If you don’t look for it, you will probably not find it: Determining barriers to equitable implementation in healthcare settings

Rajinder Singh, Phd
South Central Mental Illness, Research, and Clinical Center
Central Arkansas Veterans Healthcare System
University of Arkansas for Medical Sciences

ABSTRACTS:
The integration of health equity and implementation science is a relatively novel topic and there is a need for practical tools for researchers and practitioners. Methodological advancements in the integration between health equity and implementation science assist with the uptake of new treatments and at the same time, assist with reducing healthcare disparities. One such methodological advancement is the Health Equity Implementation Framework designed by Woodward and colleagues (2019). The original Health Equity Implementation Framework suggested enhancing existing implementation science frameworks with three health equity domains that have significant evidence to suggest they impact implementation: 1) culturally relevant factors of recipients (e.g., biases), 2) clinical encounter, or patient-provider interaction (e.g., discrimination), and 3) societal influences (social norms such as racism, political forces, physical structures, economic barriers, including but not limited to social determinants of health). This presentation will provide an overview of the Health Equity Implementation Framework, discuss practical ways to incorporate three health equity domains (culturally relevant factors, clinical encounter, and societal influences) into implementation determinants frameworks, and review an example of using the Health Equity Implementation Framework applied to Hepatitis C Virus and its treatment among Black and African American patients seeking care in the U.S. Department of Veterans Affairs.