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Implementation Science at UW

Keywords: Why Implementation Science

✪ Addictions treatment mechanisms of change science and implementation science: A critical review

Authors:

Molly Magill, Stephan Maisto, Brian Borsari, Joseph E. Glass, Kevin Hallgren, Jon Houck, Brian Kiluk & Alexis Kuerbis

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: March 2023

Read the full text in the open access journal Prevention Science

Abstract:

This manuscript aims to contribute to the next phase of mechanisms of behavior change (MOBC) science on alcohol or other drug use. Specifically, we encourage the transition from a basic science orientation (i.e., knowledge generation) to a translational science orientation (i.e., knowledge application or Translational MOBC Science). To inform that transition, we examine MOBC science and implementation science and consider how these two research areas can intersect to capitalize on the goals, strengths, and key methodologies of each. First, we define MOBC science and implementation science and offer a brief historical rationale for these two areas of clinical research. Second, we summarize similarities in rationale and discuss two scenarios where one draws from the other—MOBC science on implementation strategy outcomes and implementation science on MOBC. We then focus on the latter scenario, and briefly review the MOBC knowledge base to consider its readiness for knowledge translation. Finally, we provide a series of research recommendations to facilitate the translation of MOBC science. These recommendations include: (1) identifying and targeting MOBC that are well suited for implementation, (2) use of MOBC research results to inform broader health behavior change theory, and (3) triangulation of a more diverse set of research methodologies to build a translational MOBC knowledge base. Ultimately, it is important for gains borne from MOBC science to affect direct patient care, while basic MOBC research continues to be developed and refined over time. Potential implications of these developments include greater clinical significance for MOBC science, an efficient feedback loop between clinical research methodologies, a multi-level approach to understanding behavioral change, and reduced or eliminated siloes between MOBC science and implementation science.

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

✪ Aligning implementation science with improvement practice: A call to action

Authors:

Jennifer Leeman, Catherine Rohweder, Matthew Lee, Alison Brenner, Andrea Dwyer, Linda K. Ko, Meghan C. O’Leary, Grace Ryan, Thuy Vu, & Shoba Ramanadhan

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: September 2021

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

Background

In several recent articles, authors have called for aligning the fields of implementation and improvement science. In this paper, we call for implementation science to also align with improvement practice. Multiple implementation scholars have highlighted the importance of designing implementation strategies to fit the existing culture, infrastructure, and practice of a healthcare system. Worldwide, healthcare systems are adopting improvement models as their primary approach to improving healthcare delivery and outcomes. The prevalence of improvement models raises the question of how implementation scientists might best align their efforts with healthcare systems’ existing improvement infrastructure and practice.

Main body

We describe three challenges and five benefits to aligning implementation science and improvement practice. Challenges include (1) use of different models, terminology, and methods, (2) a focus on generalizable versus local knowledge, and (3) limited evidence in support of the effectiveness of improvement tools and methods. We contend that implementation science needs to move beyond these challenges and work toward greater alignment with improvement practice. Aligning with improvement practice would benefit implementation science by (1) strengthening research/practice partnerships, (2) fostering local ownership of implementation, (3) generating practice-based evidence, (4) developing context-specific implementation strategies, and (5) building practice-level capacity to implement interventions and improve care. Each of these potential benefits is illustrated in a case study from the Centers for Disease Control and Prevention’s Cancer Prevention and Control Research Network.

Conclusion

To effectively integrate evidence-based interventions into routine practice, implementation scientists need to align their efforts with the improvement culture and practice that is driving change within healthcare systems worldwide. This paper provides concrete examples of how researchers have aligned implementation science with improvement practice across five implementation projects.

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

Making Implementation Science Work for Children and Adolescents Living With HIV

Authors:

Daniella Mark, Elvin Geng, Susan Vorkoper, Shaffiq Essajee, Kim Bloch, Nicola Willis, Bethany Stewart, Sabrina Bakeera-Kitaka, Nandita Sugandhi, Rachel Sturke, Kechi Achebe, B. Jane Ferguson, Marissa Vicari, Chewe Luo, Nande Putta, Grace John-Stewart, Laura Guay, Angela Mushavi, Imran Muhammad, and David A. Ross
University of Washington affiliated authors are displayed in bold.
Published: August 2018

Read the full text in the subscription access Journal of Acquired Immune Deficiency Syndrome

✪ Successful Deployment of High Flow Nasal Cannula in a Peruvian Pediatric Intensive Care Unit Using Implementation Science—Lessons Learned

Authors:

Katie R. Nielsen, Rosario Becerra, Gabriela Mallma, & José Tantaleán da Fieno

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: April 2018

Read the full text in the open access journal Frontiers in Pediatrics

Abstract:

Acute lower respiratory infections are the leading cause of death outside the neonatal period for children less than 5 years of age. Widespread availability of invasive and non-invasive mechanical ventilation in resource-rich settings has reduced mortality rates; however, these technologies are not always available in many low- and middle-income countries due to the high cost and trained personnel required to implement and sustain their use. High flow nasal cannula (HFNC) is a form of non-invasive respiratory support with growing evidence for use in pediatric respiratory failure. Its simple interface makes utilization in resource-limited settings appealing, although widespread implementation in these settings lags behind resource-rich settings. Implementation science is an emerging field dedicated to closing the know-do gap by incorporating evidence-based interventions into routine care, and its principles have guided the scaling up of many global health interventions. In 2016, we introduced HFNC use for respiratory failure in a pediatric intensive care unit in Lima, Peru using implementation science methodology. Here, we review our experience in the context of the principles of implementation science to serve as a guide for others considering HFNC implementation in resource-limited settings.

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

✪ Sexually transmitted infections in the era of antiretroviral-based HIV prevention: Priorities for discovery research, implementation science, and community involvement

Authors:

Jeanne M. Marrazzo, Julia C. Dombrowski, & Kenneth H. Mayer

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: January 2018

Read the full text in the open access journal PLOS Medicine

Excerpt:

Summary points
  • Persons living with HIV who achieve sustained viral suppression with antiretroviral therapy can avoid sexual transmission of HIV without using condoms.
  • Similarly, pre-exposure prophylaxis with tenofovir-emtricitabine in HIV-uninfected persons is highly effective.
  • With this background, rates of sexually transmitted infections are increasing in some HIV-infected populations, and in some at risk for HIV acquisition.
  • The implications require reassessment of the alignment and prioritization of HIV research funding, public health policy, and community engagement.

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