Identifying high-priority implementation science research questions regarding equity, sustainability, spread, and scale of effective evidence-based practices.


There is a growing understanding of how to put research evidence into practice. Less is known about how to sustain changes over time or how to effectively, and equitably, bring evidence-based practices (EBPs) to other settings or to benefit more people. For example, little is known about how to support the identification of core functions of an intervention or program, how to adapt those functions over time or to different contexts, nor how to ensure health equity is considered throughout implementation, sustainability, spread, or scale processes. The Office of Spread and Scale (OSS) at Women’s College Hospital is strategically positioned to bridge this evidence-to-practice gap through efforts to amplify successful models of care and innovative programs while learning from the successes of others.  


Preliminary work is underway at the OSS following the James Lind Alliance (JLA) methodology to develop a Top 10 list of high-priority research questions regarding equity, sustainability, spread, and scale. This list will be developed through a series of consultation sessions with researchers, health system and community organizations, trainees, and patients (following the broad CIHR definition). Potential research questions may be about strategies for deciding what should be sustained, spread, or scaled, or how to support champions to navigate the fidelity/adaptation dilemma to meet patient needs after initial implementation. 

To contribute to the development of this Top 10 list, a workshop conducted by the OSS will seek input through interactive group discussion on two key questions: 

  1. What implementation science research questions do you think should be high-priority when planning a research study focused on equity, sustainability, spread and scale? 
  2. What needs to be considered to ensure that the high-priority research question(s) is equitable and anti-racist?

The session will open with an introduction to sustainability, spread, scale, and the importance of considering health equity throughout one’s work. A summary of existing research priorities in these areas will be presented before beginning group discussion around the two key questions. Interactive, online, discussion boards will be used to prompt reflection and stimulate discussion from the group so everyone can contribute, even if participants are not comfortable sharing ideas verbally. 


Results of this workshop will be included as part of the JLA process along with an environmental scan and extensive consultation with health system and community representatives (i.e., researchers, trainees, and patients with a specified role in a health system or community organization).


Insights generated through this workshop, and additional consultation sessions, will inform the development of high-priority, experience-informed research questions regarding equity, sustainability, spread, and scale of effective EBPs from a variety of viewpoints. This work also encourages the development of diverse partnerships and the planning of collaborative research to support organisation and health systems partners who are challenged on how best to equitably sustain, spread, and scale health-related interventions.

Celia Laur poster_OSS

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