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Table 1 Implementation Science and NIEHS Research Priorities

From: Advancing environmental health sciences through implementation science

Priority Area

Integration of Implementation Science

Evidence-Based Prevention and Intervention: moving evidence into action through the development and testing of interventions that can improve human health by preventing or reducing harmful environmental exposures

• Incorporation of implementation science into intervention development using effectiveness-implementation hybrid designs (e.g., ‘designing for implementation’ by collecting data on barriers and facilitators that may impact intervention adoption and sustained use)

• Identification and testing of implementation strategies to facilitate the effective uptake of environmental health interventions to maximize public health impact

• Example: the Community Mobilization for Improved Clean Cookstove Uptake, Household Air Pollution Reduction, and Hypertension Prevention study funded through the National Heart, Lung & Blood Institute uses a hybrid design to test both effectiveness (if the clean cooking technology improves blood pressure) and implementation (testing a strategy to improve adoption of the stoves) (NCT05048147)

Environmental Health Disparities and Environmental Justice: understanding and addressing the disparate health impacts of environmental exposures on populations with health disparities (https://www.nimhd.nih.gov/about/overview/), including the intersection of social and structural determinants of health (e.g., race, income) with environmental exposures

• Examining multi-level (individual, community, organizational, structural) factors, including social determinants of health (SDOH), that could influence equitable implementation of environmental health interventions [7]

• Understanding contextual factors that influence equitable implementation to design and deliver interventions that will mitigate and not exacerbate existing environmental health disparities

• Example: Clean Cooking Implementation Science Network projects highlight contextual barriers and facilitators to liquid petroleum gas stove adoption and how barriers such as cost or lack of transportation limit scale-up and spread of an effective intervention [8, 9]

Emerging Environmental Health Issues: building resilience in the face of emerging environmental threats including human and natural caused environmental disasters, including acute and long-term impacts of climate change on human health

• Understanding how to effectively adapt interventions and policies in the face of environmental disasters and rapidly changing evidence

• Use of rapid cycle implementation research designs (e.g., approaches that allow for incremental and contextually informed modifications) [10]

• Hypothetical Example: Designing implementation strategies that are more anticipatory or proactive vs. reactive in the face of environmental disasters, to facilitate and enhance preparedness.

Community and Multi-Sectoral Partnerships: building and sustaining partnerships with communities impacted by environmental exposures and across multiple organizations and sectors (federal, state, tribal, public health agencies)

• Equitable engagement of communities to ensure community concerns and priorities are incorporated into intervention development and choice of implementation strategies [11]

• Developing multi-sectoral partnerships to facilitate the scale-up and spread of environmental health interventions and assure sustainability.

• Engaging policy makers to support the implementation of environmental health interventions

• Example: Collaborating with community working groups to co-design clean solutions to plastic waste disposal and reduce plastic waste incineration