Grounding implementation science in health equity for cancer prevention and control.

• Type of Material: Article
• Authors: Prajakta Adsul, University of New Mexico, Albuquerque; David Chambers, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.; Heather M Brandt, St. Jude Children’s Research Hospital; Maria E Fernandez, University of Texas Health Science Center at Houston, Houston; Shoba Ramanadhan, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Essie Torres, East Carolina University; Jennifer Leeman, University of North Carolina, Chapel Hill, NC, 27599, USA.; Barbara Baquero, University of Washington, 3980 15th Ave. NE, Seattle, WA, 98195, USA.; Linda Fleischer, Fox Chase Cancer Center; Ngoc-Cam Escoffery, Emory University; Karen Emmons, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.; Montserrat Soler, Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.; April Oh, National Cancer Institute, National Institutes of Health, Bethesda, USA.; Ariella R Korn, Cancer Prevention Fellowship Program, Implementation Science, Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, USA.; Stephanie Wheeler, University of North Carolina at Chapel Hill; Rachel C Shelton, Columbia University
• Language: English
• Date: 2022-06-03
• Publisher: Emory University Libraries
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s43058-022-00311-4
• Title of Journal or Parent Work: Implement Sci Commun
• Volume: 3
• Issue: 1
• Start Page: 56
• End Page: 56
• Grant/Funding Information: HMB: Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number P30CA021765 and the American Lebanese and Syrian Associated Charities (ALSAC) of St. Jude Children’s Research Hospital.; PA: This work was conducted as a part of the Cancer Prevention Fellowship Program, funded by the National Cancer Institute. The research was also supported by an Internal Research Grant (PI: Adsul, P.) from the American Cancer Society 131567-IRG-17-178-22-IRG (PI: Ozbun, M.).
• Keywords: Health equity; Health disparities; Implementation science; Cancer prevention and control; Dissemination
• Research Categories: Health Sciences, Public Health; Health Sciences, Medicine and Surgery

Abstract

BACKGROUND: The past decade of research has seen theoretical and methodological advances in both implementation science and health equity research, opening a window of opportunity for facilitating and accelerating cross-disciplinary exchanges across these fields that have largely operated in siloes. In 2019 and 2020, the National Cancer Institute's Consortium for Cancer Implementation Science convened an action group focused on 'health equity and context' to identify opportunities to advance implementation science. In this paper, we present a narrative review and synthesis of the relevant literature at the intersection of health equity and implementation science, highlight identified opportunities (i.e., public goods) by the action group for advancing implementation science in cancer prevention and control, and integrate the two by providing key recommendations for future directions. DISCUSSION: In the review and synthesis of the literature, we highlight recent advances in implementation science, relevant to promoting health equity (e.g., theories/models/frameworks, adaptations, implementation strategies, study designs, implementation determinants, and outcomes). We acknowledge the contributions from the broader field of health equity research and discuss opportunities for integration and synergy with implementation science, which include (1) articulating an explicit focus on health equity for conducting and reviewing implementation science; (2) promoting an explicit focus on health equity in the theories, models, and frameworks guiding implementation science; and (3) identifying methods for understanding and documenting influences on the context of implementation that incorporate a focus on equity. To advance the science of implementation with a focus on health equity, we reflect on the essential groundwork needed to promote bi-directional learning between the fields of implementation science and health equity research and recommend (1) building capacity among researchers and research institutions for health equity-focused and community-engaged implementation science; (2) incorporating health equity considerations across all key implementation focus areas (e.g., adaptations, implementation strategies, study design, determinants, and outcomes); and (3) continuing a focus on transdisciplinary opportunities in health equity research and implementation science. We believe that these recommendations can help advance implementation science by incorporating an explicit focus on health equity in the context of cancer prevention and control and beyond.