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Methodology
Eva N Woodward
Central Arkansas Veterans Healthcare System Eugene J Towbin Healthcare Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7880-0054
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Due to limited systematic integration of health equity and implementation science, it is imperative to provide researchers and practitioners tools to guide implementation in settings where there is inequitable implementation of an intervention. Our prior work documented and piloted the first published adaptation of an existing implementation science framework with health equity determinants to create the Health Equity Implementation Framework. We suggested how others’ might adapt their preferred implementation science frameworks with three health equity domains: 1) cultural factors of recipients, 2) clinical encounter, or patient-provider interaction, and 3) societal influences (including but not limited to social determinants of health). This manuscript is a practical guide to utilize three health equity domains in implementation research and practice.
Methods: We describe in greater depth than in our previous publication domains typical in implementation determinants frameworks and three adaptations: domains known to affect health equity. For each domain, we compiled definitions with supporting literature, defined relevant subdomains, showcased an illustrative example, and suggested sample measures, both quantitative and qualitative.
Results: We describe how to incorporate the three health equity domains in one’s preferred implementation science framework, or how to use the Health Equity Implementation Framework specifically. Practical guidelines follow ten published recommendations on how to use frameworks in implementation research and practice. We describe a new case study in which the framework guided evaluation.
Conclusions: Incorporating health equity domains within implementation frameworks may optimize the scientific yield and equity of implementation efforts by assessing and ideally, addressing, implementation and equity barriers simultaneously. The practical guidance and tools provided can assist implementation scientists and practitioners to concretely address inequity in implementation across populations to capture and analyze information used to assess health outcomes.
Contributions to the Literature
Specific definitions of implementation and three health equity domains with examples of how they have been applied in published literature and sample measures.
Practical tools, including a qualitative interview guide and codebook
Case study of how the Health Equity Implementation Framework guided analysis in an implementation study
Keywords
health equity, implementation, health disparities, framework, theory, implementation science, healthcare, dissemination
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CURRENT STATUS: Under Review
The most recent version of this article is available here.
No community comments so far
Editorial decision: Minor revision
On 24 Jan, 2021
Review #1 received
Received 11 Jan, 2021
Reviewers invited
Invitations sent on 17 Dec, 2020
Reviewer #1 agreed
On 17 Dec, 2020
Editor assigned
On 15 Nov, 2020
Submission checks complete
On 15 Nov, 2020
Editor invited
On 15 Nov, 2020
Version 1
Posted 08 Jun, 2020
No comments provided
Editorial decision: Major revision
On 16 Sep, 2020
Review #3 received
Received 05 Sep, 2020
Review #2 received
Received 05 Sep, 2020
Reviewer #2 agreed
On 10 Aug, 2020
Reviewer #3 agreed
On 10 Aug, 2020
Review #1 received
Received 03 Jul, 2020
Reviewers invited
Invitations sent on 15 Jun, 2020
Reviewer #1 agreed
On 15 Jun, 2020
Editor assigned
On 04 Jun, 2020
Submission checks complete
On 03 Jun, 2020
Editor invited
On 03 Jun, 2020
First submitted
On 02 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Sociology
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at Implementation Science Communications. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Methodology
Eva N Woodward
Central Arkansas Veterans Healthcare System Eugene J Towbin Healthcare Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7880-0054
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
The most recent version of this article is available here.
No community comments so far
Editorial decision: Minor revision
On 24 Jan, 2021
Review #1 received
Received 11 Jan, 2021
Reviewers invited
Invitations sent on 17 Dec, 2020
Reviewer #1 agreed
On 17 Dec, 2020
Editor assigned
On 15 Nov, 2020
Submission checks complete
On 15 Nov, 2020
Editor invited
On 15 Nov, 2020
Version 1
Posted 08 Jun, 2020
No comments provided
Editorial decision: Major revision
On 16 Sep, 2020
Review #3 received
Received 05 Sep, 2020
Review #2 received
Received 05 Sep, 2020
Reviewer #2 agreed
On 10 Aug, 2020
Reviewer #3 agreed
On 10 Aug, 2020
Review #1 received
Received 03 Jul, 2020
Reviewers invited
Invitations sent on 15 Jun, 2020
Reviewer #1 agreed
On 15 Jun, 2020
Editor assigned
On 04 Jun, 2020
Submission checks complete
On 03 Jun, 2020
Editor invited
On 03 Jun, 2020
First submitted
On 02 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Sociology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
Background: Due to limited systematic integration of health equity and implementation science, it is imperative to provide researchers and practitioners tools to guide implementation in settings where there is inequitable implementation of an intervention. Our prior work documented and piloted the first published adaptation of an existing implementation science framework with health equity determinants to create the Health Equity Implementation Framework. We suggested how others’ might adapt their preferred implementation science frameworks with three health equity domains: 1) cultural factors of recipients, 2) clinical encounter, or patient-provider interaction, and 3) societal influences (including but not limited to social determinants of health). This manuscript is a practical guide to utilize three health equity domains in implementation research and practice.
Methods: We describe in greater depth than in our previous publication domains typical in implementation determinants frameworks and three adaptations: domains known to affect health equity. For each domain, we compiled definitions with supporting literature, defined relevant subdomains, showcased an illustrative example, and suggested sample measures, both quantitative and qualitative.
Results: We describe how to incorporate the three health equity domains in one’s preferred implementation science framework, or how to use the Health Equity Implementation Framework specifically. Practical guidelines follow ten published recommendations on how to use frameworks in implementation research and practice. We describe a new case study in which the framework guided evaluation.
Conclusions: Incorporating health equity domains within implementation frameworks may optimize the scientific yield and equity of implementation efforts by assessing and ideally, addressing, implementation and equity barriers simultaneously. The practical guidance and tools provided can assist implementation scientists and practitioners to concretely address inequity in implementation across populations to capture and analyze information used to assess health outcomes.
Contributions to the Literature
Specific definitions of implementation and three health equity domains with examples of how they have been applied in published literature and sample measures.
Practical tools, including a qualitative interview guide and codebook
Case study of how the Health Equity Implementation Framework guided analysis in an implementation study
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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