Implementation research for advancing health equity: Design and competency-based assessment of a short-term...

Implementation research (IR) provides tools to address health inequities and complex global health issues, facilitating real-world health impact at scale. Limited training opportunities exist for applying IR to health inequities. The 2024 Sparkman Center for Global Health Summer Institute (SI) in the School of Public Health, University of Alabama at Birmingham, provided a one-week intensive workshop that introduced concepts, methodologies, and applications of IR in global health settings, explicitly targeting health inequities. This paper describes a competency-based assessment of SI. We utilized the reliability- and validity-tested Self-evaluation of Implementation Research Competencies and Objective Assessment questionnaires. Analyses included pre/post-SI comparisons of self-assessed knowledge, self-efficacy, and objective knowledge scores; associations between participant characteristics and changes in knowledge/self-efficacy scores; and explored psychometric properties of the objective assessment tool to estimate item difficulty and discrimination parameters. Open-ended questions were analyzed thematically to reveal participant experiences, perceived relevance of the training, and suggestions for future improvement. SI was completed by 28 participants from 12 countries working on various global health topics. Equity considerations within projects focused on social/structural barriers, differentiating outcomes, and strategies to target disadvantaged groups within IR. Significant improvements were observed across IR domains, with the mean self-assessed knowledge increasing from 57.67% [Confidence interval (CI):43.78; 71.55] to 87.68% (CI: 76.96;98.41), p = 0.003, and the largest improvements in competencies related to stakeholder engagement, scientific inquiry, and the application of IR strategies to real-world problems. Objective assessment scores demonstrated modest, nonsignificant improvement, increasing from 65.35% (CI: 61.28;69.41) to 68.18% (CI: 64.38;71.97), p = 0.324). Participants reported high satisfaction with SI's structure, content, and delivery, highlighting its practical focus on stakeholder engagement, real-world case studies, mentorship, networking, calling for continued mentorship engagement and further training. This evaluation will be used to improve the impact of IR training in global health settings, emphasizing importance of hands-on application of IR concepts in tackling health inequities.