Top Things to Know: Leveraging Implementation Science for Cardiovascular (CV) Health Equity
Published: October 10, 2022
Prepared by Sally S. Wong, PhD, RD, CDN, FAHA, Senior Science & Medicine Advisor
- Historically disenfranchised populations, defined as groups and communities experiencing discrimination and exclusion (social, political and economic) because of unequal power relationships across economic, political, social, ideologic, or cultural dimensions, continue to have disproportionately high rates of cardiovascular disease (CVD) and CVD risk factors.
- Implementation science is the study of methods for promoting the systematic uptake of research findings and other EBPs into healthcare policy and routine practice, and hence to improve the quality and effectiveness of health services.
- Implementation science is a relatively young, rapidly changing field. The lack of consistent implementation science language in the literature affects the ability to answer specific research question(s) or to provide evidence to inform clinical decision-making.
- This Statement proposes key steps and critical equity considerations for using implementation science to achieve CV health equity.
- Implementation science can provide a useful lens for understanding and intervening on “evidence-to-practice” gaps and offers a pathway to achieving population level CV health equity, where everyone can achieve their fullest health potential.
- It may not always be possible to distinguish implementation strategies from EBPs, particularly in health services/quality improvement research.
- Leveraging implementation science to achieve CV health equity requires an explicit understanding of how social and structural determinants of health contribute to inequities and thus poor CV health.
- While the focus of this Statement is in U.S. settings, much can be learned from the rich history of global implementation efforts.
- Future studies should examine groups with disparately high CVD burden or suboptimal adoption of CVD EBPs, such as American Indians/Alaska Natives, Asian and Pacific Islander communities, both urban and rural settings, as well as sexual and gender minority populations.
- Lastly, the Statement discusses how best to apply the checklist developed in organization, community, policy or multiple settings, drawing on decades of intervention, quality improvement and implementation research in CVD disparities.
Citation
Moise N, Cené CW, Tabak RG, Young DR, Mills KT, Essien UR‚ Anderson CAM, Lopez-Jimenez F; on behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Hypertension; and Stroke Council. Leveraging implementation science for cardiovascular health equity: a scientific statement from the American Heart Association [published online ahead of print October 10, 2022]. Circulation. doi: 10.1161/CIR.0000000000001096