No Easy Answers: Avoiding Potential Pitfalls of De-implementation
- PMID: 30549283
- PMCID: PMC6590245
- DOI: 10.1002/ajcp.12298
No Easy Answers: Avoiding Potential Pitfalls of De-implementation
Abstract
In 2012, the Centers for Disease Control and Prevention (CDC) began to de-emphasize and de-implement multiple evidence-based HIV prevention practices that had been around for 20 years, thus changing the scope of implementation across the globe. The authors provide evidence how existing interventions (e.g., CDC HIV interventions) may influence implementation of interventions that came after the program was discontinued. De-implementation is an ecological event that influences, and is influenced by, many parts of a system, for instance, implementation of one type of intervention may influence the implementation of other interventions (biomedical and/or behavioral) after a long-running program is discontinued. Researchers and policy makers ought to consider how de-implementation of behavioral interventions is influenced by biomedical interventions mass-produced by companies with lobbying power. The scientific study of de-implementation will be inadequate without consideration of the political climate that surrounds de-implementation of certain types of interventions and the promotion of more-profitable ones.
Keywords: De-implementation pitfalls; HIV-prevention; Politics; Pre-exposure prophylaxis.
© 2018 The Authors. American Journal of Community Psychology published by Wiley Periodicals, Inc. on behalf of Society for Community Research and Action.
Comment on
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Letting Go: Conceptualizing Intervention De-implementation in Public Health and Social Service Settings.Am J Community Psychol. 2018 Sep;62(1-2):189-202. doi: 10.1002/ajcp.12258. Epub 2018 Jul 3. Am J Community Psychol. 2018. PMID: 29971792 Free PMC article. Review.
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