Equity-Grounded Implementation Science: Comparative Case Analysis of Three Studies

Despite research and treatment advances in health care, the implementation of research evidence into practice remains a challenge, especially for historically marginalized populations. There have been numerous calls to action to integrate health equity into implementation science frameworks, models, and theories. Yet, progress toward better integration of these approaches has been hampered by the theoretical and aspirational nature of calls to action up to the present time, which poses a challenge as it remains unclear how to specifically move from rhetoric to action. We present three case examples from our work to illustrate how to synergize health equity research and implementation science into our approach to “equity-grounded implementation science” focused on processes and practices located at the intersection of these fields. These three distinct studies focused on reducing mental health inequities in historically marginalized communities, namely, Latino and Black individuals in mainland United States and Puerto Rico. For each study, we describe the study aim, methodology, setting in which activities were carried out, the health equity elements, and the implementation science aspects. We articulate how each study bridged implementation science and health equity research by (a) situating the study activities in community settings; (b) codesigning interventions to ensure their cultural, linguistic, and contextual relevance; and (c) weaving mixed methods and community-engaged approaches to draw community insights. Finally, we illustrate how to address key implementation outcomes in these health equity studies, representing a significant step toward turning rhetoric into actionable solutions for reducing mental health inequities in marginalized communities.