Implementation science should give higher priority to health equity.
Implementation science should give higher priority to health equity.
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DOI：
10.1186/s13012-021-01097-0
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发表时间：
2021-03-19
期刊：
影响因子：
--
通讯作者：
Haire-Joshu D
中科院分区：
文献类型：
--
作者：
Brownson RC;Kumanyika SK;Kreuter MW;Haire-Joshu D
解决美国和全世界的公平和正义问题变得越来越紧迫。健康公平是一种框架，它从对社会做得不好（差异）的赤字心态转变为对社会可以取得的成就持积极态度，在使用实施科学方法的健康研究中变得越来越重要。公平始于正义——健康差异往往反映出社会不公正。应用实施科学的观点和工具有可能对改善健康公平产生直接影响。我们提出了一个愿景和一系列行动步骤，使健康公平成为实施科学的更加突出和核心的目标，从而致力于通过以公平为中心的原则进行实施科学，以在美国的研究和实践中实现这一愿景。我们确定并讨论了当前未充分考虑社会决定因素的健康差异方法中的挑战。实施研究的挑战概括为三个方面：证据基础的局限性、措施和方法不完善以及对背景的关注不够。为了应对这些挑战，我们提出的建议旨在：(1) 将社会决定因素与健康结果联系起来，(2) 将公平纳入所有政策，(3) 使用与公平相关的指标，(4) 研究已经发生的情况，(5) 将公平纳入实施模型，(6) 设计和定制实施战略，(7) 连接卫生以外的系统和部门，(8) 让组织参与内部和外部公平工作，(9) 建立 (10) 注重传播工作的公平性。实施科学中的每个项目都应关注公平性。对于一些研究来说，公平是项目的主要目标，也是项目各个方面的核心特征。在其他研究中，股权是项目的一部分，但不是唯一的焦点。在这些研究中，我们至少应该确保“不让任何一个人掉队”，并且现有的差距不会扩大。通过资助者、研究人员、从业者、倡导者、评估者和政策制定者对健康公平的更坚定承诺，我们可以从投资于健康相关研究以消除差距的资源中获得回报，从而实现健康公平。
There is growing urgency to tackle issues of equity and justice in the USA and worldwide. Health equity, a framing that moves away from a deficit mindset of what society is doing poorly (disparities) to one that is positive about what society can achieve, is becoming more prominent in health research that uses implementation science approaches. Equity begins with justice—health differences often reflect societal injustices. Applying the perspectives and tools of implementation science has potential for immediate impact to improve health equity. We propose a vision and set of action steps for making health equity a more prominent and central aim of implementation science, thus committing to conduct implementation science through equity-focused principles to achieve this vision in U.S. research and practice. We identify and discuss challenges in current health disparities approaches that do not fully consider social determinants. Implementation research challenges are outlined in three areas: limitations of the evidence base, underdeveloped measures and methods, and inadequate attention to context. To address these challenges, we offer recommendations that seek to (1) link social determinants with health outcomes, (2) build equity into all policies, (3) use equity-relevant metrics, (4) study what is already happening, (5) integrate equity into implementation models, (6) design and tailor implementation strategies, (7) connect to systems and sectors outside of health, (8) engage organizations in internal and external equity efforts, (9) build capacity for equity in implementation science, and (10) focus on equity in dissemination efforts. Every project in implementation science should include an equity focus. For some studies, equity is the main goal of the project and a central feature of all aspects of the project. In other studies, equity is part of a project but not the singular focus. In these studies, we should, at a minimum, ensure that we “leave no one behind” and that existing disparities are not widened. With a stronger commitment to health equity from funders, researchers, practitioners, advocates, evaluators, and policy makers, we can harvest the rewards of the resources being invested in health-related research to eliminate disparities, resulting in health equity.
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影响因子：
15.8
作者：
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影响因子：
11.1
作者：
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影响因子：
9.8
作者：
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影响因子：
3.3
作者：
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通讯作者：
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DOI：
10.1186/1748-5908-8-90
发表时间：
2013-08-19
期刊：
Implementation science : IS
影响因子：
--
作者：
Cabassa LJ;Baumann AA
通讯作者：
Baumann AA