Grant Details
Grant Number: |
3R01CA262325-02S1 Interpret this number |
Primary Investigator: |
Lewis, Cara |
Organization: |
Kaiser Foundation Research Institute |
Project Title: |
Building Health Equity Into Implementation Strategies and Mechanisms |
Fiscal Year: |
2022 |
Abstract
PROJECT SUMMARY
Cancer is one of the leading causes of death in the United States. Despite the successes of cancer control
efforts, historically marginalized populations continue to experience a disproportionate burden of cancer
morbidity and mortality. Implementation science has the potential to advance health equity by improving the
adoption, implementation, and sustainment of evidence-based practices delivered to disadvantaged groups.
However, the integration of health equity into implementation science methods is still in the early stages, and
several limitations in the field must be overcome to enhance equitable implementation. This supplement builds
on the parent award’s efforts to improve the specification of implementation strategies and to elucidate
potential causal mechanisms through which strategies elicit desired outcomes. This supplement enhances the
parent award’s impact by bringing a health equity lens to the study of implementation strategies and their
causal mechanisms. This supplement has two aims: 1) Develop and refine a resource guide for integrating
health equity into the selection, tailoring, and specification of implementation strategies; and 2) generate visual
representations of causal mechanisms of equity-focused implementation strategies. The first aim will integrate
health equity literature and existing guidance for selecting implementation strategies, tailoring them to address
context-specific determinants (barriers and facilitators), and specifying strategy components so that they may
be tested and replicated. Input from experts in health equity and implementation research will inform the
resource guide development. Stakeholder feedback sessions applying user-centered design methods will
generate preliminary mixed-methods data on the resource guide’s usability and recommendations for its
refinement. The investigative team will apply the resource guide to specify a subset of implementation
strategies for health equity impact. Aim 2 draws upon the causal diagramming methods from the parent award
to illustrate plausible strategy-mechanism linkages of four health-equity focused implementation strategies and
articulate moderators, preconditions, and outcomes associated with those linkages. The health equity-focused
implementation strategy specification and the causal pathways of their proposed mechanisms will be
compared to “standard” versions of the same strategies to highlight key similarities and differences. The
products from this supplement will be added to the parent award web repository and disseminated to
implementation scientists and practitioners so they may apply these in equity-focused implementation research
and practice. The proposed supplement is innovative in that it is among the first efforts to articulate specific
guidance for applying a health equity lens to implementation strategies. It is significant for its potential to
advance equitable implementation of evidence-based practices in cancer control and other health fields.
Publications
None. See parent grant details.