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Implementation Science at UW

Keywords: Scoping Review

✪ Exploring implementation strategies in evidence-based open streets programs for promoting physical activity in the Americas: a scoping review

Authors:

Raúl D. Gierbolini-Rivera, Milena Franco Silva, Milena Franco Silva, Lorna Fabiola Pineda, Bryan J. Weiner, Byron J. Powell, Ross C. Brownson & Diana C. Parra

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: November 2025

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

Abstract:

Background

Chronic diseases are a leading public health concern in the Americas, and physical inactivity contributes significantly to their burden. Open streets program—community initiatives that temporarily close urban streets to vehicles—promote physical activity and community engagement, demonstrating positive health and social impacts. Effective implementation depends on identifying suitable strategies and frameworks. The Expert Recommendations for Implementing Change (ERIC) taxonomy, developed for clinical/healthcare contexts, has not been widely assessed for community-based interventions such as Open Streets. Implementation strategies could lead to specific outcomes (e.g., adoption, sustainability) that differ from program outcomes (e.g., PA levels, chronic disease prevalence). This scoping review focuses on the strategies that influence implementation outcomes. The primary aims of this review were to (1) identify implementation strategies for Open Streets programs and (2) identify opportunities for Open Streets programs to promote chronic disease prevention and physical activity, specifically in the Americas.

Methods

A scoping review was conducted using Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Six databases (PubMed, Scopus, Scielo, Web of Science, TRIS, and LILACS) were searched for studies on Open Streets programs in the Americas (January 2004–April 2024). Three reviewers independently screened studies in Rayyan. Strategies were extracted and coded according to the 73 ERIC taxonomy strategies. Quality appraisal used MMAT for empirical studies, AMSTAR-2 for reviews, and AACODS for gray literature.

Results

Fifty-nine studies met the inclusion criteria, yielding 63 distinct implementation strategies for Open Streets programs. All 63 strategies were classified within the ERIC taxonomy. Frequently aligned ERIC strategies included building coalitions, capturing local knowledge, conducting needs assessments, and fostering stakeholder engagement. Open Streets strategies emphasized multisectoral collaboration, cultural adaptation, equity, and sustainability.

Discussion

Among the 63 identified Open Streets strategies, many aligned with ERIC, providing a foundation in stakeholder engagement, coalition building, and flexible, context-sensitive implementation. However, several ERIC strategies were not relevant to Open Streets, underscoring that while many ERIC strategies were applicable, not all suited this setting. Open Streets programs may require supplemental approaches to address equity, cultural competence, and multisectoral collaboration. Findings present opportunities to tailor, test, and scale strategies that maximize the population health impact of Open Streets and similar community-based programs.

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

✪ A Conceptual Framework for Group Well-Child Care: A Tool to Guide Implementation, Evaluation, and Research

Authors:

Ashley Gresh, Deborah Wilson, Ada Fenick, Crystal L. Patil, Tumaini Coker, Sharon Schnidler Rising, Nancy Glass, & Rheanna Platt.

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: April 2023

Read the full text in the open access Maternal and Child Health Journal
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Abstract:

Objective

To use scoping review methods to construct a conceptual framework based on current evidence of group well-child care to guide future practice and research.

Methods

We conducted a scoping review using Arksey and O’Malley’s (2005) six stages. We used constructs from the Consolidated Framework for Implementation Research and the quadruple aim of health care improvement to guide the construction of the conceptual framework.

Results

The resulting conceptual framework is a synthesis of the key concepts of group well-child care, beginning with a call for a system redesign of well-child care to improve outcomes while acknowledging the theoretical antecedents structuring the rationale that supports the model. Inputs of group well-child care include health systems contexts; administration/logistics; clinical setting; group care clinic team; community/patient population; and curriculum development and training. The core components of group well-child care included structure (e.g., group size, facilitators), content (e.g., health assessments, service linkages). and process (e.g., interactive learning and community building). We found clinical outcomes in all four dimensions of the quadruple aim of healthcare.

Conclusion

Our conceptual framework can guide model implementation and identifies several outcomes that can be used to harmonize model evaluation and research. Future research and practice can use the conceptual framework as a tool to standardize model implementation and evaluation and generate evidence to inform future healthcare policy and practice.

Significance

What is already known on this subject? Group well-child care (GWCC) is associated with improved healthcare utilization (e.g., attendance, immunization rates), parent outcomes (e.g., psychological well-being, satisfaction), and clinician outcomes (e.g., self-efficacy).

What this study adds? Scoping review methodology was used to generate a conceptual framework of GWCC which can be used as a guide to standardize practices for implementation, evaluation, and research in GWCC.

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

✪ Mapping Community-Engaged Implementation Strategies with Transgender Scientists, Stakeholders, and Trans-Led Community Organizations

Authors:

Arjee Restar, Brian J. Minalga, Ma. Irene Quilantang, Tyler Adamson, Emerson Dusic, Leigh-Ann van der Merwe, Greg Millet, Danvic Rosadiño, Tanya Laguing, Elle Lett, Avery Everhart, Gregory Phillips II, Rena Janamnuaysook, Pich Seekaew, Kellan Baker, Florence Ashley, Jeffrey Wickersham, Stephaun E. Wallace, Don Operario & Kristi E. Gamarel

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: April 2023

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

Abstract:

Purpose of Review

Pre-exposure prophylaxis (PrEP) represents one of the most effective methods of prevention for HIV, but remains inequitable, leaving many transgender and nonbinary (trans) individuals unable to benefit from this resource. Deploying community-engaged PrEP implementation strategies for trans populations will be crucial for ending the HIV epidemic.

Recent Findings

While most PrEP studies have progressed in addressing pertinent research questions about gender-affirming care and PrEP at the biomedical and clinical levels, research on how to best implement gender-affirming PrEP systems at the social, community, and structural levels remains outstanding.

Summary

The science of community-engaged implementation to build gender-affirming PrEP systems must be more fully developed. Most published PrEP studies with trans people report on outcomes rather than processes, leaving out important lessons learned about how to design, integrate, and implement PrEP in tandem with gender-affirming care. The expertise of trans scientists, stakeholders, and trans-led community organizations is essential to building gender-affirming PrEP systems.

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

✪ Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review

Authors:

Akash Malhotra, Ryan R. Thompson, Faith Kagoya, Felix Masiye, Peter Mbewe, Mosepele Mosepele, Jane Phiri, Jairos Sambo, Abigail Barker, Drew B. Cameron, Victor G. Davila-Roman, William Effah, Brian Hutchinson, Michael Laxy, Brad Newsome, David Watkins, Hojoon Sohn & David W. Dowdy

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: November 2022

Read the full text in the open access journal Implementation Science
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Abstract:

Background

Historically, the focus of cost-effectiveness analyses has been on the costs to operate and deliver interventions after their initial design and launch. The costs related to design and implementation of interventions have often been omitted. Ignoring these costs leads to an underestimation of the true price of interventions and biases economic analyses toward favoring new interventions. This is especially true in low- and middle-income countries (LMICs), where implementation may require substantial up-front investment. This scoping review was conducted to explore the topics, depth, and availability of scientific literature on integrating implementation science into economic evaluations of health interventions in LMICs.

Methods

We searched Web of Science and PubMed for papers published between January 1, 2010, and December 31, 2021, that included components of both implementation science and economic evaluation. Studies from LMICs were prioritized for review, but papers from high-income countries were included if their methodology/findings were relevant to LMIC settings.

Results

Six thousand nine hundred eighty-six studies were screened, of which 55 were included in full-text review and 23 selected for inclusion and data extraction. Most papers were theoretical, though some focused on a single disease or disease subset, including: mental health (n = 5), HIV (n = 3), tuberculosis (n = 3), and diabetes (n = 2). Manuscripts included a mix of methodology papers, empirical studies, and other (e.g., narrative) reviews. Authorship of the included literature was skewed toward high-income settings, with 22 of the 23 papers featuring first and senior authors from high-income countries. Of nine empirical studies included, no consistent implementation cost outcomes were measured, and only four could be mapped to an existing costing or implementation framework. There was also substantial heterogeneity across studies in how implementation costs were defined, and the methods used to collect them.

Conclusion

A sparse but growing literature explores the intersection of implementation science and economic evaluation. Key needs include more research in LMICs, greater consensus on the definition of implementation costs, standardized methods to collect such costs, and identifying outcomes of greatest relevance. Addressing these gaps will result in stronger links between implementation science and economic evaluation and will create more robust and accurate estimates of intervention costs.

Trial registration/h5>

The protocol for this manuscript was published on the Open Science Framework. It is available at: https://osf.io/ms5fa/ (DOI: 10.17605/OSF.IO/32EPJ).

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