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A more practical guide to incorporating health equity domains in implementation determinant frameworks
BACKGROUND: Due to striking disparities in the implementation of healthcare innovations, it is imperative that researchers and practitioners can meaningfully use implementation determinant frameworks to understand why disparities exist in access, receipt, use, quality, or outcomes of healthcare. Our...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178842/ https://www.ncbi.nlm.nih.gov/pubmed/34090524 http://dx.doi.org/10.1186/s43058-021-00146-5 |
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author | Woodward, Eva N. Singh, Rajinder Sonia Ndebele-Ngwenya, Phiwinhlanhla Melgar Castillo, Andrea Dickson, Kelsey S. Kirchner, JoAnn E. |
author_facet | Woodward, Eva N. Singh, Rajinder Sonia Ndebele-Ngwenya, Phiwinhlanhla Melgar Castillo, Andrea Dickson, Kelsey S. Kirchner, JoAnn E. |
author_sort | Woodward, Eva N. |
collection | PubMed |
description | BACKGROUND: Due to striking disparities in the implementation of healthcare innovations, it is imperative that researchers and practitioners can meaningfully use implementation determinant frameworks to understand why disparities exist in access, receipt, use, quality, or outcomes of healthcare. 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) culturally relevant 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 healthcare 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-021-00146-5. |
format | Online Article Text |
id | pubmed-8178842 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-81788422021-06-07 A more practical guide to incorporating health equity domains in implementation determinant frameworks Woodward, Eva N. Singh, Rajinder Sonia Ndebele-Ngwenya, Phiwinhlanhla Melgar Castillo, Andrea Dickson, Kelsey S. Kirchner, JoAnn E. Implement Sci Commun Methodology BACKGROUND: Due to striking disparities in the implementation of healthcare innovations, it is imperative that researchers and practitioners can meaningfully use implementation determinant frameworks to understand why disparities exist in access, receipt, use, quality, or outcomes of healthcare. 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) culturally relevant 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 healthcare 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-021-00146-5. BioMed Central 2021-06-05 /pmc/articles/PMC8178842/ /pubmed/34090524 http://dx.doi.org/10.1186/s43058-021-00146-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Methodology Woodward, Eva N. Singh, Rajinder Sonia Ndebele-Ngwenya, Phiwinhlanhla Melgar Castillo, Andrea Dickson, Kelsey S. Kirchner, JoAnn E. A more practical guide to incorporating health equity domains in implementation determinant frameworks |
title | A more practical guide to incorporating health equity domains in implementation determinant frameworks |
title_full | A more practical guide to incorporating health equity domains in implementation determinant frameworks |
title_fullStr | A more practical guide to incorporating health equity domains in implementation determinant frameworks |
title_full_unstemmed | A more practical guide to incorporating health equity domains in implementation determinant frameworks |
title_short | A more practical guide to incorporating health equity domains in implementation determinant frameworks |
title_sort | more practical guide to incorporating health equity domains in implementation determinant frameworks |
topic | Methodology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178842/ https://www.ncbi.nlm.nih.gov/pubmed/34090524 http://dx.doi.org/10.1186/s43058-021-00146-5 |
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