Social Workers Harnessing Implementation Science Frameworks and Community Engaged Research and Practice to Build Solutions for Health Equity

Implementation science is a field of research dedicated to closing the gap between research and practice. Although there have been substantial advances within the implementation field, particularly in high resourced, hierarchical clinical settings and institutions, there are growing calls for advancement of implementation science to promote health equity beyond clinical settings and into more upstream community environments. Indeed, community settings are foundational sites of social health determinants, with research showing that up to 80% of variation in health outcomes are determined by behaviors and health within communities, compared to 20% attributable to clinical domain factors. However, implementation science has focused less on community settings, where contextual factors are less hierarchical, more informally structured, and highly dynamic. In particular, implementation barriers and supports are often fundamentally different in marginalized and exploited communities than in resource rich settings where evidence-supported practices are typically developed and tested. Additionally, community needs, understandings, and priorities do not always align with those embedded within Western scientific approaches. Areas of misalignment can include financial costs, face validity (based on different understandings/priorities) acceptability, feasibility, and other community identified outcomes which speak to external validity.

One advancing approach to addressing these issues is the use of participatory and community-engaged approaches for implementation. Social Workers are in a unique position to integrate participatory practices with implementation science models and frameworks to improve intervention utility for community settings and advance health equity. Many social work scholars and practitioners utilize community-engaged approaches when developing and delivering new programs and services, but often do not formally identify, assess, or evaluate implementation processes and strategies. This presents an important opportunity to combine social work expertise in community engagement with models and methods from implementation science to advance the use of culturally appropriate evidence supported practices in community settings, particularly for marginalized communities.

This workshop seeks to: 1) provide an opportunity for participants to increase their knowledge about implementation science and its utility for social work research and practice in community settings and 2) support participants in applying established as well as newly emerging implementation frameworks and methods to programs using community-based participatory principles for research and practice. Workshop leaders will first provide an introductory overview of implementation science, with emphasis on where and how participatory approaches fit. Second, we will present implementation frameworks, including newly developed frameworks intentionally focused on health equity. Third, participants will collaborate in small groups to review specific implementation frameworks identify areas where participatory research principles and approaches are important for community programs, and report out to the larger group. Fourth, we will present a case study of a community-engaged intervention project, and small groups will practice application of one of the frameworks, using the previous discussion to identify ways implementation factors might be explored, assessed, or evaluated. Finally, we will facilitate a closing discussion to share and discuss ways participants can integrate community-engaged research and practice approaches with implementation frameworks in their own work to improve access to evidence-supported interventions in community settings and ultimately advance health equity.