Advancing systems thinking in implementation science: An epidemiologic perspective

The population-level impact of public health interventions depends on their implementation in real-world settings. This is the purview of implementation science. As the field of implementation science advances, there is growing recognition that complex health challenges demand solutions that account for the dynamic systems in which interventions unfold. Epidemiologists, trained to define causal relationships and quantify population-level effects, are uniquely positioned to contribute to this effort. Yet, realizing that potential requires moving beyond traditional epidemiologic methods, which can be reductionist in nature, and embracing tools from systems thinking. This paper illustrates how integrating epidemiologic methods with principles of systems thinking can strengthen implementation science and inform implementation strategies for evidence-based interventions in complex real-world settings.