title: The importance of context in implementation research.
abstract: This article describes the pertinence of context in HIV/AIDS implementation research. Without attending to context and how it interacts with interventions, national protocols for HIV/AIDS interventions are likely to fail or underperform. With its focus on what works, for whom, under what contextual circumstances, and whether interventions are scalable, implementation research yields context-sensitive designs and enhances the likelihood of scale-up for equitable outcomes. A framework for implementation science is presented alongside a review of published HIV/AIDS protocols for complex interventions. A case study of the South African Prevention of Mother-to-Child Transmission of HIV program highlights the application of complex system improvement principles in developing adaptive and context-sensitive scale-up designs. Preliminary recommendations are provided that can be used to characterize context when reporting interventions and describing how context can be accounted for in implementation strategies.
authors.affiliation: *School of Nursing, University of Ottawa, Ottawa, CA; †Institute for Health Care Improvement (IHI), Cambridge, MA; and ‡Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
authors.forename: Nancy
authors.initials: N
authors.lastname: Edwards
authors.forename: Pierre M
authors.initials: PM
authors.lastname: Barker
mesh_terms: D005260:Female; D015658:HIV Infections / Q000150:complications / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control / Q000628:therapy*; D013019:South Africa