Application of an Anti-racism Lens in the Field of Implementation Science: Reflections and Recommendations for Reframing Implementation Research with a Focus on Justice and Racial Equity

Rachel Shelton, ScD, MPH
Columbia University

Derek Griffith, PhD
Georgetown University

April Oh, PhD, MPH
National Institute of Health

Prajakta Adsul, MBBS, MPH, PhD
University of New Mexico

ABSTRACT:
Despite the promise of implementation science (IS) to reduce health inequities, critical gaps and opportunities remain in the field to promote health equity. Prioritizing racial equity and anti-racism approaches is critical in these efforts, so that IS does not inadvertently exacerbate disparities based on the selection of frameworks, methods, interventions, and strategies that do not reflect consideration of structural racism and its impacts. Grounded in extant research on structural racism and anti-racism, we discuss the importance of advancing understanding of how structural racism as a system shapes racial health inequities and inequitable implementation of evidence-based interventions among racially and ethnically diverse communities. We provide guidance for application of an anti-racism lens in the field of IS, focusing on select core elements in implementation research, including: 1) Stakeholder Engagement; 2) Conceptual Frameworks, Theories, Models; 3) Development, Selection, Adaptation of Evidence-based Interventions; 4) Evaluation; and 5) Implementation Strategies. We highlight the need for foundational grounding in anti-racism frameworks among implementation scientists to facilitate ongoing self-reflection, accountability, and attention to racial equity, and provide questions to guide such reflection and consideration.