Development of an integrated implementation determinant framework for shared learning to promote health equity

Lilian Perez, PhD
RAND Corporation

James Merle, PhD
University of Utah

ABSTRACT:
As evidence-based innovations (EBIs) are translated into clinical and community settings, implementation determinant frameworks can help understand the factors that impede or facilitate implementation outcomes. Use of different frameworks across implementation initiatives can impede shared learning. To develop a framework for shared learning in the DECIPHeR Alliance (www.decipheralliance.org), we conducted a crosswalk of three determinant frameworks used in the Alliance: 1) Exploration, Preparation, Implementation, and Sustainment (EPIS); 2) Practical, Robust Implementation and Sustainability Model (PRISM); and 3) Consolidated Framework for Implementation Research (updated CFIR). To operationalize health justice and equity considerations, we also incorporated elements of the Health Equity Implementation Framework (HEIF).  In this talk, we will discuss the process for developing the integrated framework, called “IM4Equity,” and describe our user-centered feedback process to improve the framework’s understandability and usefulness across the Alliance. IM4Equity can help guide evaluations of EBIs and implementation outcomes across diverse contexts. Compared to any single framework, it has the potential to better identify the myriad of implementation determinants with a focus on health equity considerations. It can also aid in common data elements and cross-project synthesis.