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Implementation Science at UW

Keywords: regression discontinuity

✪ The Science of Precision Prevention: Research Opportunities and Clinical Applications to Reduce Cardiovascular Health Disparities

Authors:

Thomas A Pearson, Debbie Vitalis, Charlotte Pratt, Rebecca Campo, Antonis A Armoundas, David Au, Bettina Beech, Olga Brazhnik, Christopher G Chute, Karina W Davidson, Ana V Diez-Roux, Lawrence J Fine, Davera Gabriel, Peter Groenveld, Jaclyn Hall, Alison B Hamilton, Hui Hu, Heng Ji, Amy Kind, William E Kraus, Harlan Krumholz, George A Mensah, Raina M Merchant, Dariush Mozaffarian, David M Murray, Dianne Neumark-Sztainer, Maya Petersen & David Goff

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: January 2024

Read the full text in the open access journal JACC: Advances

Abstract:

Precision prevention embraces personalized prevention but includes broader factors such as social determinants of health to improve cardiovascular health. The quality, quantity, precision, and diversity of data relatable to individuals and communities continue to expand. New analytical methods can be applied to these data to create tools to attribute risk, which may allow a better understanding of cardiovascular health disparities. Interventions using these analytic tools should be evaluated to establish feasibility and efficacy for addressing cardiovascular disease disparities in diverse individuals and communities. Training in these approaches is important to create the next generation of scientists and practitioners in precision prevention. This state-of-the-art review is based on a workshop convened to identify current gaps in knowledge and methods used in precision prevention intervention research, discuss opportunities to expand trials of implementation science to close the health equity gaps, and expand the education and training of a diverse precision prevention workforce.

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

✪ Implementation Science to Respond to the COVID-19 Pandemic

Authors:

Arianna Rubin Means, Anjuli D. Wagner, Eli Kern, Laura P. Newman, and Bryan J. Weiner

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: September 2020

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

Abstract:

The COVID-19 pandemic continues to expand globally, requiring massive public health responses from national and local governments. These bodies have taken heterogeneous approaches to their responses, including when and how to introduce and enforce evidence-based interventions—such as social distancing, hand-washing, personal protective equipment (PPE), and testing. In this commentary, we reflect on opportunities for implementation science to contribute meaningfully to the COVID-19 pandemic response. We reflect backwards on missed opportunities in emergency preparedness planning, using the example of PPE stockpiling and supply management; this planning could have been strengthened through process mapping with consensus-building, microplanning with simulation, and stakeholder engagement.

We propose current opportunities for action, focusing on enhancing the adoption, fidelity, and sustainment of hand washing and social distancing; we can combine qualitative data, policy analysis, and dissemination science to inform agile and rapid adjustment to social marketing strategies to enhance their penetration. We look to future opportunities to enhance the integration of new evidence in decision-making, focusing on serologic and virologic testing systems; we can leverage simulation and other systems engineering modeling to identify ideal system structures. Finally, we discuss the ways in which the COVID-19 pandemic challenges implementation science to become more rapid, rigorous, and nimble in its approach, and integrate with public health practice. In summary, we articulate the ways in which implementation science can inform, and be informed by, the COVID-19 pandemic, looking backwards, proposing actions for the moment, and approaches for the future.

Contributions to the Literature
  • The COVID-19 pandemic response has illuminated gaps in emergency preparedness planning that could be addressed by implementation scientists working in coordination with public health practitioners.
  • Classical implementation science tools and measures can be operationalized within the context of the COVID-19 pandemic, and at each stage of the pandemic. Doing so empowers implementation scientists to apply their skillsets toward optimizing uptake of evidence-based interventions such as such as social distancing, hand washing, and personal protective equipment.
  • To be more responsive to public health emergencies, implementation science as a discipline must evolve to be more rapid, nimble, and policy-oriented in its approaches.

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

✪ The role of dissemination and implementation science in global breast cancer control programs: Frameworks, methods, and examples

Authors:

Anne F. Rositch, Karla Unger‐Saldaña, Rebecca J. DeBoer, Anne Ng’ang’a, & Bryan J. Weiner

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: April 2020

Read the full text in the open access journal Cancer

Abstract:

Global disparities in breast cancer outcomes are attributable to a sizable gap between evidence and practice in breast cancer control and management. Dissemination and implementation science (D&IS) seeks to understand how to promote the systematic uptake of evidence‐based interventions and/or practices into real‐world contexts. D&IS methods are useful for selecting strategies to implement evidence‐based interventions, adapting their implementation to new settings, and evaluating the implementation process as well as its outcomes to determine success and failure, and adjust accordingly.

Process models, explanatory theories, and evaluation frameworks are used in D&IS to develop implementation strategies, identify implementation outcomes, and design studies to evaluate these outcomes. In breast cancer control and management, research has been translated into evidence‐based, resource‐stratified guidelines by the Breast Health Global Initiative and others. D&IS should be leveraged to optimize the implementation of these guidelines, and other evidence‐based interventions, into practice across the breast cancer care continuum, from optimizing public education to promoting early detection, increasing guideline‐concordant clinical practice among providers, and analyzing and addressing barriers and facilitators in health care systems. Stakeholder engagement through processes such as co‐creation is critical.

In this article, the authors have provided a primer on the contribution of D&IS to phased implementation of global breast cancer control programs, provided 2 case examples of ongoing D&IS research projects in Tanzania, and concluded with recommendations for best practices for researchers undertaking this work.

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

✪ A Mobile Health Strategy to Support Adherence to Antiretroviral Preexposure Prophylaxis

Authors:

Jonathan D. Fuchs, Kristefer Stojanovski, Eric Vittinghoff, Vanessa M. McMahan, Sybill G. Hosek, K. Rivet Amico, Aminta Kouyate, Hailey J. Gilmore, Susan P. Buchbinder, Richard T. Lester, Robert M. Grant, and Albert Y. Liu

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: March 2018

Read the full text open access in the journal AIDS Patient Care and STDs

The role of implementation science training in global health: from the perspective of graduates of the field’s first dedicated doctoral program

Authors:

Arianna R. Means, David E. Phillips, Grégoire Lurton, Anne Njoroge, Sabine M. Furere, Rong Liu, Wisal M. Hassan, Xiaochen Dai, Orvalho Augusto, Peter Cherutich, Gloria Ikilezi, Caroline Soi, Dong (Roman) Xu & Christopher G. Kemp

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: November 2016

Read the full text in the open access journal Implementation Science

Abstract:

Bridging the ‘know-do gap’ is an enormous challenge for global health practitioners. They must be able to understand local health dynamics within the operational and social contexts that engender them, test and adjust approaches to implementation in collaboration with communities and stakeholders, interpret data to inform policy decisions, and design adaptive and resilient health systems at scale. These skills and methods have been formalized within the nascent field of Implementation Science (IS). As graduates of the world's first PhD program dedicated explicitly to IS, we have a unique perspective on the value of IS and the training, knowledge, and skills essential to bridging the ‘know-do gap’. In this article, we describe the philosophy and curricula at the core of our program, outline the methods vital to IS in a global health context, and detail the role that we believe IS will increasingly play in global health practice. At this junction of enormous challenges and opportunities, we believe that IS offers the necessary tools for global health professionals to address complex problems in context and raises the bar of success for the global health programs of the future.

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