Recommendations for Applying Antiracism to Implementation Science

If applicable, enter a short description here..

Reviewed by Brian Xu


Over the last several years, the field of implementation science (IS) has become an increasingly popular framework for policymakers to translate evidence-based interventions (EBIs) into routine, real-world practices. IS is most salient in health settings, as it is primarily used with the objective of improving the quality and effectiveness of healthcare services. Despite the noble intent of implementation science, there exist significant gaps with respect to how it can best be leveraged to close racial disparities.

This piece of research aims to address these areas of opportunity by applying an antiracism lens to the core facets of implementation science. The authors seek to provide tangible and actionable recommendations for researchers looking to actively reduce the influence of structural racism on their work. Furthermore, they emphasize the need for grounding and self-reflection that can empower implementation scientists to bring an antiracism perspective to their research. Incorporating antiracism into IS can improve the efficacy, implementation, and sustainability of policy interventions in diverse settings.

Dr. Rachel Shelton is an Associate Professor at the Columbia University Mailman School of Public Health, where she helps lead a university-wide implementation science initiative across Columbia. Dr. Prajakta Adsul is an Assistant Professor in the Department of Internal Medicine at the University of New Mexico, where she currently studies the implementation context of cervical and colorectal cancer screening to improve population-level outcomes. Dr. April Oh is a Senior Advisor for Implementation Science at the National Cancer Institute, where she leads efforts to advance the intersection of implementation science and health equity research. Dr. Nathalie Moise is the Florence Irving Associate Professor of Medicine at the Columbia University Irving Medical Center, where she researches the implementation of team based care at the intersection of chronic cardiovascular disease and mental illness. Dr. Derek M. Griffith is a founding Co-Director of Georgetown University’s Racial Justice Institute, where he specializes in interventions to promote Black men’s health and well-being.

Methods and Findings

The authors build their discussion of antiracism upon existing scholarship on health equity and structural racism. Drawing from a variety of sources of antiracism literature, the authors outline specific recommendations for combatting structural racism within IS across five distinct elements: stakeholder engagement; conceptual models and frameworks; development, selection, and adaptation of interventions; evaluation approaches; and implementation strategies.

First, the researchers argued for the importance of community engagement and co-creation in stakeholder engagement. By emphasizing transparency, acknowledging power dynamics, and including diverse partners as decision-makers, implementation scientists can more effectively create interventions that target the underlying problems that communities face.
Second, IS frameworks should give greater consideration to racism as a key factor that can shape how care is distributed to populations. Equity-focused frameworks will acknowledge how racism permeates institutional norms, healthcare systems, and organizational structures.
Third, the authors assert that implementation science demands the development, selection, and adaptation of interventions that focus on health equity and antiracism. Few existing interventions truly address the root causes of health inequity, so it is imperative to create new interventions that mitigate the detrimental health effects of racism.
Fourth, there are few metrics within IS that are able to capture either racism or racial equity. In order to track improvements in health equity outcomes, IS researchers need to develop new measures that can more clearly operationalize the effects of racism.
Finally, there needs to be a demonstrated antiracist effort when it comes to implementation strategies. Examples include building diverse teams or training on antiracist principles.

Across all five of these elements, the authors underscore the need for implementation scientists to engage in critical self-reflection, consistently thinking about whether racism is explicitly or implicitly affecting their work.


Because implementation science is located at such a critical juncture between research and practice, it is necessary to apply an antiracism lens in order to improve health equity. By positioning IS in the long history of antiracism scholarship, researchers can generate interventions that achieve social justice and lasting impact.

The authors conclude by raising more questions that need to be answered in implementation science, such as: 

  • How has structural racism shaped the field of implementation science?
  • Is one of the reasons that interventions struggle in communities experiencing inequities the lack of examination of structural racism?
  • How could an antiracism approach facilitate the sustainability of EBIs?
  • What would it mean to center the values and experiences of individuals experiencing racism in adaptation and de-implementation efforts?
  • What does it mean that dissemination efforts encouraging adoption typically focus on gatekeepers and those who already hold power?

Furthermore, racism manifests in unique ways across a variety of physical and cultural environments, which necessitates more research. 


Thank you for visiting RRAPP

Please help us improve the site by answering three short questions.