Opportunities to Advance Equity Through Implementation Strategy Design.

Autor:	Hoskins K; University of Pennsylvania School of Nursing., Maye M; Henry Ford Health System., Wright L; Kaiser Permanente Colorado Institute for Health Research., Jager-Hyman S; University of Pennsylvania Perelman School of Medicine., Wolk CB; University of Pennsylvania Perelman School of Medicine., Ahmedani B; Henry Ford Health System., Boggs JM; Kaiser Permanente Colorado Institute for Health Research., Johnson C; Northwestern University Feinberg School of Medicine., Linn K; University of Pennsylvania Perelman School of Medicine., Quintana L; Kaiser Permanente Colorado Institute for Health Research., Pappas C; Henry Ford Health System., Beidas RS; Northwestern University Feinberg School of Medicine.
Jazyk:	angličtina
Zdroj:	Research square [Res Sq] 2024 Sep 02. Date of Electronic Publication: 2024 Sep 02.
DOI:	10.21203/rs.3.rs-4773990/v1
Abstrakt:	Background: Implementation strategies are potential tools for advancing equity goals in healthcare. Implementation scientists have increased attention to the integration of equity considerations into implementation research, but limited concrete guidance is available for developing implementation strategies to improve equity. Main: In parallel to an active hybrid effectiveness-implementation trial in two large health systems, our research team explored potential inequities in implementation across four non-study clinics, developed equity focused audit and feedback procedures, examined the feasibility of our approach, and identified design insights that could be tested in future work to inform equitable program scale-up. Based on our experiences deploying these strategies in pilot format, our research team identified key complexities meriting further examination in future work. These considerations are vital given the dearth of guidance on delivering feedback to clinicians in efforts to improve equity. Key takeaways include the importance of understanding local data culture, engaging constituents in co-design for the full feedback cycle, leveraging feedback for shared discourse, and centering multi-level strategies as part of robust implementation approaches. Conclusion: Prioritizing health equity in implementation science requires that research teams probe, interrogate, and innovate - and in doing so, grapple with central conceptual and pragmatic considerations that arise in the design of implementation strategies. Our work emphasizes the value of bidirectional and continuous learning. Competing Interests: Competing interests: Dr. Beidas is principal at Implementation Science & Practice, LLC. She is currently an appointed member of the National Advisory Mental Health Council and the NASEM study, “Blueprint for a national prevention infrastructure for behavioral health disorders,” and serves on the scientific advisory board for AIM Youth Mental Health Foundation and the Klingenstein Third Generation Foundation. She has received consulting fees from United Behavioral Health and OptumLabs. She previously served on the scientific and advisory board for Optum Behavioral Health and has received royalties from Oxford University Press. All activities are outside of the submitted work.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu