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Implementation Science at UW

Keywords: Yanfang Su

✪ Editorial: Learning for action in policy implementation

Authors:

Yanfang Su, Heather L Bullock, Michael Trisolini, Karen M Emmons

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: November 2024

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

Excerpt:

Introduction

Policy implementation science (IS) is an emerging field that intersects implementation science and public policy studies to support the translation of evidence into policy. As a multidisciplinary field, Policy IS uses methodologies and frameworks from economics, political science, sociology, public administration, knowledge translation, and other fields. Policy IS would benefit from broader consensus on definitions, theories, frameworks, methodologies, and outcomes, so that a wide range of studies could build on a common conceptual foundation and thus build scientific knowledge more rapidly. The objective of this Research Topic is to reach consensus and drive learning for action in policy implementation by strengthening...

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

✪ Reimagining policy implementation science in a global context: a theoretical discussion

Authors:

Kellie List, Peter Agamile, Didier Yélognissè Alia, Peter Cherutich, Kristen Danforth, John Kinuthia, Arianna Rubin Means, Irene Mukui, Nancy Ngumbau, Yanfang Su, Anjuli Dawn Wagner, Bryan J Weiner, and Sarah Masyuko

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: September 2024

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

Abstract:

Introduction

Policy implementation science (IS) is defined here as generating knowledge and deploying implementation strategies to effectively adopt and integrate evidence-based interventions (EBIs) into policy designs and improve policy implementation and effectiveness (1–3). Most existing policy IS scholarly works originate from the Global North (United States, Canada, and Western Europe) and describe or evaluate strategies to increase the uptake of EBIs (4). The existing Global North-generated frameworks focus less on the critical resources needed to formulate and implement a policy in diverse settings. Current approaches to policy IS lack sufficient contextual nuance to be applicable to...[read more].

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

✪ Mending the gap: Measurement needs to address policy implementation through a health equity lens

Authors:

Gabriella M McLoughlin, Shiriki Kumanyika, Yanfang Su, Ross C Brownson, Jennifer O Fisher, & Karen M Emmons

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: March 2024

Read the full text in the open access journal Translational Behavioral Medicine

Abstract:

Policies represent a key opportunity to improve the health outcomes of populations, and if implemented well, can reduce disparities affecting marginalized populations. Many policies are only evaluated on whether they elicit their intended health outcome. However, a lack of understanding regarding if and how they are implemented may hinder the intended impact overall and on addressing health disparities. Implementation science offers an array of frameworks and methodological approaches for assessing policy delivery, yet few examples exist that meaningfully include health equity as a core focus.

This commentary describes the importance of equity-informed implementation measurement by providing case examples and implications for assessment. In addition, we highlight examples of emerging work in policy implementation grounded in health equity with suggested steps for moving the field forward. The ultimate goal is to move toward open-access measurement approaches that can be adapted to study implementation of a variety of policies at different stages of implementation, driven by input from marginalized populations and implementation practitioners, to move the needle on addressing health disparities.

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

✪ ‘I understood the texting process well’ – Participant perspectives on usability and acceptability of SMS-based telehealth follow-up after voluntary medical male circumcision in South Africa

Authors:

Jacqueline Pienaar, Sarah Day, Geoffrey Setswe, Beatrice Wasunna, Vuyolwethu Ncube, Felex Ndebele, Femi Oni, Evelyn Waweru, Calsile Khumalo, Hannock Tweya, Kenneth Sherr, Yanfang Su, and Caryl Feldacker

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: August 2023

Read the full text in the open access journal Digital Health

Abstract:

Background

Voluntary medical male circumcision (MC) is a biomedical HIV prevention method that requires post-operative follow-up for healing confirmation. Recent research found that a two-way texting (2wT) app providing SMS-based telehealth for MC patients was safe and reduced provider workload. We evaluated 2wT usability among MC clients in South Africa assigned the 2wT intervention within a larger randomized controlled trial (RCT) of 2wT safety and workload.

Methods

This quantitative usability study is within an RCT where 547 men used 2wT to interact with an MC provider via SMS. The sub-study involved the first 100 men assigned to 2wT who completed a usability survey 14 days after surgery. Acceptability was assessed through 2wT response rates of the 547 men. Regression models analyzed associations between age, wage, location, potential adverse events (AEs), and 2wT responses.

Results

Men assigned to 2wT found it safe, comfortable, and convenient, reporting time and cost savings. High response rates (88%) to daily messages indicated acceptability. Age, wage, and location didn't affect text responses or potential AEs.

Conclusion

2wT for post-MC follow-up was highly usable and acceptable, suggesting its viability as an alternative to in-person visits. It enhanced confidence in wound self-management. This SMS-based telehealth can enhance MC care quality and be adapted to similar contexts for independent healing support, particularly for men.

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

✪ A 4D Theoretical Framework for Measuring Topic-Specific Influence on Twitter: Development and Usability Study on Dietary Sodium Tweets

Authors:

Lingchao Mao, Emily Chu, Jinghong Gu, Tao Hu, Bryan J Weiner, Yanfang Su

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: June 2023

Read the full text in the open access journal Journal of Medical Internet Research

Abstract:

Background

Social media has emerged as a prominent approach for health education and promotion. However, it is challenging to understand how to best promote health-related information on social media platforms such as Twitter. Despite commercial tools and prior studies attempting to analyze influence, there is a gap to fill in developing a publicly accessible and consolidated framework to measure influence and analyze dissemination strategies.

Objective

We aimed to develop a theoretical framework to measure topic-specific user influence on Twitter and to examine its usability by analyzing dietary sodium tweets to support public health agencies in improving their dissemination strategies.

Methods

We designed a consolidated framework for measuring influence that can capture topic-specific tweeting behaviors. The core of the framework is a summary indicator of influence decomposable into 4 dimensions: activity, priority, originality, and popularity. These measures can be easily visualized and efficiently computed for any Twitter account without the need for private access. We demonstrated the proposed methods by using a case study on dietary sodium tweets with sampled stakeholders and then compared the framework with a traditional measure of influence.

Results

More than half a million dietary sodium tweets from 2006 to 2022 were retrieved for 16 US domestic and international stakeholders in 4 categories, that is, public agencies, academic institutions, professional associations, and experts. We discovered that World Health Organization, American Heart Association, Food and Agriculture Organization of the United Nations (UN-FAO), and World Action on Salt (WASH) were the top 4 sodium influencers in the sample. Each had different strengths and weaknesses in their dissemination strategies, and 2 stakeholders with similar overall influence, that is, UN-FAO and WASH, could have significantly different tweeting patterns. In addition, we identified exemplars in each dimension of influence. Regarding tweeting activity, a dedicated expert published more sodium tweets than any organization in the sample in the past 16 years. In terms of priority, WASH had more than half of its tweets dedicated to sodium. UN-FAO had both the highest proportion of original sodium tweets and posted the most popular sodium tweets among all sampled stakeholders. Regardless of excellence in 1 dimension, the 4 most influential stakeholders excelled in at least 2 out of 4 dimensions of influence.

Conclusions

Our findings demonstrate that our method not only aligned with a traditional measure of influence but also advanced influence analysis by analyzing the 4 dimensions that contribute to topic-specific influence. This consolidated framework provides quantifiable measures for public health entities to understand their bottleneck of influence and refine their social media campaign strategies. Our framework can be applied to improve the dissemination of other health topics as well as assist policy makers and public campaign experts to maximize population impact.

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

✪ Phased Implementation of COVID-19 Vaccination: Rapid Assessment of Policy Adoption, Reach and Effectiveness to Protect the Most Vulnerable in the US

Authors:

Yun Li, Moming Li, Megan Rice, Yanfang Su, and Chaowei Yang

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: July 2021

Read the full text in the open access International Journal of Environmental Research and Public Health

Abstract:

The US and the rest of the world have suffered from the COVID-19 pandemic for over a year. The high transmissibility and severity of this virus have provoked governments to adopt a variety of mitigation strategies. Some of these previous measures, such as social distancing and mask mandates, were effective in reducing the case growth rate yet became economically and administratively difficult to enforce as the pandemic continued. In late December 2020, COVID-19 vaccines were first approved in the US and states began a phased implementation of COVID-19 vaccination. However, there is limited quantitative evidence regarding the effectiveness of the phased COVID-19 vaccination. This study aims to provide a rapid assessment of the adoption, reach, and effectiveness of the phased implementation of COVID-19 vaccination. We utilize an event-study analysis to evaluate the effect of vaccination on the state-level daily COVID-19 case growth rate. Through this analysis, we assert that vaccination was effective in reducing the spread of COVID-19 shortly after the first shots were given. Specifically, the case growth rate declined by 0.124, 0.347, 0.345, 0.464, 0.490, and 0.756 percentage points corresponding to the 1–5, 6–10, 11–15, 16–20, 21–25, and 26 or more day periods after the initial shots. The findings could be insightful for policymakers as they work to optimize vaccine distribution in later phases, and also for the public as the COVID-19 related health risk is a contentious issue.

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