title: Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs.
abstract: Though great progress has been realized over the last decade in extending HIV prevention, care and treatment in some of the least resourced settings of the world, a substantial gap remains between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs. Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings. We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage the multi-sectoral community of stakeholders, including community members, health care teams, program managers, researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap.
authors.affiliation: Pangaea Global AIDS, 436 14th St, Suite 920, Oakland, CA 94612, USA. blambdin@pgaf.org.
authors.forename: Barrot H
authors.initials: BH
authors.lastname: Lambdin
authors.forename: Ben
authors.initials: B
authors.lastname: Cheng
authors.forename: Trevor
authors.initials: T
authors.lastname: Peter
authors.forename: Jessie
authors.initials: J
authors.lastname: Mbwambo
authors.forename: Tsitsi
authors.initials: T
authors.lastname: Apollo
authors.forename: Megan
authors.initials: M
authors.lastname: Dunbar
authors.forename: Ifeoma C
authors.initials: IC
authors.lastname: Udoh
authors.forename: Adithya
authors.initials: A
authors.lastname: Cattamanchi
authors.forename: Elvin H
authors.initials: EH
authors.lastname: Geng
authors.forename: Paul
authors.initials: P
authors.lastname: Volberding
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy*; D006801:Humans