Implementation science communications最新文献

{"title":"Mechanisms of practice facilitation identified using system dynamics diagramming in a tailored implementation study of unhealthy alcohol screening and treatment in primary care.","authors":"Erin S Kenzie, Mellodie Seater, Chrystal Barnes, Tiff Weekley, Victoria Sanchez, Jennifer Coury, Brigit A Hatch, Melinda M Davis","doi":"10.1186/s43058-026-00909-y","DOIUrl":"https://doi.org/10.1186/s43058-026-00909-y","url":null,"abstract":"<p><strong>Background: </strong>Practice facilitation is a valuable strategy for enhancing the adoption, implementation, and sustainability of evidence-based practices in primary care. It is important to understand how practice facilitation works to develop implementation strategies that are tailored to the needs of the practice. Research is needed to understand the mechanisms by which practice facilitation strategies impact clinic dynamics.</p><p><strong>Methods: </strong>We used a diagramming approach from qualitative system dynamics to model the mechanisms by which practice facilitators supported implementation in a pragmatic study of unhealthy alcohol use screening and treatment in primary care settings. The model was developed based on secondary analysis of qualitative data and participatory modeling sessions with study team members. We then analyzed the model to identify individual mechanisms underlying strategies used by practice facilitators by connecting strategies to feedback loops.</p><p><strong>Results: </strong>We produced two systems diagrams, one describing the dynamics of screening and treatment for unhealthy alcohol use in the usual care scenario and one illustrating how the practice facilitator strategies acted on those dynamics in the intervention. Facilitator strategies included health information technology support, workflow mapping, toolkit sharing, academic detailing, support finding community resources, goal setting, relationship building, needs assessment, and monthly facilitation sessions. We identified twenty-seven unique mechanisms connected with the facilitator strategies, which we illustrate using diagrams and narrative descriptions.</p><p><strong>Conclusions: </strong>Our analysis demonstrates that practice facilitation is a highly adaptive, context-sensitive meta-strategy. System dynamics diagramming is well suited for identifying and describing mechanisms of practice facilitation in implementation research because it illustrates how strategies act on existing dynamics to affect outcomes. This approach could provide a way to specify mechanisms of change in future implementation of screening and treatment of unhealthy alcohol use, as well as other evidence-based interventions.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing the Safer Baby Bundle for stillbirth prevention across Queensland maternity services using a modified breakthrough series collaborative.","authors":"Michael Rice, Simin Arabshahi, Colette McIntyre, Adam Burns, Jocelyn Toohill, Kym Warhurst, Anne Bousfield, David Ellwood, Vicki Flenady, Christine Andrews","doi":"10.1186/s43058-026-00921-2","DOIUrl":"https://doi.org/10.1186/s43058-026-00921-2","url":null,"abstract":"<p><strong>Background: </strong>Australia's ≥ 28‑weeks stillbirth rate is 19.5% higher than that of high‑income countries with the lowest rates. The Safer Baby Bundle (SBB) is a national initiative to reduce stillbirth in Australia targeting five components of antenatal care and is the key prevention strategy within National Stillbirth Action and Implementation Plan. This paper reports the experience in one Australian state that delivered the Safer Baby Bundle Improvement Project (SBBIP) to support clinical staff implementing the SBB. In the setting of extreme maternity workforce challenges compounded by the COVID-19 pandemic, the implementation used a modified Breakthrough Series Collaborative (BTS).</p><p><strong>Methods: </strong>Over an 18-month period, antenatal services across Queensland used a modified BTS Collaborative approach, removing the need for teams to document Plan-Do-Study-Act cycles, use statistical process control (SPC) charts, document project progress scores and monthly reporting. Engagement during the improvement effort was assessed. A before-and-after multimethod study was used to evaluate the program. Routinely collected perinatal data, clinical audits, project administrative data and surveys of healthcare professionals and women receiving antenatal care were used to measure improvements before and after implementation, and logistic regression interrupted time series (ITS) analyses were used for comparisons of the outcomes.</p><p><strong>Results: </strong>Despite disruptions from the COVID-19 pandemic, the SBB was implemented across antenatal services, and the modified BTS implementation strategy achieved positive results. Eighty-nine percent of the 45 enrolled teams were actively engaged in the improvement effort across the SBBIP and all (100%) implemented one or more change ideas. Post implementation, improvements were observed in all key process measures and balance measures (planned singleton birth before 39 weeks, late preterm and early-term singleton births), whereas other measures remained unchanged. The stillbirth rate ≥ 28 weeks in singletons remained at 2.1 per 1000 births before and after implementation. ITS analyses of eligible measures supported these patterns.</p><p><strong>Conclusions: </strong>In an environment challenged by workforce shortages, high workload demand, and competing priorities (global pandemic), a modified BTS Collaborative approach is a useful model to implement improvement at scale to reduce stillbirth risk factors.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organizational readiness and program sustainability within juvenile justice and community mental health: the mediating role of cross-system collaboration.","authors":"Lauren M O'Reilly, Allyson Dir, Katherine Schwartz, Yoonsang Kim, Mateusz Borowiecki, Bruce Taylor, Zachary W Adams, Tamika Zapolski, Leslie Hulvershorn, Matthew C Aalsma","doi":"10.1186/s43058-026-00919-w","DOIUrl":"https://doi.org/10.1186/s43058-026-00919-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Evidence-based system-level intervention is needed to address the problem of poor connection to behavioral health (BH) services among justice-involved youth. System preparedness to implement evidence-based practices (EBP) or interventions, i.e. \"organizational readiness,\" is theoretically predictive of the sustainability of these practices. Cross-system collaboration-crucial for the connection of justice-involved youth between juvenile justice (JJ) to BH agencies-is theoretically related to organizational readiness and EBP sustainability, as the process of EBP implementation requires individual and shared efforts from involved systems. Despite strong theoretical justification, there has been minimal quantitative investigation into the relationships among organizational readiness, program sustainability, and cross-system collaboration. The current paper aimed to examine a) the association between organizational readiness and EBP sustainability, and b) the mediational role of cross-system collaboration in that association.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were derived from a hybrid type II effectiveness-implementation trial in eight counties in one Midwest state of partnered JJ and community mental health center (CMHC) agencies. Throughout the study, JJ and CMHC personnel participated in five waves of survey data collection measuring organizational readiness (Organizational Readiness to Implement Change; ORIC), sustainability (Program Sustainability Assessment Tool; PSAT), and cross-system collaboration (Cultural Exchange Inventory process and output scales; CEI). The final analyzable dataset included 274 participants with 529 observations. Linear mixed-effects models were conducted to account for the cluster-randomized, stepped-wedge design and repeated participant measurement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Organizational readiness was significantly positively associated with program sustainability (B = 0.79, 95% Confidence Interval [CI] 0.68-0.90), and the association was weakened when including the mediator CEI process subscale (B = 0.69, 95% CI 0.58-0.80). CEI process was significantly associated with program sustainability (B = 0.21, 95% CI 0.15-0.28) and accounted for 17.4% of the association between organizational readiness and sustainability. Results were comparable when examining the second mediating subscale, CEI output, which accounted for 17.2% of the observed association between organizational readiness and sustainability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Results supported the findings that organizational readiness was positively associated with sustainability, with cross-system collaboration partially mediating the association. Although our study is observational, cross-system collaboration may serve as a promising intervention target to rigorously examine in future implementation studies between JJ and BH agencies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The study was preregistered as a cli","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a pediatric antibiotic stewardship intervention across a large integrated health system: protocol to optimize antibiotic selection and prescription duration for acute respiratory tract infections in children.","authors":"Timothy R Fowles, Payal K Patel, Allan M Seibert, Adam L Hersh, Tom Belnap, Bridgett Hanna, Julia E Szymczak, Heather T Keenan, Bradley J Barney, Rajendu Srivastava","doi":"10.1186/s43058-026-00915-0","DOIUrl":"https://doi.org/10.1186/s43058-026-00915-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Appropriate antibiotic prescribing for routine childhood illnesses in ambulatory settings remains a major challenge especially at scale. The frequent overuse and misuse of antibiotics may lead to side effects in the children receiving them and contribute to the emergence of antibiotic-resistant bacteria. Substantial evidence suggests that adherence to established antibiotic prescribing guidelines curtails negative consequences without compromising treatment outcomes. However, adoption of guidelines remains stubbornly static. Implementation studies show specific strategies are effective at improving antibiotic stewardship (e.g., audit and feedback, electronic medical records [EMR] tools); however, there is limited evidence on how these strategies function when implemented across a large health system. As a large integrated health system, Intermountain Health (IH) is well-positioned for a scaled implementation of guideline-concordance antibiotic stewardship for acute respiratory tract infections (ARTIs) in children due to its previous stewardship work, culture of continuous quality improvement, and implementation infrastructure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study will evaluate the implementation of guideline-concordance prescribing for Acute Respiratory Tract Infections (ARTIs) in children 6 months to less than 18 years of age in ~ 250 sites across 5 care specialties (pediatrics, family medicine, urgent care, emergency department, and telehealth). The evaluation will focus on: (1) the overall effectiveness of implementation strategies at driving adherence to guideline-concordant care across the organization, (2) the nature of variability in strategy implementation and adherence by context (e.g., specialty, rurality, region), and (3) the utility of a more intensive implementation, termed \"Boost,\" for sites with lower adherence after general implementation. Primary effectiveness outcome is adherence to guideline-concordant antibiotic selection. Secondary outcomes include adherence to guideline-concordant antibiotic prescription duration, and the combination of both selection and duration termed Recommended Antibiotic and Duration Adherence Rate (RADAR). We will employ an observational, quasi-experimental approach comparing adherence before and after implementation in two waves across the organization and pre-post Boost for sites selected for intensive implementation support. In addition, we will investigate the correlations between use of implementation strategies and changes in adherence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;This study aims to fill a critical gap in the literature concerning implementation of antibiotic stewardship at large scale. Following established implementation science regarding effective implementation strategies, this evaluation tests their utility across diverse settings thus enabling investigation of contextual determinants. In addition, the evaluation will investigate the response to ","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An implementation mapping approach to equitable program delivery: building readiness in community organizations.","authors":"Thea Franke, Lindsay Nettlefold, Joanie Sims Gould, Karim M Khan, Heather A McKay","doi":"10.1186/s43058-026-00918-x","DOIUrl":"https://doi.org/10.1186/s43058-026-00918-x","url":null,"abstract":"<p><strong>Background: </strong>Community-based, not-for-profit organizations have potential to advance health equity through delivery of health-promoting interventions to underserved populations. However, structural barriers (e.g., limited resources) and contextual nuances often inhibit organizations' ability to adopt, implement, and sustain evidence-based interventions (EBIs). Implementation support systems ('support systems') can address these challenges by providing tailored support to enhance organizational readiness - an essential precursor for high-quality equitable implementation. In this paper, we used a case study approach to identify implementation strategies ('strategies') that a support system uses to build readiness in community organizations to adopt, implement, and sustain a health-promoting EBI for diverse groups of older adults (Choose to Move; CTM).</p><p><strong>Methods: </strong>We used a novel application of implementation mapping to name, define, and operationalize strategies used by the support system. We operationalized each strategy across eight dimensions: actor, action, action target, dose, theoretical justification, mechanism of action, temporality, and implementation outcomes addressed. We aligned strategies to a readiness framework (R=MC²; motivation, innovation-specific capacity, general capacity) and devised an equitable implementation roadmap to build organizational readiness.</p><p><strong>Results: </strong>We identified 17 strategies enacted by the support system to enhance organizational readiness, particularly motivation and innovation-specific capacity, across a five-stage implementation roadmap: 1. engagement, 2. readiness assessment, 3. feedback and prioritization, 4. preparation, and 5. support during delivery. The 17 strategies aimed to improve adoption, reach, fidelity, and sustainment of CTM.</p><p><strong>Conclusions: </strong>Our results highlight the critical role of support systems to achieve equitable implementation of EBIs in community organizations. When support systems use tailored strategies to build readiness, they contribute to equitable access to health-promoting EBIs which in turn can prevent widening health inequities. The equitable implementation roadmap offers a practical guide for others working in community health promotion. Future studies that evaluate the selection and effectiveness of strategies that build readiness to achieve equitable implementation and improve health outcomes in diverse groups are needed.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a national strategy to support implementation of reablement for community-dwelling people living with dementia.","authors":"Claire Mc O'Connor, Sasha Houlden, Christopher J Poulos, Michele Callisaya, Angela Collins, Kylie Miskovski, Glenys Petrie, John Quinn, Natalie Taylor, Susan Kurrle, Kaarin J Anstey","doi":"10.1186/s43058-026-00917-y","DOIUrl":"10.1186/s43058-026-00917-y","url":null,"abstract":"<p><strong>Background: </strong>Dementia reablement is globally recommended to support people living with dementia to maximise their independence. Despite this, dementia reablement is not broadly available and there is currently no consensus around how it should be implemented. This study aimed to develop a national strategy by reaching expert consensus on the barriers, enablers, and potential implementation strategies to promote uptake of evidence-informed dementia reablement.</p><p><strong>Methods: </strong>A modified online Delphi survey process was used to gain national consensus on the determinants and implementation strategies pertaining to implementing community-based dementia reablement in Australia. Purposive sampling and snowballing were used to recruit a range of knowledge and experience-based expert interest holders, including people living with dementia, informal/family carers, allied health professionals, program managers/referrers, policy makers, experts and thought leaders. Using the Consolidated Framework for Implementation Research (CFIR), round one sought consensus around a range of determinants (i.e. barriers and enablers) to implementing reablement for community dwelling people living with dementia across four domains: (1) the system, (2) service providers, (3) family, and (4) the person living with dementia. Using the Expert Recommendations for Implementing Change (ERIC) strategies compilation, round two sought consensus on a range of implementation strategies, presented across the same four domains. Across each domain in both survey rounds, participants were invited to provide written comments to supplement their ratings. Consensus for inclusion of each item was defined as ≥ 70% agreement across experts.</p><p><strong>Results: </strong>Fifty participants completed the round one survey, and n = 35 (70%) participants completed round two. In round one, a range of determinants (barriers (n = 11) and enablers (n = 17)) for implementing community-based dementia reablement reached consensus. In round two, n = 28 implementation strategies reached consensus. Taken together, outcomes from this Delphi process highlight four key themes relating to the implementation of dementia reablement: (1) education and promotion, (2) engaging consumers and providing support to carers and people living with dementia, (3) service provider capacity to deliver reablement, and (4) funding, policy, and access to services.</p><p><strong>Conclusions: </strong>Effectively implementing dementia reablement will take a sector-wide approach that involves top-down and bottom-up support, focuses on education and promotion of reablement, and leverages policy and funding.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling pediatric mental health care through primary care workforce training: a task-sharing and upskilling implementation strategy.","authors":"Peter S Jensen, Ruth E K Stein, M Lynn Crismon, Cathryn A Galanter, Lawrence V Amsel","doi":"10.1186/s43058-026-00916-z","DOIUrl":"https://doi.org/10.1186/s43058-026-00916-z","url":null,"abstract":"<p><strong>Background: </strong>Anxiety and depression are among the most prevalent and disabling mental health conditions in children and adolescents, yet they remain under-recognized and undertreated in primary care. Persistent shortages of child mental health specialists in the U.S., Canada, and other countries represent a major implementation barrier to timely access to evidence-based care. Scalable workforce training of primary care clinicians represents a promising task-sharing/upskilling strategy to address this gap.</p><p><strong>Methods: </strong>We conducted a longitudinal evaluation of 3,246 primary care clinicians across the United States and Canada who participated in a pediatric mental health workforce training program between 2017 and 2024. The program combined a 3-day interactive workshop with six months of twice-monthly, case-based group coaching and was explicitly designed to support implementation of evidence-based assessment and treatment for pediatric anxiety and depression in primary care. Clinician outcomes were assessed at baseline (T1), post-workshop (T2), and 6-month follow-up (T3), including knowledge, self-efficacy, use of standardized rating scales, and willingness/intentions to perform appropriate diagnostic and treatment practices.</p><p><strong>Results: </strong>From T1 to T3, clinicians demonstrated sustained improvements across all domains, including increased adoption of evidence-based rating scales, greater willingness to initiate and manage antidepressant treatment, and increased self-efficacy in diagnosis and management. Mixed-effects regression analyses showed comparable outcomes for in-person and live-online delivery modalities, supporting the feasibility of remote implementation at scale.</p><p><strong>Conclusions: </strong>Intensive, theory-informed workforce training can function as an effective upskilling implementation strategy to expand primary care capacity for pediatric anxiety and depression across disciplines and health systems. Embedding structured training and longitudinal coaching within routine practice environments may represent a pragmatic approach to addressing workforce-related implementation barriers in pediatric mental health care.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods to design, adapt and apply equity-focused implementation science theories, models and frameworks in healthcare systems: a scoping review.","authors":"Laura J Kennedy, Grace MacIntyre, Leah Boulos, Simonne E Collins, Alannah Delahunty-Pike, Megan Gray, Ash Hariharan, Christine Cassidy","doi":"10.1186/s43058-026-00910-5","DOIUrl":"https://doi.org/10.1186/s43058-026-00910-5","url":null,"abstract":"<p><strong>Background: </strong>Implementation science has a key role to play in reducing health inequities within healthcare systems. In recent years, the number of health equity-focused implementation science theories, models, and frameworks (TMFs) has increased. However, the methods used to design and adapt TMFs are not well understood. Exploring these methods will help us understand how health equity is considered in implementation science TMFs and inform future adaptations and applications in real-world, healthcare system contexts. The purpose of this review is to explore the methods used to design, adapt, and apply health equity-focused implementation science TMFs.</p><p><strong>Methods: </strong>This scoping review followed Arksey & O'Malley (2006) and Levac, Colquhoun & O'Brien's (2010) revised scoping review methodology. We updated the search of a recent scoping review published by Gustafson et al. in 2023. We searched CINAHL and MEDLINE for articles published from April 2022 to November 13, 2024. Eligibility included articles which described or applied an implementation science TMF that explicitly incorporated health equity. Two independent reviewers screened the titles, abstracts and full texts of the included articles. Two independent reviewers extracted data. We used a narrative synthesis to report our findings.</p><p><strong>Results: </strong>This review identified 40 articles, 11 from the review by Gustafson et al. and 29 papers from our updated search. 34 articles provided a detailed description of the methods they used; 6 articles did not. Methods included evidence synthesis (e.g., scoping review, integrative review) consensus (e.g., modified Delphi, Indigenous consensus, nominal group technique), community engagement (e.g., partnerships, workshops), and qualitative analysis. Articles also reported using multiple methods. Equity considerations included social (e.g. race, ethnicity, gender) and structural determinants of health (e.g. power, policies). Articles reported novel (n = 12), applied (n = 9), adapted (n = 9), adapted and applied (n = 5), and novel and applied (n = 5) equity-focused TMFs.</p><p><strong>Conclusions: </strong>This scoping review explored the methods for developing and using equity-focused implementation science TMFs. There was a focus on who is invited to the table and tensions between expert (consensus) and experiential (community engagement) knowledge. Our findings suggest that the methods to design and adapt TMFs should be tailored to communities' ways of knowing and doing, and consider the health equity factors relevant to their lived experiences. These results can inform future equity-focused TMFs to reduce health inequities.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A stakeholder engagement method to inform adaptation of a multicomponent hypertension control program in Ghana: A mixed methods study.","authors":"Olutobi A Sanuade, Leonard Baatiema, Irene A Kretchy, Alicia N Velazquez, Okpawura Yaw W Kpolar, Olamide C Ogundare, Fridaus A Samed, Richard P Yalley, Allison J Carroll, Justin D Smith","doi":"10.1186/s43058-026-00908-z","DOIUrl":"https://doi.org/10.1186/s43058-026-00908-z","url":null,"abstract":"<p><strong>Background: </strong>Hypertension prevalence in Ghana is high, yet diagnosis, treatment, and control rates remain low. The Kaiser Permanente hypertension control program (\"Kaiser bundle\") has demonstrated success in high-income settings and has been implemented in some low-resource contexts but not in Ghana. This study describes a community-engaged, mixed-methods process to plan the equitable implementation of the Kaiser bundle for hypertension control in Ghanaian primary healthcare centers (PHCs).</p><p><strong>Methods: </strong>We conducted five iterative workgroup meetings over 9 months with 46 participants, including 15 adults with hypertension, 16 healthcare providers, 6 policymakers, and 9 community leaders and Civil Society Organization representatives. Using semi-structured discussions, human-centered design activities, and surveys. Workgroup transcripts were analyzed using framework-guided rapid turnaround qualitative analysis, applying the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change compilation, and the to identify determinants and generate and specify strategies. Survey ratings informed prioritization of strategies. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was applied to define and organize implementation outcomes, while the Implementation Research Logic Model (IRLM) was used to organize the determinants/strategies and link them to hypothesized mechanisms and outcomes.</p><p><strong>Results: </strong>The Stakeholder groups identified 45 implementation determinants across individual, organizational, and community levels, with barriers such as limited access to care, provider shortages, fragmented health systems, and financial constraints, while facilitators included community partnerships and existing BP screening initiatives. Based on these determinants, the stakeholder groups co-developed 29 discrete implementation strategies targeting the Kaiser bundle components. Strategies emphasized infrastructure strengthening, provider training, community engagement, telemedicine integration, and culturally responsive approaches. The finalized IRLM mapped and linked determinants, strategies, mechanisms, and anticipated outcomes, providing a transparent and equity-focused implementation plan.</p><p><strong>Conclusions: </strong>Combining community engagement with established implementation science frameworks enabled the development of an implementation plan for adapting the Kaiser bundle in Ghana. This approach offers a replicable model for planning and reporting implementation efforts in low-resource settings and highlights the importance of equity-focused strategies for improving hypertension outcomes.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation costs and relationships between costs and outcomes in the Faith, Activity, and Nutrition program: a church-based intervention.","authors":"A Caroline Rudisill, Anna L Chupak, Sara Wilcox, Ruth P Saunders, Andrew T Kaczynski","doi":"10.1186/s43058-026-00911-4","DOIUrl":"10.1186/s43058-026-00911-4","url":null,"abstract":"<p><strong>Background: </strong>Program administration and implementation costs are critical for scale-up and dissemination of effective public health interventions. Costing methods within dissemination and implementation studies examining organizational-level implementation outcomes are limited, especially in community settings. Therefore, this study focuses on costs as an implementation outcome in the 2020-2023 national implementation study of Faith, Activity, and Nutrition (FAN). FAN is an evidence-based intervention that targets church policy, systems, and environments to support church members' physical activity and dietary behaviors.</p><p><strong>Methods: </strong>We examined costs in two ways using micro-costing approaches. The first is costs to an organization (n = 1) hosting and administering web-based training and support for churches, using time tracking and programmatic data. The second is costs to churches (n = 90) trained to implement FAN, using surveys. We accounted for the potential voluntary nature of FAN church implementation by costing labor in three ways: assume FAN is run by volunteers and time is donated (time costed at zero), assume FAN is run by volunteers and they could be undertaking other activities in society (time costed at minimum wage), assume FAN is run by church employees (time costed as church employees). We also analyzed church implementation costs by church size, region, and existence of a health ministry. Finally, we analyzed the relationship between church implementation costs and implementation outcomes (i.e., fidelity).</p><p><strong>Results: </strong>On average, 3.97 h/week were spent by an organization hosting and administering FAN. The average cost/year to host and administer FAN was $7,844.29, including program administration, recruitment, and IT support. Churches implementing FAN spent 15.2 ± 6.28 h/year training, 23.4 ± 19.6 h/year planning, and 28.3 ± 37.3 h/year implementing FAN-related activities. For church implementation of FAN, the average annual cost was between $327.30 ($0.00-$2,099.98) and $2,858.11 ($330.94-$10,490.01), depending on labor cost assumptions. Church implementation costs were positively and significantly correlated with healthy eating (r = 0.344, P = 0.017), but not physical activity (r = 0.106, P = 0.372) outcomes.</p><p><strong>Conclusions: </strong>Administration and implementation of FAN may be feasible from a resource perspective. This analysis provides an exemplar for public health program costing methods for organizational-level implementations.</p>","PeriodicalId":73355,"journal":{"name":"Implementation science communications","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}