Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University, 722 W 168th Street, New York, NY, 10032, USA.
Columbia University, Irving Institute for Clinical and Translational Research, New York, NY, 10032, USA.
Prev Sci. 2024 Apr;25(Suppl 1):174-189. doi: 10.1007/s11121-023-01589-z. Epub 2023 Oct 25.
Despite investments in evidence-based interventions and Implementation Science, most evidence-based interventions are not widely or routinely adopted, delivered, or sustained in many real-world community and healthcare settings. This gap is even greater in settings and populations experiencing numerous social and structural barriers to health, with important implications for persistent patterns in health inequities. In this Viewpoint, as part of a Special Issue on Advancing the Adaptability of Chronic Disease Prevention and Management through Implementation Science, we outline seven calls to action for the field of Implementation Science, with the goal of encouraging researchers, practitioners, and funders to be more intentional and accountable in applying Implementation Science to have greater impact on promoting health equity. Calls to action include (1) enhance public health, community, and multi-sectoral partnerships to promote health equity and equitable implementation; (2) revisit and build the evidence base needed to promote health equity and impact at multiple levels; (3) prioritize focus on policy development, dissemination, and implementation; (4) be agile and responsive in application of Implementation Science frameworks, processes, and methods; (5) identify and redefine meaningful metrics for equity and impact; (6) disseminate scientific evidence and research to a diverse range of partners and potential beneficiaries; and (7) extend focus on de-implementation, mis-implementation, and sustainability which are central to enhancing health equity. Additionally, we outline why a focus on prevention and public health is essential to making progress towards health equity in Implementation Science, summarize important advancements that the field has made towards making equity more foundational, and pose important research questions to enhance equitable impact of work in this area.
尽管在循证干预措施和实施科学方面投入了资金,但在许多现实社区和医疗保健环境中,大多数循证干预措施并没有得到广泛或常规的采用、实施或维持。在那些存在许多社会和结构性健康障碍的环境和人群中,这种差距更大,这对持续存在的健康不平等模式有着重要影响。在这篇观点文章中,作为推进实施科学在慢性病预防和管理中适应性的特刊的一部分,我们概述了实施科学领域的七个行动呼吁,旨在鼓励研究人员、实践者和资助者更有意识地、更负责地应用实施科学,以更大程度地促进健康公平。行动呼吁包括:(1)加强公共卫生、社区和多部门伙伴关系,以促进健康公平和公平实施;(2)重新审视和建立促进健康公平和多层次影响所需的证据基础;(3)优先关注政策制定、传播和实施;(4)在应用实施科学框架、流程和方法时灵活应变;(5)确定和重新定义公平和影响的有意义指标;(6)向多样化的合作伙伴和潜在受益者传播科学证据和研究;(7)扩大对去实施、错误实施和可持续性的关注,这些是增强健康公平的核心。此外,我们还概述了为什么关注预防和公共卫生对于在实施科学中朝着健康公平方向取得进展至关重要,总结了该领域在使公平更基础方面取得的重要进展,并提出了重要的研究问题,以增强该领域工作的公平影响。