Abstract
Background
While many interventions have reduced transmission of HIV or increased access to HIV care, fewer have been scaled-up or sustained. Implementation science (IS) maximizes the population-level impact of interventions, but globally, knowledge about IS among researchers and policymakers is limited, particularly in low and middle-income countries. This gap can be addressed through an innovative IS training model, the Depth and Diffusion Model, that can be used to build implementation science capacity to increase equity in the distribution of global implementation science training programs.
Methods
In the Depth and Diffusion Model, depth creates an in-country institution as a leader in IS research and training; diffusion ensures the spread of fundamental IS knowledge across universities and governmental agencies throughout the country. We are using the Depth and Diffusion Model in the Vietnam Implementation Science Advancement Program (VISA), a case study of applying this model in practice. VISA’s goals are to: (1) initiate the Hanoi Medical University Implementation Science Program; (2) develop IS knowledge and research capacity among four universities in Vietnam; and (3) cultivate IS capacity among Vietnamese policymakers and health program leaders.
Discussion
The Depth and Diffusion Model is being used to efficiently scale-up IS knowledge among researchers and policymakers, while fostering collaboration to increase impact of research and policies. By the end of VISA, HIV-related IS capacity will be well-established in Vietnam, demonstrating how the Depth and Diffusion Model can be a blueprint for adoption of IS research and practice in a country with limited previous IS capacity.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abimbola, S., & Pai, M. (2020). Will global health survive its decolonisation? The Lancet, 396(10263), 1627–1628. https://doi.org/10.1016/S0140-6736(20)32417-X.
Abimbola, S., Asthana, S., Montenegro, C., Guinto, R. R., Jumbam, D. T., Louskieter, L., Kabubei, K. M., Munshi, S., Muraya, K., Okumu, F., Saha, S., Saluja, D., & Pai, M. (2021). Addressing power asymmetries in global health: Imperatives in the wake of the COVID-19 pandemic. PLOS Medicine, 18(4), e1003604. https://doi.org/10.1371/journal.pmed.1003604.
Akiba, C. F., Go, V., Mwapasa, V., Hosseinipour, M., Gaynes, B. N., Amberbir, A., Udedi, M., & Pence, B. W. (2019). 2019/11/09). The Sub-saharan Africa Regional Partnership (SHARP) for Mental Health Capacity Building: A program protocol for building implementation science and mental health research and policymaking capacity in Malawi and Tanzania. International Journal of Mental Health Systems, 13(1), 70. https://doi.org/10.1186/s13033-019-0327-2.
Andermann, A., Pang, T., Newton, J. N., Davis, A., & Panisset, U. (2016). 2016/03/14). Evidence for Health II: Overcoming barriers to using evidence in policy and practice. Health Research Policy and Systems, 14(1), 17. https://doi.org/10.1186/s12961-016-0086-3.
Bartels, S. M., Haider, S., Williams, C. R., Mazumder, Y., Ibisomi, L., Alonge, O., Theobald, S., Bärnighausen, T., Escallon, J. V., Vahedi, M., Ramaswamy, R., & Sarker, M. (2022). Diversifying implementation science: A Global Perspective. Global Health: Science and Practice. https://doi.org/10.9745/ghsp-d-21-00757.
Beidas, R. S., Dorsey, S., Lewis, C. C., Lyon, A. R., Powell, B. J., Purtle, J., Saldana, L., Shelton, R. C., Stirman, S. W., & Lane-Fall, M. B. (2022, Aug 13). Promises and pitfalls in implementation science from the perspective of US-based researchers: learning from a pre-mortem. Implement Sci, 17(1), 55. https://doi.org/10.1186/s13012-022-01226-3.
Bloomfield, G. S., Xavier, D., Belis, D., Alam, D., Davis, P., Dorairaj, P., Ghannem, H., Gilman, R. H., Kamath, D., Kimaiyo, S., Levitt, N., Martinez, H., Mejicano, G., Miranda, J. J., Koehlmoos, T. P., Rabadán-Diehl, C., Ramirez-Zea, M., Rubinstein, A., Sacksteder, K. A., Steyn, K., Tandon, N., Vedanthan, R., Wolbach, T., Wu, Y., & Yan, L. L. (2016, Mar). Training and capacity building in LMIC for Research in Heart and Lung diseases: The NHLBI-UnitedHealth Global Health Centers of Excellence Program. Glob Heart, 11(1), 17–25. https://doi.org/10.1016/j.gheart.2016.01.004.
Brownson, R. C., & Jones, E. (2009). Bridging the gap: Translating research into policy and practice. Preventive Medicine, 49(4), 313–315. https://doi.org/10.1016/j.ypmed.2009.06.008. (2009/10/01/).
Brownson, R. C., Royer, C., Ewing, R., & McBride, T. D. (2006, Feb). Researchers and policymakers: Travelers in parallel universes. American Journal of Preventive Medicine, 30(2), 164–172. https://doi.org/10.1016/j.amepre.2005.10.004.
Choi, B. C. K., Pang, T., Lin, V., Puska, P., Sherman, G., Goddard, M., Ackland, M. J., Sainsbury, P., Stachenko, S., Morrison, H., & Clottey, C. (2005). Can scientists and policy makers work together? Journal of Epidemiology and Community Health, 59(8), 632. https://doi.org/10.1136/jech.2004.031765.
Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., Hakim, J. G., Kumwenda, J., Grinsztejn, B., Pilotto, J. H. S., Godbole, S. V., Mehendale, S., Chariyalertsak, S., Santos, B. R., Mayer, K. H., Hoffman, I. F., Eshleman, S. H., Piwowar-Manning, E., Wang, L., Makhema, J., Mills, L. A., de Bruyn, G., Sanne, I., Eron, J., Gallant, J., Havlir, D., Swindells, S., Ribaudo, H., Elharrar, V., Burns, D., Taha, T. E., Nielsen-Saines, K., Celentano, D., Essex, M., & Fleming, T. R. (2011). Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine, 365(6), 493–505. https://doi.org/10.1056/NEJMoa1105243.
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). 2009/08/07). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(1), 50. https://doi.org/10.1186/1748-5908-4-50. (2009/08/07).
Davis, R., & D’Lima, D. (2020). Building capacity in dissemination and implementation science: A systematic review of the academic literature on teaching and training initiatives. Implementation Science, 15(1), 97. https://doi.org/10.1186/s13012-020-01051-6. (2020/10/30).
Dawson, A., Brodie, P., Copeland, F., Rumsey, M., & Homer, C. (2014, Apr). Collaborative approaches towards building midwifery capacity in low income countries: A review of experiences. Midwifery, 30(4), 391–402. https://doi.org/10.1016/j.midw.2013.05.009.
Dearing, J. W., Kee, K. F., & Peng, T. Q. (2017). Historical roots of dissemination and implementation science. Dissemination and Implementation Research in Health (2 ed.). Oxford University Press. https://doi.org/10.1093/oso/9780190683214.003.0003.
Eccles, M. P., & Mittman, B. S. (2006). 2006/02/22). Welcome to Implementation Science.Implementation Science 1(1), 1. https://doi.org/10.1186/1748-5908-1-1.
Gichane, M. W., & Wallace, D. D. (2022). 2022/12/31). Dismantling and reimagining global health education. Global Health Action, 15(1), 2131967. https://doi.org/10.1080/16549716.2022.2131967.
Go, V. F., Morales, G. J., Mai, N. T., Brownson, R. C., Ha, T. V., & Miller, W. C. (2016). 2016/04/20). Finding what works: Identification of implementation strategies for the integration of methadone maintenance therapy and HIV services in Vietnam. Implementation Science, 11(1), 54. https://doi.org/10.1186/s13012-016-0420-8. (2016/04/20).
Grant, R. M., Lama, J. R., Anderson, P. L., McMahan, V., Liu, A. Y., Vargas, L., Goicochea, P., Casapía, M., Guanira-Carranza, J. V., Ramirez-Cardich, M. E., Montoya-Herrera, O., Fernández, T., Veloso, V. G., Buchbinder, S. P., Chariyalertsak, S., Schechter, M., Bekker, L. G., Mayer, K. H., Kallás, E. G., Amico, K. R., Mulligan, K., Bushman, L. R., Hance, R. J., Ganoza, C., Defechereux, P., Postle, B., Wang, F., McConnell, J. J., Zheng, J. H., Lee, J., Rooney, J. F., Jaffe, H. S., Martinez, A. I., Burns, D. N., & Glidden, D. V. (2010). Preexposure Chemoprophylaxis for HIV Prevention in men who have sex with men. New England Journal of Medicine, 363(27), 2587–2599. https://doi.org/10.1056/NEJMoa1011205.
Haines, A., Kuruvilla, S., & Borchert, M. (2004, Oct). Bridging the implementation gap between knowledge and action for health. Bulletin of the World Health Organization, 82(10), 724–731. discussion 732.
Higgins, D. L., Galavotti, C., O’Reilly, K. R., Schnell, D. J., Moore, M., Rugg, D. L., & Johnson, R. (1991, Nov 6). Evidence for the effects of HIV antibody counseling and testing on risk behaviors. JAMA, 266(17), 2419–2429.
Kemp, C. G., Jarrett, B. A., Kwon, C. S., Song, L., Jetté, N., Sapag, J. C., Bass, J., Murray, L., Rao, D., & Baral, S. (2019). 2019/02/15). Implementation science and stigma reduction interventions in low- and middle-income countries: A systematic review. BMC Medicine, 17(1), 6. https://doi.org/10.1186/s12916-018-1237-x.
Kempf, M. C., Huang, C. H., Savage, R., & Safren, S. A. (2015). Technology-Delivered Mental Health Interventions for People Living with HIV/AIDS (PLWHA): A review of recent advances. Current HIV/AIDS Reports, 12(4), 472–480. https://doi.org/10.1007/s11904-015-0292-6.
Khan, M., Abimbola, S., Aloudat, T., Capobianco, E., Hawkes, S., & Rahman-Shepherd, A. (2021). Decolonising global health in 2021: A roadmap to move from rhetoric to reform. BMJ Global Health, 6(3), e005604. https://doi.org/10.1136/bmjgh-2021-005604.
Kilbourne, A. M., Neumann, M. S., Pincus, H. A., Bauer, M. S., & Stall, R. (2007). 2007/12/09). Implementing evidence-based interventions in health care: Application of the replicating effective programs framework. Implementation Science, 2(1), 42. https://doi.org/10.1186/1748-5908-2-42.
Means, A. R., Kemp, C. G., Gwayi-Chore, M. C., Gimbel, S., Soi, C., Sherr, K., Wagenaar, B. H., Wasserheit, J. N., & Weiner, B. J. (2020). 2020/03/12). Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: A systematic review. Implementation Science, 15(1), 17. https://doi.org/10.1186/s13012-020-0977-0.
Miller, R. L. (2001). Aug). Innovation in HIV prevention: Organizational and intervention characteristics affecting program adoption. American Journal of Community Psychology, 29(4), 621–647. https://doi.org/10.1023/a:1010426218639.
Nguyen, T. T., Luong, A. N., Nham, T. T. T., Chauvin, C., Feelemyer, J., Nagot, N., Jarlais, D. D., Le, M. G., & Jauffret-Roustide, M. (2019, Jun). Struggling to achieve a ‘normal life’: A qualitative study of Vietnamese methadone patients. International Journal of Drug Policy, 68, 18–26. https://doi.org/10.1016/j.drugpo.2019.03.026.
NIH Reporter Retrieved January 3 (2023). from https://reporter.nih.gov/search/DZo_u5L-_EeOrvvkDAxfKg/project-details/10393653.
NIH Reporter Retrieved January 4 (2023). from https://reporter.nih.gov/search/DZo_u5L-_EeOrvvkDAxfKg/project-details/10376263.
Panisset, U., Koehlmoos, T. P., Alkhatib, A. H., Pantoja, T., Singh, P., Kengey-Kayondo, J., McCutchen, B., & Miguel, G. B. Á. (2012). 2012/07/02). Implementation research evidence uptake and use for policy-making. Health Research Policy and Systems, 10(1), 20. https://doi.org/10.1186/1478-4505-10-20.
Philbin, M. M., Hirsch, J. S., Wilson, P. A., Ly, A. T., Giang, L. M., & Parker, R. G. (2018). Structural barriers to HIV prevention among men who have sex with men (MSM) in Vietnam: Diversity, stigma, and healthcare access. PLoS One, 13(4), e0195000. https://doi.org/10.1371/journal.pone.0195000.
Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., Proctor, E. K., & Kirchner, J. E. (2015). 2015/02/12). A refined compilation of implementation strategies: Results from the Expert recommendations for Implementing Change (ERIC) project. Implementation Science, 10(1), 21. https://doi.org/10.1186/s13012-015-0209-1.
Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., & Hensley, M. (2011). Mar). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health, 38(2), 65–76. https://doi.org/10.1007/s10488-010-0319-7.
Ramaswamy, R., Chirwa, T., Salisbury, K., Ncayiyana, J., Ibisomi, L., Rispel, L., van der Horst, C., & Pettifor, A. (2020). 2020/03/01). Developing a field of study in implementation science for the Africa Region: The Wits–UNC AIDS implementation Science Fogarty D43. Pedagogy in Health Promotion, 6(1), 46–55. https://doi.org/10.1177/2373379919897088.
Reporter, N., Retrieved, & January (2023). 2, from https://reporter.nih.gov/search/8A6OO2Mc1U2Dp5HjuPiKlQ/projects.
Rotheram-Borus, M. J., Rebchook, G. M., Kelly, J. A., Adams, J., & Neumann, M. S. (2000). Bridging research and practice: Community-researcher partnerships for replicating effective interventions. Aids Education and Prevention, 12(5 Suppl), 49–61.
Schouten, E. J., Jahn, A., Midiani, D., Makombe, S. D., Mnthambala, A., Chirwa, Z., Harries, A. D., van Oosterhout, J. J., Meguid, T., Ben-Smith, A., Zachariah, R., Lynen, L., Zolfo, M., Van Damme, W., Gilks, C. F., Atun, R., Shawa, M., & Chimbwandira, F. (2011, Jul 16). Prevention of mother-to-child transmission of HIV and the health-related Millennium Development Goals: time for a public health approach. Lancet, 378(9787), 282–284. https://doi.org/10.1016/s0140-6736(10)62303-3.
Schwartz, S. R., Smith, J. D., Hoffmann, C., Hansoti, B., Mishra, S., Means, A. R., Go, V., Sherr, K., Nash, D., Sullivan, P., & Baral, S. (2021). Jun). Implementing implementation research: Teaching implementation research to HIV Researchers. Current HIV/AIDS Reports, 18(3), 186–197. https://doi.org/10.1007/s11904-021-00551-4.
Solberg, L. I., Glasgow, R. E., Unützer, J., Jaeckels, N., Oftedahl, G., Beck, A., Maciosek, M. V., & Crain, A. L. (2010). Partnership research: A practical trial design for evaluation of a natural experiment to improve depression care. Medical care, 48(7), 576–582. https://doi.org/10.1097/MLR.0b013e3181dbea62.
UNAIDS (2016). Understanding Fast-Track. https://www.unaids.org/sites/default/files/media_asset/201506_JC2743_Understanding_FastTrack_en.pdf.
UNAIDS (2020). Viet Nam Country Factsheethttps://www.unaids.org/en/regionscountries/countries/vietnam.
Van de Ven, A. H., & Johnson, P. E. (2006). Knowledge for theory and practice. Academy of Management Review, 31(4), 802–821.
Williamson, A., Tait, H., El Jardali, F., Wolfenden, L., Thackway, S., Stewart, J., O’Leary, L., & Dixon, J. (2019). 2019/04/15). How are evidence generation partnerships between researchers and policy-makers enacted in practice? A qualitative interview study. Health Research Policy and Systems, 17(1), 41. https://doi.org/10.1186/s12961-019-0441-2.
Funding
Research reported in this publication was supported by the Fogarty International Center under award number 5D43TW011548-02 and Sophia M. Bartels was supported by NIH’s Population Research Infrastructure Program awarded to the Carolina Population Center (P2C HD050924) during the writing of this manuscript.
Author information
Authors and Affiliations
Contributions
Giang Minh Le, Irving F. Hoffman, Suzanne Maman, Teerada Sripaipan, William C. Miller, Vivian F. Go, and Le Thi Huong contributed to the training model conceptualization and design. The first draft of the manuscript was written by Sophia M. Bartels and all authors commented on subsequent versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethical Approval/Consent
This is a description of a capacity building model so neither ethical approval nor informed consent was required.
Competing Interests
The authors have no competing interests to declare that are relevant to the content of this article.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Bartels, S.M., Hai Hoang, V.T., Le, G.M. et al. Innovations for Building Implementation Science Capacity among Researchers and Policymakers: The Depth and Diffusion Model. Glob Implement Res Appl (2024). https://doi.org/10.1007/s43477-024-00121-x
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s43477-024-00121-x