Navigating grey areas in HIV and mental health implementation science

Author:

Harkness Audrey1,Giusto Ali2,Hamilton Alison B.34,Hernandez‐Ramirez Raul U.5,Spiegelman Donna5ORCID,Weiner Bryan J.6,Beidas Rinad S.7,Larson Michaela E.18ORCID,Lippman Sheri A.8ORCID,Wainberg Milton L.2,Smith Justin D.9

Affiliation:

1. School of Nursing and Health Studies University of Miami Coral Gables Florida USA

2. Department of Psychiatry Columbia University Irving Medical Center New York State Psychiatric Institute New York New York USA

3. Center for the Study of Healthcare Innovation Implementation & Policy, VA Greater Los Angeles Healthcare System Los Angeles California USA

4. Department of Psychiatry & Biobehavioral Sciences University of California Los Angeles Los Angeles California USA

5. Department of Biostatistics Center for Interdisciplinary Research on AIDS and Center for Methods in Implementation and Prevention Science Yale School of Public Health New Haven Connecticut USA

6. School of Public Health University of Washington Seattle Washington USA

7. Department of Medical Social Sciences Feinberg School of Medicine Northwestern University Chicago Illinois USA

8. Division of Prevention Science University of California San Francisco San Francisco California USA

9. Department of Population Health Sciences Spencer Fox Eccles School of Medicine at the University of Utah Salt Lake City Utah USA

Abstract

AbstractIntroductionImplementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high‐impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, “grey areas,” or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research.DiscussionA group of IS experts affiliated with NIMH‐funded ARCs convened to identify common and challenging grey areas. The group generated a preliminary list of 19 grey areas in HIV/MH‐related IS. From the list, the authors developed a survey which was distributed to all ARCs to prioritize grey areas to address in this paper. ARC members across the United States (N = 60) identified priority grey areas requiring clarification. This commentary discusses topics with 40% or more endorsement. The top grey areas that ARC members identified were: (1) Differentiating implementation strategies from interventions; (2) Determining when an intervention has sufficient evidence for adaptation; (3) Integrating recipient perspectives into HIV/MH implementation research; (4) Evaluating whether an implementation strategy is evidence‐based; (5) Identifying rigorous approaches for evaluating the impact of implementation strategies in the absence of a control group or randomization; and (6) Addressing innovation in HIV/MH IS grants. The commentary addresses each grey area by drawing from the existing literature (when available), providing expert guidance on addressing each in the context of HIV/MH research, and providing domestic and global HIV and HIV/MH case examples that address these grey areas.ConclusionsHIV/MH IS is key to achieving domestic and international goals for ending HIV transmission and mitigating its impact. Guidance offered in this paper can help to overcome challenges to rigorous and high‐impact HIV/MH implementation research.

Funder

National Institute on Minority Health and Health Disparities

Fogarty International Center

National Heart, Lung, and Blood Institute

National Institute of Mental Health

National Institute of Nursing Research

National Institute of Allergy and Infectious Diseases

Health Services Research and Development

Publisher

Wiley

Reference94 articles.

1. Ending the HIV Epidemic

2. A need for implementation science to optimise the use of evidence-based interventions in HIV care: A systematic literature review

3. National Institutes of Health.PAR‐19‐274: Dissemination and Implementation Research in Health (R01 Clinical Trial Optional).2021. (accessed August 10 2023).https://grants.nih.gov/grants/guide/pa‐files/PAR‐19‐274.html

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