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. 2020 Mar 12;20(1):190.
doi: 10.1186/s12913-020-4975-3.

Reframing implementation science to address inequities in healthcare delivery

Affiliations

Reframing implementation science to address inequities in healthcare delivery

Ana A Baumann et al. BMC Health Serv Res. .

Abstract

Background: Research has generated valuable knowledge in identifying, understanding, and intervening to address inequities in the delivery of healthcare, yet these inequities persist. The best available interventions, programs and policies designed to address inequities in healthcare are not being adopted in routine practice settings. Implementation science can help address this gap by studying the factors, processes, and strategies at multiple levels of a system of care that influence the uptake, use, and the sustainability of these programs for vulnerable populations. We propose that an equity lens can help integrate the fields of implementation science and research that focuses on inequities in healthcare delivery.

Main text: Using Proctor et al.' (12) framework as a case study, we reframed five elements of implementation science to study inequities in healthcare. These elements include: 1) focus on reach from the very beginning; 2) design and select interventions for vulnerable populations and low-resource communities with implementation in mind; 3) implement what works and develop implementation strategies that can help reduce inequities in care; 4) develop the science of adaptations; and 5) use an equity lens for implementation outcomes.

Conclusions: The goal of this paper is to continue the dialogue on how to critically infuse an equity approach in implementation studies to proactively address healthcare inequities in historically underserved populations. Our examples provide ways to operationalize how we can blend implementation science and healthcare inequities research.

Keywords: Adaptation; Equity; Healthcare inequities; Implementation science.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care [Internet]. Washington, D.C; 2003. Available from: http://www.nap.edu/catalog/10260/unequal-treatment-confronting-racial-an....
    1. Alvidrez J, Stinson N. Sideways Progress in Intervention Research Is Not Sufficient to Eliminate Health Disparities. Am J Public Health. 2019;109(S1):S102–S104. doi: 10.2105/AJPH.2019.304953. - DOI - PMC - PubMed
    1. Thomas SB, Quinn SC, Butler J, Fryer CS, Garza MA. Toward a Fourth Generation of Disparities Research to Achieve Health Equity. Annu Rev Public Health. 2011;32(1):399–416. doi: 10.1146/annurev-publhealth-031210-101136. - DOI - PMC - PubMed
    1. Blendon RJ, Schoen C, DesRoches CM, Osborn R, Scoles KL, Zapert K. Inequities In Health Care: A Five-Country Survey. Health Aff (Millwood) 2002;21(3):182–191. doi: 10.1377/hlthaff.21.3.182. - DOI - PubMed
    1. Cleary M, Visentin DC, West S, Hills AP, Kornhaber R. When the Problem Is ‘Global’ but the Response Is Not: Inequities in Mental Health Services in Low-and Middle-Income Countries. Issues Ment Health Nurs. 2019;40(1):83–85. doi: 10.1080/01612840.2018.1534477. - DOI - PubMed