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Implementation Science at UW

Keywords: Policy Co-Design

✪ A framework policy analysis of single-dose HPV vaccination adoption in East Africa: a rapid review

Authors:

Grace Umutesi, Bryan J. Weiner, Teresa Jewell, Saidi Kapiga, Jeff Lane, Nelly R. Mugo & Ruanne V. Barnabas

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: March 2026

Read the full text in the open access journal BMC Health Services Research

Abstract:

Cervical cancer is a global public health problem. While HPV vaccination effectively prevents cervical cancer, vaccination coverage remains low in low -and middle-income countries (LMICs) where around 94% of cervical cancer-related deaths occur. To improve coverage and accelerate progress toward achieving cervical cancer elimination, the World Health Organization (WHO) recommended that countries switch to a single-dose HPV vaccination schedule in 2022. Despite strong evidence of the health and economic benefits of a single-dose HPV vaccination schedule, its adoption has varied across countries.

We sought to rapidly review existing evidence to assess the “how” of policy reform on HPV vaccination, leveraging a policy analysis of single-dose HPV vaccination adoption in three East African countries. We used the Health Policy Triangle Framework (HPF) to compile key considerations that led to the adoption of single-dose HPV vaccination in Ethiopia, Uganda, and Tanzania. Relevant articles from peer-reviewed journals and grey literature published up to December 2024 were selected using pre-set inclusion and exclusion criteria. Data were extracted and summarized using a rapid qualitative analysis approach guided by the HPF. Twenty-four articles from academic and grey literature were examined.

Beyond context-specific aspects, a few common themes emerged across the three countries. Political will focused on addressing cervical cancer as a public health problem, and it was crucial to prioritize the revision of the HPV vaccination policy. The policy revision on the HPV vaccination schedule was undertaken, building on existing evidence and the WHO endorsement. Additionally, the availability of key evidence on the magnitude of this public health problem (eg: burden of the disease), the potential benefit of a single-dose schedule (efficacy, and the economic impact) played an important role in the policy revision process. At the national level, National Immunization Technical Advisory Groups (NITAGs) that provided evidence-based guidance to policy-makers were central to the single-dose decision-making process. Our findings highlighted key considerations for the policy revision process in three East African countries, which could inform strategic policy decisions in these countries and comparable settings.

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

✪ Partnering with Policymakers to Design Suicide Care Research: Maximizing Impact in Adolescent Mental Health Policy

Authors:

Katherine Anne Comtois, Juliann Salisbury, Richelle L. Clifton, Julie Goldstein Grumet & Molly Adrian

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: May 2025

Read the full text in the open access journal Evidence-Based Practice in Child and Adolescent Mental Health

Abstract:

Outpatient medical settings are a critical source of mental health care for adolescents and young adults. This is due to the familiarity and accessibility of those settings and challenges accessing mental health care elsewhere. Adolescents and young adults who die by suicide are more likely to have seen a medical provider in the prior month than a mental health specialist, but few suicide care interventions have been developed to specifically address the challenges of working in these outpatient medical settings. This paper provides the perspective of the University of Washington Suicide Care Research Center on the importance of incorporating evidence into public policy decisions regarding workforce development and standards of care for adolescents and young adults experiencing suicidal thoughts and behaviors, their families, and their outpatient medical setting providers; and the equal importance of integrating policy and funding perspectives in clinical services and implementation science. The paper will review the trends in suicide care policy and funding structures as relevant to adolescents and young adults in outpatient medical settings, provide recommendations to advance the translation of research into evidence-based policy decisions for adolescents and young adults at risk of suicide, and recommendations for researchers on incorporating policy perspectives in the development and evaluation of evidence-based interventions. We will share how the University of Washington Suicide Care Research Center is operationalizing these recommendations.

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

Better Guidelines and Policies: AAP’s Partnership for Policy Implementation

Authors:

Christoph U. Lehmann, William G. Adams, Juan D. Chaparro, Alexander G. Fiks, Randall W. Grout, Michael G. Leu, Eneida A. Mendonca, Jeremy J. Michel, Kymika Okechukwu, Jeremiah Salmon, Mona Sharifi, & Stephen M. Downs

University of Washington affiliated authors are displayed in bold.

Subscription Required for Full Text Access

Published: July 2024

Read the full text in the subscription access journal Pediatrics

✪ Using policy codesign to achieve multi-sector alignment in adolescent behavioral health: a study protocol

Authors:

Sarah Cusworth Walker, Kym R. Ahrens, Mandy D. Owens, McKenna Parnes, Joe Langley, Christine Ackerley, Jonathan Purtle, Lisa Saldana, Gregory A. Aarons, Aaron Hogue & Lawrence A. Palinkas

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: May 2024

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

Abstract:

Background

Policymaking is quickly gaining focus in the field of implementation science as a potential opportunity for aligning cross-sector systems and introducing incentives to promote population health, including substance use disorders (SUD) and their prevention in adolescents. Policymakers are seen as holding the necessary levers for realigning service infrastructure to more rapidly and effectively address adolescent behavioral health across the continuum of need (prevention through crisis care, mental health, and SUD) and in multiple locations (schools, primary care, community settings). The difficulty of aligning policy intent, policy design, and successful policy implementation is a well-known challenge in the broader public policy and public administration literature that also affects local behavioral health policymaking. This study will examine a blended approach of coproduction and codesign (i.e., Policy Codesign), iteratively developed over multiple years to address problems in policy formation that often lead to poor implementation outcomes. The current study evaluates this scalable approach using reproducible measures to grow the knowledge base in this field of study.

Methods

This is a single-arm, longitudinal, staggered implementation study to examine the acceptability and short-term impacts of Policy Codesign in resolving critical challenges in behavioral health policy formation. The aims are to (1) examine the acceptability, feasibility, and reach of Policy Codesign within two geographically distinct counties in Washington state, USA; (2) examine the impact of Policy Codesign on multisector policy development within these counties using social network analysis; and (3) assess the perceived replicability of Policy Codesign among leaders and other staff of policy-oriented state behavioral health intermediary organizations across the USA.

Discussion

This study will assess the feasibility of a specific approach to collaborative policy development, Policy Codesign, in two diverse regions. Results will inform a subsequent multi-state study measuring the impact and effectiveness of this approach for achieving multi-sector and evidence informed policy development in adolescent SUD prevention and treatment.

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