Building Health Equity into Implementation Strategies and Mechanisms

项目摘要 癌症是美国主要的死亡原因之一。尽管癌症控制取得了成功 尽管作出了种种努力，但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医疗保健服务， 通过、实施和维持向弱势群体提供的循证做法。 然而，将健康公平纳入实施科学方法仍处于早期阶段， 必须克服实地的一些限制，以加强公平执行。该补充建立 关于家长奖的努力，以改善具体的实施战略，并阐明 潜在的因果机制，通过这些机制，战略可以产生预期的结果。这种补充增强了 家长奖的影响，使一个健康公平的透镜的研究实施战略和他们的 因果机制这一补充有两个目的：1）制定和完善一个资源指南， 健康公平的选择，剪裁，和实施战略的规格;和2）产生视觉 以公平为重点的执行战略的因果机制的陈述。第一个目标将整合 卫生公平文献和选择实施战略的现有指南， 具体背景的决定因素（障碍和促进因素），并具体说明战略组成部分， 进行测试和复制。健康公平和实施研究专家的投入将为 资源导向发展。采用以用户为中心的设计方法的利益相关者反馈会议将 生成关于资源指南可用性的初步混合方法数据， 精致。调查小组将应用资源指南， 卫生公平影响的战略。目标2借鉴了母公司裁决的因果关系分析方法 说明四个注重健康公平的执行战略之间的合理战略-机制联系， 阐明与这些联系相关的调节因素、前提条件和结果。注重健康公平 实施战略规范及其拟议机制的因果路径将 与相同策略的“标准”版本进行比较，以突出关键的相似性和差异性。的 本补编的产品将添加到母奖网络存储库，并分发给 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 和实践拟议的补编具有创新性，因为它是阐明具体 指导将卫生公平透镜应用于实施战略。它的潜力在于， 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.