Heather Schacht Reisinger, Teresa Damush, Teresa Damush,Erin Balkenende, Edwin Wong, Kanika Arora, Rachael R. Kenney, Laura D. Taylor & Monica Matthieu
University of Washington affiliated authors are displayed in bold.
Published: October 2025
Neel S. Bhatt, Azra Borogovac, Yvonne A. Efebera, Anna DeSalvo, Steven M. Devine, Amy Foley, Valerie Greco-Stewart, Betty K. Hamilton, Mykala Heuer, Todd Molfenter, John P. Plastaras, Brittany K. Ragon, Sarah A. Wall, Larisa Broglie, Mark B. Juckett, Nandita Khera, Mary M. Horowitz & Amy E. DeZern
University of Washington affiliated authors are displayed in bold.
Published: September 2025
Severe aplastic anemia (SAA) is a rare and life-threatening bone marrow failure disorder. Immunosuppressive therapy (IST) with antithymocyte globulin and cyclosporine has long been a frontline treatment option in SAA; however, its limited durability and risk of long-term complications such as secondary malignancies remain a drawback in this treatment modality. Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative option with significantly improved outcomes over the long term, particularly with HLA-matched related donors. However, the use of alternative donors, such as haploidentical, mismatched, or matched unrelated donors, has previously been limited due to increased transplant-related morbidity, particularly graft-versus-host disease (GVHD). HCTs have therefore been limited to young recipients and those with HLA-matched related donors, creating significant disparity for older adults and those who lack matched donor options. Nevertheless, more recent advances in HCT, such as posttransplant cyclophosphamide for GVHD prophylaxis, have led to improved outcomes of HCT with alternative donors; however, alternative donor HCT remains underused as up-front therapy, in part because of limited multicenter trial data. This review discusses current SAA treatment approaches, including both IST and HCT, and highlights remaining gaps. It also discusses how ongoing clinical trials such as CureAA and TransIT could help address these gaps. Furthermore, we discuss the importance of stakeholder engagement and implementation science in the integration of research-based evidence into clinical practice. Bridging these gaps is necessary for achieving equitable access for patients historically excluded from frontline HCT, including older adults and racially or ethnically diverse populations.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Chelsea L Kracht, Alison Tovar, Kim M Gans, Rebecca E Lee, Pooja S Tandon, Tayla von Ash, & Lucine Francis
University of Washington affiliated authors are displayed in bold.
Published: March 2025
Patricia Mae G. Santos, Sierra Silverwood, Gita Suneja, Eric C. Ford, Nikhil G. Thaker, Jamie S. Ostroff, Bryan J. Weiner, and Erin F. Gillespie
University of Washington affiliated authors are displayed in bold.
Published: December 2024
Audrey Harkness, Ali Giusto, Alison B. Hamilton, Raul U. Hernandez-Ramirez, Donna Spiegelman, Bryan J. Weiner, Rinad S. Beidas, Michaela E. Larson, Sheri A. Lippman, Milton L. Wainberg, and Justin D. Smith
University of Washington affiliated authors are displayed in bold.
Published: June 2024
Implementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high-impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, “grey areas,” or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research.
A group of IS experts affiliated with NIMH-funded ARCs convened to identify common and challenging grey areas. The group generated a preliminary list of 19 grey areas in HIV/MH-related IS. From the list, the authors developed a survey which was distributed to all ARCs to prioritize grey areas to address in this paper. ARC members across the United States (N = 60) identified priority grey areas requiring clarification. This commentary discusses topics with 40% or more endorsement. The top grey areas that ARC members identified were: (1) Differentiating implementation strategies from interventions; (2) Determining when an intervention has sufficient evidence for adaptation; (3) Integrating recipient perspectives into HIV/MH implementation research; (4) Evaluating whether an implementation strategy is evidence-based; (5) Identifying rigorous approaches for evaluating the impact of implementation strategies in the absence of a control group or randomization; and (6) Addressing innovation in HIV/MH IS grants. The commentary addresses each grey area by drawing from the existing literature (when available), providing expert guidance on addressing each in the context of HIV/MH research, and providing domestic and global HIV and HIV/MH case examples that address these grey areas.
HIV/MH IS is key to achieving domestic and international goals for ending HIV transmission and mitigating its impact. Guidance offered in this paper can help to overcome challenges to rigorous and high-impact HIV/MH implementation research.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Quinhas Fernandes, Orvalho Augusto & Kenneth Sherr
University of Washington affiliated authors are displayed in bold.
Published: February 2024
A thorough examination of context, and how it influences implementation of evidence-based interventions, is a promising strategy for enhancing child survival initiatives. Spreading approaches that are identified as drivers of successful reduction in under-five mortality from ‘exemplar’ countries could be pivotal in leading to reductions in other settings facing stagnant mortality rates, in particular for low- and middle-income countries with high disease burden and insufficient programmatic capacity to effectively implement evidence-based interventions at scale. Yet there remains a lack of robust analytic methods to accurately assess mortality and describe the drivers of interventions’ implementation success at both national and subnational levels. The field of implementation science and its defining targets and tools is well positioned to address this knowledge gap by integrating qualitative and quantitative research methods into an adaptable evaluation framework that can be tailored to meet the specific needs across varying country contexts. These tools enhance the measurement of population health outcomes and provide crucial evidence on implementation barriers and facilitators that can inform policies that can be adjusted for diverse contexts. This commentary aims to emphasize the role of implementation research in understanding how exemplar countries achieved significant improvements in child survival and in identifying replicable lessons for other settings. Ultimately, all manuscripts underscore the relevance of implementation research in bolstering the reduction of under-five mortality.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Alexandra L. Rose, Helen E. Jack, Muneera A. Rasheed, Jessica F. Magidson
University of Washington affiliated authors are displayed in bold.
Published: February 2024
Implementation outcomes, which focus on the barriers to, and facilitators and processes of healthcare delivery, are critical to translating research evidence to health planning and practice and to improving healthcare delivery. This article summarizes key quality issues in reporting of implementation science outcomes within global health and describes the ways in which this presents a challenge for shifting health planning and practice across low-resource health systems. This article also suggests that the wider use of reporting guidelines for implementation outcomes could help address this issue.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Jeff Lane & Andy Stergachis
University of Washington affiliated authors are displayed in bold.
Published: January 2024
Laws and policies affecting access to medicines have been in the global health spotlight for decades, yet our understanding of their effects remains substantially underdeveloped. The emerging field of legal epidemiology combined with the methods of implementation science presents an opportunity to help address this gap. Legal epidemiology refers to the scientific study and deployment of law as a factor in the cause, distribution, and prevention of disease and injury in a population. Legal epidemiology studies consist of a systematic collection and coding of laws and policies relating to a particular topic. Quasi-experimental or observational research methods can then be applied to take advantage of natural experiments resulting from heterogenous adoption and/or implementation of laws and policies.
Often legal epidemiology studies fail to account for heterogenous law implementation processes, presenting a need and opportunity to integrate implementation science methods. Researchers may face challenges in integrating these methods for access to medicines studies, including data access issues and a complex legal and implementation environment. Yet, the opportunities presented by increasingly transparent legal environments, improved monitoring of medicine availability, universal health coverage expansion, and electronic health and insurance records integration may facilitate overcoming these challenges. Improved collaboration and communication between researchers, health authorities, manufacturers, and health providers from public and private sectors will be critical. In spite of the challenges, combining the fields of legal epidemiology and implementation science may present an important strategy toward creating a legal and policy environment that supports global and equitable access to medicines.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Zhenyu Zhang & Ken-Yu Lin
University of Washington affiliated authors are displayed in bold.
Published: November 2023
Eric Goosby, Judith N Wasserheit, Roger Glass & Peter Kilmarx
University of Washington affiliated authors are displayed in bold.
Published: March 2023
AIDS continues to be a major driver of adolescent mortality in Sub-Saharan Africa. Despite evidence of efficacy in this population, many efforts to address adolescent HIV have had limited impact across the region because of difficulty with implementation. The field of implementation science holds promise for addressing these challenges. The Fogarty-led Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) creates a platform for bidirectional learning between researchers and the users of research evidence that promotes the use of implementation science to strengthen adolescent HIV prevention and care across Africa. The unique contributions of AHISA are reflected in this supplement’s articles which represent the collective learning of the Alliance; illustrate the value of implementation science in the context of adolescent HIV; and identify critical research gaps that should be addressed by implementation science in the future.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**