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.
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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 striking disparities in implementation of healthcare innovations, it is imperative researchers and practitioners can meaningfully use implementation determinant frameworks to understand why disparities exist in access, receipt, use, quality, or outcomes of health care. Our prior work documented and piloted the first published adaptation of an existing implementation determinant framework with health equity domains to create the Health Equity Implementation Framework. We recommended integrating these three health equity domains to existing implementation determinant frameworks: 1) cultural factors of recipients, 2) clinical encounter, or patient-provider interaction, and 3) societal context (including but not limited to social determinants of health). This framework was developed for health care and clinical practice settings. Some implementation teams have begun using the Health Equity Implementation Framework in their evaluations and asked for more guidance.
Methods: We completed a consensus process with our authorship team to clarify steps to incorporate a health equity lens into an implementation determinant framework.
Results: We describe steps to integrate health equity domains into implementation determinant frameworks for implementation research and practice. For each step, we compiled examples or practical tools to assist implementation researchers and practitioners in applying those steps. For each domain, we compiled definitions with supporting literature, showcased an illustrative example, and suggested sample quantitative and qualitative measures.
Conclusion: Incorporating health equity domains within implementation determinant frameworks may optimize the scientific yield and equity of implementation efforts by assessing and ideally, addressing, implementation and equity barriers simultaneously. These practical guidance and tools provided can assist implementation researchers and practitioners to concretely capture and understand barriers and facilitators to implementation disparities.
Keywords
health equity, implementation, health disparities, framework, theory, implementation science, determinant
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Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 18 Nov, 2020
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
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!
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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
Version 2
Posted 18 Nov, 2020
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
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
Background: Due to striking disparities in implementation of healthcare innovations, it is imperative researchers and practitioners can meaningfully use implementation determinant frameworks to understand why disparities exist in access, receipt, use, quality, or outcomes of health care. Our prior work documented and piloted the first published adaptation of an existing implementation determinant framework with health equity domains to create the Health Equity Implementation Framework. We recommended integrating these three health equity domains to existing implementation determinant frameworks: 1) cultural factors of recipients, 2) clinical encounter, or patient-provider interaction, and 3) societal context (including but not limited to social determinants of health). This framework was developed for health care and clinical practice settings. Some implementation teams have begun using the Health Equity Implementation Framework in their evaluations and asked for more guidance.
Methods: We completed a consensus process with our authorship team to clarify steps to incorporate a health equity lens into an implementation determinant framework.
Results: We describe steps to integrate health equity domains into implementation determinant frameworks for implementation research and practice. For each step, we compiled examples or practical tools to assist implementation researchers and practitioners in applying those steps. For each domain, we compiled definitions with supporting literature, showcased an illustrative example, and suggested sample quantitative and qualitative measures.
Conclusion: Incorporating health equity domains within implementation determinant frameworks may optimize the scientific yield and equity of implementation efforts by assessing and ideally, addressing, implementation and equity barriers simultaneously. These practical guidance and tools provided can assist implementation researchers and practitioners to concretely capture and understand barriers and facilitators to implementation disparities.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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