Implementation Science

This post is the final entry in our series about the use of race and ethnicity in population health research. Our previous posts have detailed information around defining, measuring, coding, and analyzing data on race and ethnicity.

For states to move toward antiracist, equitable, and inclusive policies that build an economic recovery that extends to all people, three principles should guide state policymakers in these equity efforts.

At the root of structural issues is powerlessness. This primer examines how health equity can be achieved through a community power-building approach to structural change.

The Racial Equity and Policy (REAP) framework provides a conceptually sound, empirically grounded basis for systematically assessing racial equity in health policy

This work seeks to shift awareness and practice by centering racial equity and community voice within the context of data integration and use that supports power sharing and building across agencies and community members.

The chief research officer of the Seattle Indian Health Board is creating programs and databases that are not based on Western concepts to better serve indigenous communities.

This paper outlines new academic incentives at the system-, institution-, and person-level that, if implemented, could make proving societal impact an integral part of the research process.

Designed for physicians and other health care professionals, this document provides guidance and promotes a deeper understanding of equity-focused, person-first language and why it matters.

While each organization will follow its own path towards a Race Equity Culture, our research suggests that all organizations go through a cycle of change as they transform from a white dominant culture to a Race Equity Culture.

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In this essay, two women of Color researchers examine the intersections of race and disability and ask, ?What is the power and purpose of positioning and positionality statements?? Informed by Black feminist theory, and drawing from the DisCrit tenets of intersectional oppressions, historicity, and whiteness and ability as property, the authors focus on researchers? positioning in relation to how they engage and communicate knowledge about multiply marginalized people.

A recent literature review revealed most studies of social need interventions were poorly designed, inadequately documented, and inconsistently presented. In this post, Robert Dubois of the National Pharmaceutical Council, an AcademyHealth Organizational Member, outlines the state of the research and provides recommendations to improve study design quality.

This expert roundtable focuses on how the disaggregation of data, especially race and ethnicity data, can improve equity.

The authors report on the Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) program, a D&I training program for postdoctoral or early-career cancer prevention and control scholars.

Christopher F. Koller, President of the Milbank Memorial Fund, Lillie Tyson Head, President of VFOFLF, and Pamela Browner White, Chief Diversity, Equity and Inclusion Officer and Senior Vice President of Communications at the American Board of Internal Medicine and the ABIM Foundation, spoke about the importance of building trust by acknowledging past harm, committing to do better, and partnering for the long term to improve trust in the health system.

The Commission’s report and recommendations make it clear that in our current system, data on health inequities are divorced from the history and community conditions that shape poor health outcomes.

This review provides a characterization and conceptualization of community voice in health-oriented collaborations that provides a new theoretical basis for future research.

This paper provides recommendations on how to appropriately engage in scientific inquiry aimed at understanding racial health inequities. Race should not be used as a measure of biologic difference, but as a proxy for exposure to systemic racism.

This guide was developed in response to librarians fielding multiple requests from UMN researchers looking to incorporate anti-racism into their research practices. This guide shares racist research systems and practices, followed by resources for mitigating those problematic systems and practices, but we wholeheartedly acknowledge that this guide is not a “solution” to the issues of racism embedded in research.

Kimberle Crenshaw invites Barbara Arnwine, Camara Phyllis Jones, Jonathan Metzl, and Keeanga-Yamahtta Taylor to ask: What has become of the supposed reckoning with white supremacy since George Floyd?s death?

Background: Multiple factors, including experiences with unethical research practices, have made some Indigenous groups in the United States and Canada reticent to participate in potentially beneficial health-related research. Yet, Indigenous peoples have also expressed a willingness to participate in research when certain conditions related to the components of data management?including data collection, analysis, security and storage, sharing, dissemination, and withdrawal?are met. A scoping review was conducted to better understand the terms of data management employed in healthrelated research involving Indigenous communities in the United States and Canada. Methods: PubMed, Embase, PsychINFO, and Web of Science were searched using terms related to the populations and topics of interest. Results were screened and articles deemed eligible for inclusion were extracted for content on data management, community engagement, and community-level research governance. Results: The search strategy returned 734 articles. 31 total articles were extracted,
of which nine contained in-depth information on data management and underwent detailed extraction. All nine articles reported the development and implementation of data management tools, including research ethics codes, data-sharing agreements, and biobank access policies. These articles reported that communities were involved in activities and decisions related to data collection (n=7), data analysis (n=5), data-sharing (n=9), dissemination (n=7), withdrawal (n=4), and development of data management tools (n=9). The articles also reported that communities had full or shared ownership of (n=5), control over (n=9), access to (n=1), and possession of data (n=5). All nine articles discussed the role of community engagement in research and communitylevel research governance as means for aligning the terms of data management with the values, needs, and interests of communities. Conclusions: There is need for more research and improved reporting on data management in health-related research involving Indigenous peoples in the United States and Canada. Findings from this review can provide guidance for the identification of data management terms and practices that may be acceptable to Indigenous communities considering participation in health-related research.

Investigation in patient safety improvement is constantly yielding new research results, yet efforts to put the results into practice are inconsistent. Therefore, a pragmatic tool is needed. The Dissemination Planning Tool was developed to assist the Agency for Healthcare Research and Quality (AHRQ) Patient Safety grantees with disseminating their research results. It was designed to help researchers consider major areas in dissemination: packaging research results, identifying target users, engaging connector organizations, identifying barriers, developing success measures, and allocating resources to implement the plan. Developing the tool included several stages, beginning with adapting Rogers’ seminal diffusion theory. Literature was reviewed from health care, sociology, organizational development, psychology, and social sciences, thus providing a breath of dissemination theory and practices. Tools currently used in field-specific instances were reviewed. All of these sources were synthesized through a process of refinement, expert review, and testing.

This style guide, which covers dozens of words and terms commonly used when referring to disability, can help journalists and other communicators to figure out how to refer to people with disabilities.

This publication presents the final recommendations of an external advisory group AcademyHealth convened to help shape a sustainable, action-oriented strategy to address diversity, equity, & inclusion in the field

For this follow-up volume, Do No Harm Guide: Additional Perspectives on Data Equity, we handed the pen to data experts and practitioners whose voices have been traditionally underrepresented.

Systematic reviews are infrequently used by health care managers (HCMs) and policy-makers (PMs) in decision-making. HCMs and PMs co-developed and tested novel systematic review of effects formats to increase their use.

This article examines what it means to use equity as a guiding principle throughout the components and functions of a modern public health data system.

The ACGME Equity Matters Video Library houses all the individual components of the ACGME Equity Matters curriculum and is accessible to anyone in the medical education community. No CME credit is provided for completion of the library?s resources. To ensure a safe environment, it is recommended that organizations using these videos show them under the proper guidance of a trained facilitator for large viewings.

This commentary will interrogate the ways we as health services researchers pose our research questions, create methodological approaches, and interpret our findings, and serve as a disciplinary self-critique that will expose how our disciplinary practices are steeped in white supremacy.

Collaborative research networks are increasingly used as an effective mechanism for accelerating knowledge transfer into policy and practice. This paper explored the characteristics and collaborative learning approaches of nine health research networks.

This guidance is meant to facilitate conversations between researchers and patient partners about authorship and/or acknowledgement regarding research projects on which they collaborate.

This article examines the health disparities experienced by transgender people with disabilities. It analyzes the prevalence and types of disabilities among transgender people, examines the health outcomes and social determinants of health among this intersectional population, and makes recommendations for areas of future research.

This paper explores the rise & consequences of ?health equity tourism?, a phenomenon where previously unengaged investigators pivot into health equity research without developing the necessary scientific expertise for high-quality work.

This resource is intended to provide state policymakers with a suite of state approaches to address health disparities ? from targeted to cross-agency comprehensive strategies. Each section below comprises best practices and state
examples from a geographically diverse set of states to guide state policymakers to the opportunity that best suits their states? needs and capacity. Also included is a lexicon, recognizing the importance of common definitions in this domain, along with links to key tools and resources.

This expert roundtable focuses on how the COVID-19 pandemic brought to light the serious and pervasive data gaps facing marginalized groups and what cross-cutting themes the panels found in their work.

Public research funding agencies and research organisations are increasingly accountable for the wider impacts of the research they support. While research impact assessment (RIA) frameworks and tools exist, little is known and shared of how these organisations implement RIA activities in practice.

This article offers a simple, easy to remember framework for designing impactful research. We call this framework: ?The 7Cs of Impact? ? Context, Communities, Constituencies, Challenge, Channels, Communication and Capture.

This study discusses three ways in which implementation science can inform efforts to address disparities in COVID deaths: (1) quantify and understand disparities; (2) design equitable interventions; and (3) test, refine, and retest interventions

Our latest episode highlights how the current equity efforts can integrate with established performance management practices. It also discusses how health agencies can use planning documents to integrate equity in health assessments, health improvement plans, strategic plans, and performance management systems.

This article highlights methodological approaches that will move the field forward in its ability to validly measure structural racism for the purposes of achieving health equity

This tool describes how to conduct intensive equity assessments of existing programs, policies, and processes. The tool first describes the scoping work that needs to be done before conducting an equity assessment and then describes and provides guiding questions for each of the six steps in the in-depth equity assessment process.

Lotteries, self-review, open peer review, innovation prizes, and other approaches have emerged as potential research funding process alternatives, but each of these options comes with its own advantages and disadvantages.

The Lancet REWARD (REduce research Waste And Reward Diligence) Campaign invites everyone involved in biomedical research to critically examine the way they work to reduce waste and maximize efficiency.

This Horizon Scan provides an overview of existing DEI programs and practices to ultimately stimulate conversations and action that can advance DEI within health services and policy research.

This 3 level framework is useful for raising new hypotheses about the basis of race-associated differences in health outcomes, as well as for designing effective interventions to eliminate those differences.

This commentary uses Black Feminism and Womanism (BFW) as epistemologies to critically address Black women’s health policy, building on the legacy of Black women’s experiences, theories, & knowledge production.

Despite decades of research exposing health disparities between populations and communities in the US, health equity goals remain largely unfulfilled. We argue these failures call for applying an equity lens in the way we approach data systems, from collection and analysis to interpretation and distribution. Hence, health equity requires data equity. There is notable federal interest in policy changes and federal investments to improve health equity. With this, we outline the opportunities to align these health equity goals with data equity by improving the way communities are engaged and how population data are collected, analyzed, interpreted, made accessible, and distributed. Policy priority areas for data equity include increasing the use of disaggregated data, increasing the use of currently underused federal data, building capacity for equity assessments, developing partnerships between government and community, and increasing data
accountability to the public.

Examines the measurement of sex, gender identity, & sexual orientation to produce recommendations for specific measures that can be used in surveys & research, administrative, clinical, & other health settings.

Despite racism?s alarming impact on health and the wealth of scholarship that outlines its ill effects, preeminent scholars and the journals that publish them routinely fail to interrogate racism as a critical driver of racial health inequities.

A guide to support funders seeking to develop and implement a preprint policy. The toolkit includes benefits of preprints for funders, guidlines on how to incorporate and review the use of preprints into current policies, and a preprint policy text document

Until recently, there were no preprint servers for medical and health sciences. In this post, Harlan Krumholz and Joseph Ross, co-founders of medRxiv, describe the benefits of preprints and highlight features of their preprint server for health sciences launched in June 2019.

This brief introduces the Belmont Report?s principles and provides selected principle-aligned practices and resources to help data experts at all levels integrate the principles into their work and move toward more equitable data practice.

Critical appraisal tools developed by First Nations peoples are available to researchers and direct attention to the social, cultural, political and human rights basis of health research.

A Racial Equity Impact Assessment (REIA) is a systematic examination of how different racial and ethnic groups will likely be affected by a proposed action or decision.

The Commission’s report and recommendations make it clear that in our current system, data on health inequities are divorced from the history and community conditions that shape poor health outcomes.

Taking the model from the American Alliance of Museums? guides for transgender inclusion, these toolkits provide a common framework for analysis, a shared vocabulary, and best practices to address racial disparities specific to the scholarly publishing community.

This article identifies where the technology and data sectors can contribute skills, expertise, and assets in support of innovative workforce models and augment the development of public health workforce competencies.

Use the Data Equity Framework to break up your data work into manageable parts and go through an intentional, equity-oriented process to make the key decisions along the way.

The current evaluation paradigm must shift and mindsets and practices evolve. The Equitable Evaluation Initiative’s Equitable Evaluation Framework provides principles and orthodoxies to guide organizations.

Our aim is to lay the groundwork for an ethically responsible development of AI in the domains of health research, clinical practice and public health.

How can health services research better ensure that high-value health care is consistently and affordably provided to different people, communities, and populations? That?s a fundamental question that this sector must answer if it?s to remain viable.

Using stories we collected from American Indian people who have experienced the results of racist policies, we describe historical trauma and its links to the health of American Indians and Alaska Natives.

This article summarizes some of the challenges around data sharing and reuse and identifies where the technology and data sectors can contribute to fill current gaps to promote interoperability and data stewardship.

We provide recommendations on how to implement systems-level change and educational reform to infuse racial equity in future policy and practice for Asian American communities.

This content was initially created to inform federal staff at the U.S. Department of Health and Human Services. In an effort to increase collaboration and share promising practices, the Office of the Assistant Secretary for Planning and Evaluation has made this tool available for both public and private partners.

Dan Gorenstein, host and executive producer of the national health policy podcast Tradeoffs, highlights ways health policy researchers and academics can share their work with reporters.

This Implementation Guidebook will help individuals, organizations, communities and First Nations in planning, implementing and evaluating the W.K. Kellogg Foundation’s Truth, Racial Healing & Transformation efforts.

As 14 Truth, Racial Healing & Transformation places approach the fourth year of implementation, these briefs offer a glimpse into the opportunities, nuances & complexities of implementing a community-based collaboration.

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Margo Edmunds and Abdul Shaikh lead attendees through an exercise on priority-setting for methods and data followed by a discussion of the results of the exercise.

Abdul Shaikh facilitates a discussion on emerging methods to advance health equity. Lisa Goldman Rosas presents on community-based participatory research, and Suzanne Tamang discusses how using big data can improve outcomes.

In this session, presenters Ninez Ponce and Juanita Chinn describe approaches to improving data collection and analysis with Asian/Pacific Islander, Native American people, and other under-represented groups.

Rashida Dorsey leads a conversation with J?Mag Karbeah, Reginald Tucker-Seeley, and Jameta Barlow on topic areas including structural racism, measuring and reporting health disparities, and understanding intersectionality.

Tools to improve communication about social needs, social determinants of health, and structural determinants of health equity.

A virtual coffee chat between two noted changemakers about how to better align health services research to the priorities of policymakers and health system leaders.

This article summarizes what data should be included and identifies where the technology and data sectors can contribute to fill current gaps to measure equity, positive health, and well-being.

If we seek to improve community and population health through effective interventions targeting social and environmental contexts, who will drive the change? On the basis of our experience in Durham County, North Carolina, we have learned that successful interventions must rely, at least in part, on stakeholders outside the public health and health care sectors, including those in business, education, philanthropy, nonprofit organizations, community development, and government.

This guidebook proposes an equity-based approach as a way to restore communities as the true authors and owners of research, and to shift the way researchers and funders work with community-based organizations to uncover knowledge together.