Commentary On “Situating implementation science (IS) in res(IS)tance: a conceptual frame toward the integration of scholarship from the black radical tradition”

Despite a field having evolved and grown a great deal over the last few decades, implementation science continues to lack the necessary awareness and attention paid to racialized systems in which our work operates. Bradley, Irie, & Geng present a multipart review and discussion of implementation science in the realm of a field that currently discusses health equity and racial disparities but in a limited way. The paper includes critiques of the current implementation science space along with the ways in which to address these criticisms through the application of work rooted in Black radical tradition and resistance. The authors first present the current state of the implementation science literature and methods in this framing, and present the ways in which there are gaps in its current form. Bradley, Irie, & Geng showcase how racism is operationalized within implementation science, normalized, and reinforced. For example, the authors describe the shortcomings of two popular frameworks – the Consolidated Framework for Implementation Research (CFIR) and the Diffusion of Innovations (DOI) – in terms of how they fall short in considering and allowing for racialized systems of power. They call out specific implementation science areas of focus – including fidelity and context. They describe context as often a problem to address, according to works in implementation science, when racialized systems and racist contexts need changing while an intervention fits within context. The authors then go on to describe tangible ways in which to alter our approaches and understandings in implementation science, including how we define implementation failures using the lens of critical race theory and Black radical tradition. Finally, the authors provide guidance on how to develop and define “multi-faceted and multi-level” implementation strategies and make a call for greater inclusion of scholarship from the Black radical tradition to address health inequities. This paper provides tangible ways in which to not only identify, but to combat the reproduction and exacerbation of health inequities through implementation science. Indeed, the authors state, “Reframing the reasons for implementation gaps as ‘designed for’ by racialized social systems and institutions means that the central task of implementation research is to identify and understand how certain drivers reproduce racialized gaps and disparities in outcomes and then to design strategies that counteract these processes through a resistant imagination.” I recommend this work as a tool for guiding work across the spectrum of research including the theories we apply as well as how we design and deliver implementation strategies.

References:

Bradley, C. D., Irie, W. C., & Geng, E. H. (2024). Situating implementation science (IS) in res (IS) tance: a conceptual frame toward the integration of scholarship from the black radical tradition. Frontiers in Public Health, 11, 1286156.