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dc.contributor.authorGravitt, Patti E
dc.contributor.authorRositch, Anne F
dc.contributor.authorJurczuk, Magdalena
dc.contributor.authorMeza, Graciela
dc.contributor.authorCarillo, Lita
dc.contributor.authorJeronimo, Jose
dc.contributor.authorAdsul, Prajakta
dc.contributor.authorNervi, Laura
dc.contributor.authorKosek, Margaret
dc.contributor.authorTracy, J Kathleen
dc.contributor.authorPaz-Soldan, Valerie A
dc.date.accessioned2021-02-11T17:50:30Z
dc.date.available2021-02-11T17:50:30Z
dc.date.issued2020-06-19
dc.identifier.urihttp://hdl.handle.net/10713/14664
dc.description.abstractBackground: The World Health Organization (WHO) has called for a systems thinking approach to health systems strengthening to increase adoption of evidence-based interventions (EBI). The Integrative Systems Praxis for Implementation Research (INSPIRE) methodology operationalizes the WHO systems thinking framework to meet cervical cancer elimination–early detection and treatment (CC-EDT) goals. Methods: Using a systems thinking approach and grounded in the consolidated framework for implementation research, INSPIRE integrates multiple research methodologies and evaluation frameworks into a multilevel implementation strategy. Results: In phase I (creating a shared understanding), soft systems methodology and pathway analysis are used to create a shared visual understanding of the CC-EDT system, incorporating diverse stakeholder perspectives of the “what, how, and why” of system behavior. Phase II (finding leverage) facilitates active stakeholder engagement in knowledge transfer and decision-making using deliberative dialogues and multiple scenario analyses. Phase III (acting strategically) represents stakeholder-engaged implementation planning, using well-defined implementation strategies of education, training, and infrastructure development. In phase IV (learning and adapting), evaluation of key performance indicators via a reach, effectiveness, adoption, implementation, and maintenance framework is reviewed by stakeholder teams, who continuously adapt implementation plans to improve system effectiveness. Conclusions: The INSPIRE methodology is a generalizable approach to context-adapted implementation of EBIs. Impact: Replacing static dissemination of implementation “roadmaps” with learning health systems through the integration of systems thinking and participatory action research, INSPIRE facilitates the development of scalable and sustainable implementation strategies adapted to local contexts.en_US
dc.description.urihttps://doi.org/10.1158/1055-9965.EPI-20-0501en_US
dc.language.isoenen_US
dc.publisherAmerican Association for Cancer Research, cosponsored by the American Society of Preventive Oncologyen_US
dc.relation.ispartofCancer Epidemiology, Biomarkers & Preventionen_US
dc.rights©2020 American Association for Cancer Research.en_US
dc.subjectIntegrated Systems Praxis for Implementation Research (INSPIRE)en_US
dc.subject.lcshCervix uteri--Canceren_US
dc.subject.meshImplementation Scienceen_US
dc.titleIntegrative Systems Praxis for Implementation Research (INSPIRE): An Implementation Methodology to Facilitate the Global Elimination of Cervical Canceren_US
dc.typeArticleen_US
dc.identifier.doi10.1158/1055-9965.EPI-20-0501
dc.identifier.pmid32561563
dc.source.volume29
dc.source.issue9
dc.source.beginpage1710
dc.source.endpage1719
dc.source.countryUnited States


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