Reva Datar, Sheree Schwartz, Wilson Gomez, David A Katz, Gustavo Morales, Debbie Humphries, April Pettit, Audrey Harkness, Pedro Alonso Serrano, Robin Gaines Lanzi, Jessica M Sales, Christopher Archiopoli, Stefan Baral, Laura K Beres
University of Washington affiliated authors are displayed in bold.
Published: April 2025
Debbie L Humphries, Carolyn M Audet, Bijal A Balasubramanian, Nanette Benbow, Christopher G Kemp, Robin Gaines Lanzi, Sung-Jae Lee, Hannah Mestel, Alexandra B Morshed, Brian Mustanski, April Pettit, Borsika A Rabin, Olivia Sadler, Alison B Hamilton, Mary-Louise E Millett, Sheree Schwartz, Kenneth Sherr, Nicole A Stadnick, & Dennis H Li
University of Washington affiliated authors are displayed in bold.
Published: April 2025
Christine M Khosropour, Arianna Rubin Means, Roxanne P Kerani, Emma M Murphy, Krupa Mehta, Kristina Santana, Kenneth Sherr, & Matthew R Golden.
University of Washington affiliated authors are displayed in bold.
Published: April 2025
Lawrence A. Palinkas, Benjamin Springgate, Leopoldo J. Cabassa, Michelle Shin, Samantha Garcia, Benjamin F. Crabtree & Jennifer Tsui
University of Washington affiliated authors are displayed in bold.
Published: April 2025
Community engagement is widely recognized as critical to successful and equitable implementation of evidence-based practices, programs, and policies. However, there are no clear guidelines for community involvement in data collection and analysis in implementation research.
We describe three specific methods for engaging community members in data collection and analysis: concept mapping, rapid ethnographic assessment, and Photovoice. Common elements are identified from a case study of each method: 1) selection and adaptation of evidence-based strategies for improving adolescent HPV vaccine initiation rates in disadvantaged communities, 2) strategies for implementing medication for opioid use disorders among low-income Medicaid enrollees during natural disasters, and 3) interventions to improve the physical health of adults with severe mental illness living in supportive housing.
In all three cases, community members assisted in participant recruitment, provided data, and validated preliminary findings created by researchers. In the Photovoice case study, community members participated in both data collection and analysis, while in the concept mapping, community members also participated in the initial phase of organizing and prioritizing evidence-based strategies during the data analysis.
Community involvement in implementation research data collection and analysis contributes to greater engagement and empowerment of community members and validation of study findings. Use of methods that exhibit both scientific rigor and community relevance of implementation research also contributes to greater community investment in successful implementation outcomes. Nevertheless, the case studies point to the importance and efficiency of the division of labor embedded in community-engaged implementation research. Building capacity for community members to assume greater roles in obtaining and organizing data for preliminary analysis prior to interpretation is recommended.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Ana A. Baumann, Danielle R. Adams, Laura-Mae Baldwin, Rachel G. Tabak, Sara Malone, Maura M. Kepper, Anita D. Misra-Hebert, Kathleen R. Stevens, Maria E. Fernandez & Sunil Kripalani
University of Washington affiliated authors are displayed in bold.
Published: April 2025
Capacity building is critical for research and practice as the fields of dissemination, implementation and translation science continue to grow. Some scholars state that capacity building should be grounded in competencies. However, the fields are unclear in determining which competencies are relevant for whom, including the content and appropriate level of information and skills for different roles. The goal of this study was to catalogue competencies across current D&I capacity building initiatives.
We conducted a mapping review to examine to what extent are theories or frameworks used to guide capacity building, who is being trained, to what extent do capacity building initiatives include a health equity focus, which competencies are being outlined or suggested, how are they being defined, and whether the competencies can be organized along different roles of participants. As a mapping review, we broadly searched for papers using the keywords “training D&I” OR “training implementation” OR “training translation” OR “training dissemination” and included debate and empirical papers about capacity building initiatives in the sample.
A total of 42 articles (from 2011 to 2024) were reviewed, including training development and/or evaluation (n = 25) and conceptual (n = 17) articles. Of the training articles, 13 (52%) specified a framework that guided training. Participants in training included graduate students, researchers, practitioners, and mixed audiences. Fourteen (56%) of the trainings were conducted in the USA, seven (28%) in Canada and other countries. The length of training ranged from two days to two years. Four trainings had an explicit focus on equity. A total of 307 unique competencies were identified and divided into themes: Knowledge, Skills, Engagement with Other Disciplines, Equity, Attitude and Relational Aspects, Capacity Building, Quality Improvement, and Mentorship.
While there are many D&I capacity building initiatives, we found little consistency in competencies that guided training activities for diverse audiences. Few training activities explicitly identified guiding theories or frameworks or tailored competencies toward different levels of interest in D&I research. Even fewer had an explicit focus on health equity. As the fields continue to foster capacity building programs, it will be important to think critically about the types of competencies we are developing for whom, how, and why.
This study provides a critical step in the dissemination, implementation and translation capacity building literatures by cataloging competencies related to these sciences, and by offering suggestions for capacity building initiatives.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Christine A March, Elissa Naame, Ingrid Libman, Chelsea N Proulx, Linda Siminerio, Elizabeth Miller, & Aaron R Lyon
University of Washington affiliated authors are displayed in bold.
Published: March 2025
School-partnered interventions may improve health outcomes for children with type 1 diabetes, though there is limited evidence to support their effectiveness and sustainability. Family, school, or health system factors may interfere with intervention usability and implementation.
To identify and address potential implementation barriers during intervention development, we combined methods in user-centered design and implementation science to adapt an evidence-based psychosocial intervention, the collaborative care model, to a virtual school-partnered collaborative care (SPACE) model for type 1 diabetes between schools and diabetes medical teams.
We recruited patient, family, school, and health system partners (n=20) to cocreate SPACE through iterative, web-based design sessions using a digital whiteboard (phase 1). User-centered design methods included independent and group activities for idea generation, visual voting, and structured critique of the evolving SPACE prototype. In phase 2, the prototype was evaluated with the usability evaluation for evidence-based psychosocial interventions methods. School nurses reviewed the prototype and tasks in cognitive walkthroughs and completed the Intervention Usability Scale (IUS). Two members of the research team independently identified and prioritized (1-3 rating) discrete usability concerns. We evaluated the relationship between prioritization and the percentage of nurses reporting each usability issue with Spearman correlation. Differences in IUS scores by school nurse characteristics were assessed with ANOVA.
In the design phase, the partners generated over 90 unique ideas for SPACE, prioritizing elements pertaining to intervention adaptability, team-based communication, and multidimensional outcome tracking. Following three iterations of prototype development, cognitive walkthroughs were completed with 10 school nurses (n=10, 100% female; mean age 48.5, SD 9.5 years) representing different districts and years of experience. Nurses identified 16 discrete usability issues (each reported by 10%-60% of participants). Two issues receiving the highest priority (3.0): ability to access a virtual platform (n=3, 30% of participants) and data-sharing mechanisms between nurses and providers (n=6, 60% of participants). There was a moderate correlation between priority rating and the percentage of nurses reporting each issue (ρ=0.63; P=.01). Average IUS ratings (77.8, SD 11.1; 100-point scale) indicated appropriate usability. There was no difference in IUS ratings by school nurse experience (P=.54), student caseload (P=.12), number of schools covered (P=.90), or prior experience with type 1 diabetes (P=.83), suggesting that other factors may influence usability. The design team recommended strategies for SPACE implementation to overcome high-priority issues, including training users on videoconferencing applications, establishing secure forms for school data reporting, and sharing glucose data in real-time during SPACE meetings.
Cross-sector interventions are complex, and perceived usability is a potential barrier to implementation. Using web-based cocreation methods with community partners promoted high-quality intervention design that is aligned with end-user priorities. Quantitative and qualitative assessments indicated appropriate degree of usability to move forward with pilot-testing.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Kelly A. Aschbrenner, Callie Walsh-Bailey, Meagan C. Brown, Tanveer Khan, Travis P. Baggett, Salene M.W. Jones, Douglas E. Levy, Lydia E. Pace, and Jonathan P. Winickoff
University of Washington affiliated authors are displayed in bold.
Published: March 2025
The primary purpose of this study was to assess perceived burdens and benefits of participating in implementation research among staff employed in resource-constrained healthcare settings. Another objective was to use findings to generate considerations for engaging staff in research across different phases of implementation research.
This qualitative focus group and consensus building study involved researchers affiliated with the National Cancer Institute Implementation Science Centers in Cancer Control program and nine Community Health Centers (CHCs) in Massachusetts. Six focus groups (n = 3 with CHC staff; n = 3 with researchers) assessed barriers and facilitators to staff participation in implementation research. During consensus discussions, we used findings to develop considerations for engaging staff as participants and partners throughout phases of implementation research.
Sixteen researchers and 14 staff participated in separate focus groups; nine researchers and seven staff participated in separate consensus discussions. Themes emerged across participant groups in three domains: (1) influences on research participation; (2) research burdens and benefits; and (3) ways to facilitate staff participation in research. Practical considerations included: (a) aligning research with organizational and staff values and priorities; (b) applying user-centered design to research methods; (c) building organizational and individual research capacity; and (d) offering equitable incentives for staff participation.
Engaging staff as participants and partners across different phases of implementation research requires knowledge about what contributes to research burden and benefits and addressing context-specific burdens and benefits.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Rangarirai Matima, Claire van der Westhuizen, Crick Lund, Ferdinand C. Mukumbang
University of Washington affiliated authors are displayed in bold.
Published: March 2025
Formulating and implementing mental health policy is foundational to public mental health. The implementation of mental health policy varies in low- and middle-income countries (LMICs), with some countries having better implementation outcomes than others. Low implementation poses challenges relating to addressing the high burden and wide treatment gaps of mental health conditions. While different implementation strategies are applied to implement mental health policy in different contexts, there is little knowledge of what category of strategies are being used and how and why their implementation produces varied outcomes. To this end, we propose to conduct a realist synthesis to explain how, why, for whom, and under what health system conditions certain policy implementation strategies work or not in LMICs.
This paper will detail the protocol on conducting a realist review of the literature on mental health policy implementation in LMICs. Realist reviews/syntheses are theory-driven reviews designed to formulate and test (confirm, refute, or refine) initial programme theories to explain how, why, for whom and under what contexts a programme, intervention or policy works as intended or not. Theory is built by exploring and abstracting context-mechanism-outcome (CMO) configurations in the data. These CMO configurations are identified through retroductive theorizing, a mechanism-centred approach to theory development. We will adopt these steps to guide the process of realist synthesis: i) identify the research question, clarifying the scope of the review and formulating the initial programme theory (ii) conducting background searches in PubMed, PsycINFO, Africa-Wide Information, African Index Medicus (AIM), CINAHL and Scopus databases, and grey literature (iii) appraising the quality of studies and data extraction and (iv) synthesising data.
The review is part of a realist evaluation exploring mental health policy implementation in LMICs and is registered under PROSPERO (registration number: CRD42024580312). Findings will inform the development of initial mental health policy implementation programme theories explaining why and how mental health policy implementation in LMICs works.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Mercy Owuor, Beatrice Wamuti, David A Katz, Wenjia Liu, Harison Lagat, Edward Kariithi, Brienna Naughton, Hanley Kingston, Mary Mugambi, Rose Bosire, Sarah Masyuko, Carey Farquhar, and Bryan J Weiner
University of Washington affiliated authors are displayed in bold.
Published: March 2025
This study explores factors affecting community-level demand for assisted partner services (APS) and HIV testing services (HTS) in western Kenya.
This is a multilevel qualitative analysis conducted as part of the APS Scale-up Study, a hybrid type 2 implementation-effectiveness study of APS integrated within routine HTS. For this analysis, in-depth phone interviews assessed demand for APS and factors influencing decisions to participate in APS.
Participants were recruited from eight healthcare facilities and (for APS stakeholders) from affiliated healthcare institutions in western Kenya (Kisumu and Homabay). Interviews were conducted by phone in 2019 and 2020.
67 participants were interviewed: 14 APS providers, 16 female index clients, 17 male sexual partners and 20 community members. Participants were recruited using criteria-based purposive sampling to represent different types of facilities and to include indexes who named different numbers of partners and stakeholders representing all Kenyan healthcare system levels.
Collectively, participants perceived that demand and uptake of APS could be impacted by multiple stigmas related to HIV, sexual behaviours and identities; long clinical wait times; certain gender norms and expectations; and fear of relationship dissolution, loss of financial support and intimate partner violence. However, different stakeholder groups generally focused on different factors; women focused more on gender dynamics and family roles; male sexual partners on stigma and structural barriers; HTS providers focused on HIV testing accessibility; and community-level stakeholders focused on low community awareness of APS.
Stigma reduction, awareness about APS, creation of male entry points at the facility level and provision of social support mechanisms have the potential to increase demand for APS.
Data are available upon reasonable request. The datasets generated and/or analysed during the current study are not publicly available because some interview transcripts may contain sensitive individual information; however, they can be made available from the corresponding author on reasonable request.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Ferdinand C. Mukumbang and Geoff Wong
University of Washington affiliated authors are displayed in bold.
Published: March 2025
Realist synthesis is a recognized methodological approach to evidence synthesis to inform evidence-based health policy and practice. The implicit assumption behind research synthesis is that the evidence it generates should be generalizable––drawing broad inferences from specific observations. While this understanding is generally shared among social scientists, tensions exist between having generalizable evidence and how this evidence can be useful in specific contexts. This paper considers the role of mechanism-based middle-range theories obtained from realist synthesis in bridging specificity to context and generalizability. Retroductive theorizing in realist synthesis helps to identify ideas about mechanisms related to the phenomenon embedded in the social and organizational contexts that could, in principle, have a much broader application. Also, because mechanism-based middle-range theories are linked to contextual features, they capture contextual nuances to enhance evidence implementation. We conclude that middle-range mechanisms provide an opportunity to achieve generalizability and contextualization in implementation science.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**