Recommendations for Addressing Structural Racism in Implementation Science: A Call to the Field

Area of Science:

• Health Services Research
• Implementation Science
• Health Equity

Background:

• Implementation science (IS) aims to bridge the research-to-practice gap for evidence-based interventions (EBIs).
• Current IS practices have critical gaps in addressing health equity, particularly concerning social determinants of health and structural racism.
• There is a need to integrate structural racism into the core of IS.

Purpose of the Study:

• To propose recommendations for explicitly incorporating structural racism into implementation science.
• To advance the focus on health equity within the field of IS.

Main Methods:

• The commentary proposes a framework for including structural racism as a construct and determinant in IS.
• It suggests considerations for EBIs and implementation strategies that address structural racism.
• It advocates for methods like community-based participatory research and stakeholder engagement within IS.

Main Results:

• Integrating structural racism into IS frameworks will build an empirical evidence base on its impact on EBI implementation.
• Developing targeted EBIs and implementation strategies can address structural racism and improve health equity.
• Utilizing appropriate IS methods can address structural racism across multiple ecological levels and settings.

Conclusions:

• Implementation science must explicitly focus on structural racism and dismantling racism to advance health equity.
• This integration is crucial for ensuring equitable adoption, implementation, and sustainability of EBIs.
• The field should adopt a research agenda that prioritizes addressing structural racism.