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.

Addressing Health Equity and Social Justice within Prevention Registries: Blueprints for Healthy Youth Development

Pamela Rose Buckley, Phd
University of Colorado Boulder

Karl Hill, Phd
University of Colorado Boulder

ABSTRACTS:
Registries of effective preventive interventions such as Blueprints for Healthy Youth Development play an important role in informing communities and policy makers about interventions that are likely to improve the lives of youths and their families. However, important challenges within prevention registries arise in addressing concerns about health equity and social justice. For example, a critical question is for whom do the certified interventions work? While establishing the internal validity of interventions appears to be the dominant focus across current clearinghouses (including Blueprints), issues of external validity are becoming more salient as program developers wrestle with barriers to implementation. Clearinghouses are positioned to play a useful role in identifying gaps in implementation to address external validity concerns, particularly those related to health equity and social justice.

 This webinar first presents an overview of the Blueprints registry, including standards for certification. We then discuss the sorts of concerns regarding adaptation/cultural relevance that registry staff and users encounter with increasing frequency. The webinar then presents the background and goals of a recently funded project that begins to address these concerns within Blueprints. While lack of representation of youth of color in health-related research studies has been well-documented, a critical evaluation of this omission has not been undertaken to substantiate this claim.  This new project will examine the representation of ethnic minority groups in preventive intervention research. This project will review and evaluate the nature, size, and/or scope of extant research involving representation of ethnic minority groups in preventive intervention research, thus serving as a vehicle for decision-making regarding the generalizability of EBIs listed on clearinghouse websites (such as Blueprints).