leaders, advocacy group leaders, and administrative government policy makers, as well as 49 program documents. Our results indicated that researcher partnerships with stakeholders had a meaningful impact on the removal of restrictions. We found key components of the causal explanatory configurations included: researcher motivation to move evidence into action, trusted reputations as credible sources of evidence, strategic partnerships, understanding of health policy processes, and researcher roles as a trusted convenor between key groups and decision makers.

Conclusions

Our study identifies several practical and transferable approaches to impactful iKT. The findings may be of relevance to researchers focused on public health topics subject to stigma.

Contributions to the literature

The effect of integrated knowledge translation (iKT) on public health policy is ambiguous, especially for issues that may be stigmatized, like abortion.
To bridge this knowledge gap, we evaluated the iKT used to support Canadian federal drug regulatory decisions to remove restrictions for the medication abortion pill, mifepristone.
Our realist evaluation identified several practical and transferable approaches to impactful iKT in complex policy systems that comprise an ‘iKT mindset’.
Key approaches for researchers include acting on motivations to move evidence into policy, building trusted reputations as credible sources of evidence, understanding and targeting policy levers, acting as a source of strategic evidence, and acting as a trusted convenor between key groups and decision makers.
Our use of realist methodology contributes to theoretical and empirical understandings of iKT with policy makers and has relevance for other stigmatized topics including opioid safe supply, vaccination, and climate change.

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

✪ Implementation Science for HIV Prevention and Treatment in Indigenous Communities: a Systematic Review and Commentary

Authors:

Christopher G. Kemp (Ngāi Tahu), Abagail J. Edwards, Lauren White (Choctaw Nation of Oklahoma), Gauri Kore, Pamela Jumper Thurman (Cherokee), Tommi Gaines (Navajo, Hopi), Paula Toko King (Te Aupōuri, Te Rarawa, Ngāpuhi, Ngāti Whātua, Waikato Tainui, Ngāti Maniapoto), Marama Cole (Ngāti Kahungunu, Ngāti Porou) & E. Roberto Orellana (Maya)

^{University of Washington affiliated authors are displayed in bold.}

✪ Open Access

Published: August 2024

Read the full text in the open access journal Current HIV/AIDS Reports

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.

Summary

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.

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

Imagining and implementing healthy city interventions: Combined results from parallel concept mapping exercises in Montreal with community members and stakeholders

✪ Reported quality indicators and implementation outcomes of community partnership in autism intervention research: A systematic review

Abstract:

There is minimal research on the quality of community partnerships in studies of interventions for autistic children. However, building high quality community engagement in autism intervention research may improve implementation outcomes. This systematic review examined studies that report community partnership in autism intervention research. A total of 135 articles were identified and 11 of these articles were included in the final review. Community partnership data were extracted using indicators from the conceptual framework for assessing research-practice partnerships (RPP; Henrick et al., Henrick et al., Assessing research-practice partnerships: Five dimensions of effectiveness, William T. Grant Foundation, 2017) and implementation outcomes data were extracted using the taxonomy of distinct implementation outcomes (Proctor et al., Administration and Policy in Mental Health and Mental Health Services Research, 38:65–76, 2011). Quality of studies were appraised using JBIs critical appraisal tools (Munn et al., JBI Evidence Synthesis, 18:2127–2133, 2020). RPP indicators and implementation outcomes were variably reported across studies. RPP indicators and implementation outcomes more likely to be reported were related to building trust, cultivating partnership relationships, conducting rigorous research to inform action, acceptability, and feasibility. RPP indicators and implementation outcomes less likely to be reported were related to building capacity to engage in partnership work, sustainability, cost, and penetration. Together, these results may suggest the need for increased sustainability and capacity building efforts in partnerships and increased guidelines for reporting outcomes.

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

Authors:

✪ Open Access

Read the full text in the open access journal Lancet Global Health

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Summary

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✪ Open Access

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

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Background

Methods

Results

Conclusions

Contributions to the literature

Authors:

✪ Open Access

Read the full text in the open access journal Current HIV/AIDS Reports

Abstract:

Purpose of Review

Recent Findings

Summary

Authors:

Subscription Required for Full Text Access

Read the full text in the subscription access journal Canadian Journal of Public Health

Authors:

✪ Open Access

Read the full text in the open access journal Autism Research

Abstract:

Authors:

Read the full text in the subscription access journal Current HIV/AIDS Reports