Building Health Equity into Implementation Strategies and Mechanisms

项目总结 癌症是美国的主要死因之一。尽管癌症控制取得了成功 经过努力，历史上被边缘化的人群继续承受着不成比例的癌症负担 发病率和死亡率。实施科学有可能通过改善 采用、实施和维持向弱势群体提供的循证做法。 然而，将卫生公平纳入执行科学方法仍处于早期阶段， 必须克服该领域的若干限制，以加强公平执行。本附录构建 关于家长奖为改进执行战略的规范和阐明 潜在的因果机制，战略通过这些机制产生预期的结果。本增补品增强了 家长奖的影响，通过将健康公平的视角引入实施战略及其研究 因果机制。本附录有两个目的：1)开发和完善用于整合的资源指南 将卫生公平纳入实施战略的选择、定制和规范；以及2)产生视觉效果 阐述以公平为重点的执行战略的因果机制。第一个目标是整合 卫生公平文献和现有指南，用于选择实施战略，调整这些战略以解决 特定于背景的决定因素(障碍和促进者)，并指定战略组成部分，以便它们可以 被测试和复制。来自卫生公平和执行研究的专家的意见将向 资源引导型开发。应用以用户为中心的设计方法的利益相关者反馈会议将 就资源指南的可用性和其建议生成初步的混合方法数据 精致。调查小组将应用资源指南来具体说明实施的一个子集 影响健康公平的战略。目标2借鉴了父母奖的因果图方法 为了说明四项侧重于卫生公平的执行战略与机制之间看似合理的联系 阐明与这些联系相关的主持人、前提条件和结果。以健康公平为中心 实施战略规范和他们提议的机制的因果路径将是 对比《标准》版本的相同策略，突出关键的异同。这个 本附录中的产品将被添加到家长奖励网站库中，并分发到 实施科学家和实践者，以便他们可以将这些应用于以公平为重点的实施研究 和练习。拟议的补编具有创新性，因为它是第一批努力阐明具体具体情况的努力之一 将卫生公平视角应用于实施战略的指导意见。它的重要意义在于它的潜力 推动在癌症控制和其他卫生领域公平实施循证做法。

PROJECT SUMMARY Cancer is one of the leading causes of death in the United States. Despite the successes of cancer control efforts, historically marginalized populations continue to experience a disproportionate burden of cancer morbidity and mortality. Implementation science has the potential to advance health equity by improving the adoption, implementation, and sustainment of evidence-based practices delivered to disadvantaged groups. However, the integration of health equity into implementation science methods is still in the early stages, and several limitations in the field must be overcome to enhance equitable implementation. This supplement builds on the parent award’s efforts to improve the specification of implementation strategies and to elucidate potential causal mechanisms through which strategies elicit desired outcomes. This supplement enhances the parent award’s impact by bringing a health equity lens to the study of implementation strategies and their causal mechanisms. This supplement has two aims: 1) Develop and refine a resource guide for integrating health equity into the selection, tailoring, and specification of implementation strategies; and 2) generate visual representations of causal mechanisms of equity-focused implementation strategies. The first aim will integrate health equity literature and existing guidance for selecting implementation strategies, tailoring them to address context-specific determinants (barriers and facilitators), and specifying strategy components so that they may be tested and replicated. Input from experts in health equity and implementation research will inform the resource guide development. Stakeholder feedback sessions applying user-centered design methods will generate preliminary mixed-methods data on the resource guide’s usability and recommendations for its refinement. The investigative team will apply the resource guide to specify a subset of implementation strategies for health equity impact. Aim 2 draws upon the causal diagramming methods from the parent award to illustrate plausible strategy-mechanism linkages of four health-equity focused implementation strategies and articulate moderators, preconditions, and outcomes associated with those linkages. The health equity-focused implementation strategy specification and the causal pathways of their proposed mechanisms will be compared to “standard” versions of the same strategies to highlight key similarities and differences. The products from this supplement will be added to the parent award web repository and disseminated to implementation scientists and practitioners so they may apply these in equity-focused implementation research and practice. The proposed supplement is innovative in that it is among the first efforts to articulate specific guidance for applying a health equity lens to implementation strategies. It is significant for its potential to advance equitable implementation of evidence-based practices in cancer control and other health fields.