Diversifying Implementation Science: A Global Perspective

Bartels, Sophia M.; Haider, Shabab; Williams, Caitlin R.; Mazumder, Yameen; Ibisomi, Latifat; Alonge, Olakunle; Theobald, Sally; Bärnighausen, Till; Escallon, Juanita Vasquez; Vahedi, Mahnaz; Ramaswamy, Rohit; Sarker, Malabika

doi:10.9745/ghsp-d-21-00757

Cited by 17 publications

(11 citation statements)

References 42 publications

(67 reference statements)

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“…To navigate this balance, careful and rigorous usage of theories, methods and frameworks from IS can be particularly useful to adapt and scale up interventions in new contexts once they have been shown to be effective in one setting. By encouraging communication between stakeholders across multiple settings, GHRI approaches fit well within IS to improve the process of implementation, to enhance equity and shared leadership and to work towards the decolonisation of global health 34…”

Section: Discussionmentioning

confidence: 99%

Global health reciprocal innovation to address mental health and well-being: strategies used and lessons learnt

Turan,

Vinikoor,

et al. 2023

BMJ Glob Health

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Over the past two decades there have been major advances in the development of interventions promoting mental health and well-being in low- and middle-income countries (LMIC), including delivery of care by non-specialist providers, incorporation of mobile technologies and development of multilevel community-based interventions. Growing inequities in mental health have led to calls to adopt similar strategies in high-income countries (HIC), learning from LMIC. To overcome shared challenges, it is crucial for projects implementing these strategies in different global settings to learn from one another. Our objective was to examine cases in which mental health and well-being interventions originating in or conceived for LMIC were implemented in the USA. The cases included delivery of psychological interventions by non-specialists, HIV-related stigma reduction programmes, substance use mitigation strategies and interventions to promote parenting skills and family functioning. We summarise commonly used strategies, barriers, benefits and lessons learnt for the transfer of these innovative practices among LMIC and HIC. Common strategies included intervention delivery by non-specialists and use of digital modalities to facilitate training and increase reach. Common barriers included lack of reimbursement mechanisms for care delivered by non-specialists and resistance from professional societies. Despite US investigators’ involvement in most of the original research in LMIC, only a few cases directly involved LMIC researchers in US implementation. In order to achieve greater equity in global mental health and well-being, more efforts and targeted funding are needed to develop best practices for global health reciprocal innovation and iterative learning in HIC and LMIC.

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Section: Discussionmentioning

confidence: 99%

Global health reciprocal innovation to address mental health and well-being: strategies used and lessons learnt

Turan,

Vinikoor,

et al. 2023

BMJ Glob Health

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“…However, given that a great deal of implementation science capacity building occurs in high-income countries, training programs should increase access to global health colleagues in low- and middle-income countries through continued financial support and sponsorship with global health centers, as done for the PennISI. For sustainability, efforts should pivot to long-term partnership with global institutions to facilitate locally led training programs [ 18 , 19 ]. As programs continue to develop, understanding the characteristics of individuals seeking out training will help tailor programs and recruitment accordingly.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a brief virtual implementation science training program: the Penn Implementation Science Institute

Van Pelt,

Bonafide,

Rendle

et al. 2023

Implement Sci Commun

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Background To meet the growing demand for implementation science expertise, building capacity is a priority. Various training opportunities have emerged to meet this need. To ensure rigor and achievement of specific implementation science competencies, it is critical to systematically evaluate training programs. Methods The Penn Implementation Science Institute (PennISI) offers 4 days (20 h) of virtual synchronous training on foundational and advanced topics in implementation science. Through a pre-post design, this study evaluated the sixth PennISI, delivered in 2022. Surveys measures included 43 implementation science training evaluation competencies grouped into four thematic domains (e.g., items related to implementation science study design grouped into the “design, background, and rationale” competency category), course-specific evaluation criteria, and open-ended questions to evaluate change in knowledge and suggestions for improving future institutes. Mean composite scores were created for each of the competency themes. Descriptive statistics and thematic analysis were completed. Results One hundred four (95.41% response rate) and 55 (50.46% response rate) participants completed the pre-survey and post-survey, respectively. Participants included a diverse cohort of individuals primarily affiliated with US-based academic institutions and self-reported as having novice or beginner-level knowledge of implementation science at baseline (81.73%). In the pre-survey, all mean composite scores for implementation science competencies were below one (i.e., beginner-level). Participants reported high value from the PennISI across standard course evaluation criteria (e.g., mean score of 3.77/4.00 for overall quality of course). Scores for all competency domains increased to a score between beginner-level and intermediate-level following training. In both the pre-survey and post-survey, competencies related to “definition, background, and rationale” had the highest mean composite score, whereas competencies related to “design and analysis” received the lowest score. Qualitative themes offered impressions of the PennISI, didactic content, PennISI structure, and suggestions for improvement. Prior experience with or knowledge of implementation science influenced many themes. Conclusions This evaluation highlights the strengths of an established implementation science institute, which can serve as a model for brief, virtual training programs. Findings provide insight for improving future program efforts to meet the needs of the heterogenous implementation science community (e.g., different disciplines and levels of implementation science knowledge). This study contributes to ensuring rigorous implementation science capacity building through the evaluation of programs.

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“…Although 2wT is not for all patients in all settings, the 2wT intervention approach has several strengths that are worthy of consideration for other digital health collaborators working to improve early ART retention. The local team led this process, ensuring that needs, priorities, and practices from Lighthouse, and not from international collaborators, were centered in the decisionmaking (54). 2wT was purposefully built using the open-source Community Health Toolkit (CHT), a global digital good.…”

Section: Discussionmentioning

confidence: 99%

“It reminds me and motivates me”: Human-centered design and implementation of an interactive, SMS-based digital intervention to improve early retention on antiretroviral therapy: usability and acceptability among new initiates in a high-volume, public clinic in Malawi

Huwa

Tweya²,

Mureithi

et al. 2022

Preprint

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Background: Early retention of people living with HIV (PLHIV) in antiretroviral therapy (ART) program is critical to improve individual clinical outcomes and viral load suppression. Although many mobile health (mHealth) interventions aim to improve retention in care, there is still lack of evidence on mHealth success or failure, including from patient's perspectives. We describe the human-centered design (HCD) process and assess patient usability and acceptability of a two-way texting (2wT) intervention to improve early retention among new ART initiates at Lighthouse Trust clinic in Lilongwe, Malawi. Methods: An Iterative HCD approach focused on patients and provider users' needs, incorporating feedback from multidisciplinary teams to adapt 2WT for the local, public clinic context. We present mixed methods usability and and acceptability results from 100 participants, 50 at 3-months and 50 at 6-months, post 2wT enrollment, and observations from these same patients completing core tasks of the 2wT system. Results: Among the 100 usability respondents, 95% were satisfied with visit reminders, and 88% would recommend reminders and motivational messages to friends; however, 17% were worried about confidentiality. In observation of participant task completion, 94% were able to successfully confirm visit attendance and 73% could request appointment date change. More participants in 4-6 months group completed tasks correctly compared to 1-3 months group, although not significantly different (78% vs 66%, p=0.181). Qualitative results were overwhelmingly positive, but patients did note confusion with transfer reporting and concern that 2wT would not reach patients without mobile phones or with lower literacy. Conclusion: The 2wT app for early ART retention appears highly usable and acceptable, hopefully creating a solid foundation for lifelong engagement in care. The HCD approach put the local team central in this process, ensuring that both patients' and Lighthouse's priorities, policies, and practices were forefront in the 2wT optimization, raising the likelihood of 2WT success in other routine program contexts.

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Diversifying Implementation Science: A Global Perspective

Cited by 17 publications

References 42 publications

Global health reciprocal innovation to address mental health and well-being: strategies used and lessons learnt

Global health reciprocal innovation to address mental health and well-being: strategies used and lessons learnt

Evaluation of a brief virtual implementation science training program: the Penn Implementation Science Institute

“It reminds me and motivates me”: Human-centered design and implementation of an interactive, SMS-based digital intervention to improve early retention on antiretroviral therapy: usability and acceptability among new initiates in a high-volume, public clinic in Malawi

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