TY - JOUR
T1 - Strengthening implementation guidelines for HIV service delivery
T2 - Considerations for future evidence generation and synthesis
AU - Eshun-Wilson, Ingrid
AU - Ford, Nathan
AU - Mody, Aaloke
AU - Beres, Laura
AU - Schwartz, Sheree
AU - Baral, Stefan
AU - Geng, Elvin H.
N1 - Publisher Copyright:
© 2023 Public Library of Science. All rights reserved.
PY - 2023/3
Y1 - 2023/3
N2 - With highly effective diagnostic, prevention, and treatment innovations available in HIV programs globally, the HIV field is increasingly turning to implementation and service delivery questions. • Developing guidelines for implementation of interventions is markedly challenged by limitations in primary implementation research design and reporting, as well as difficulties in application of evidence synthesis and guideline development tools originally developed to appraise evidence for efficacy. • Drawing on the processes of developing the WHO HIV service delivery guidelines for testing and treatment between 2018 and 2021, we present challenges and identify areas for future methodological development to improve the incorporation of implementation research across the full spectrum of the evidence generation continuum. • We highlight gaps in design, measurement, and reporting of primary implementation research, as well as underreporting of relevant program data. • We describe how routine application of current evidence synthesis tools may not sufficiently answer implementation questions and propose that methodological tools be optimized to identify high-quality non-randomized evidence and reduce penalization for heterogeneity in meta-analysis of implementation research. • These findings serve as a blueprint for further methodological work to strengthen existing evidence synthesis and guideline development tools for HIV service delivery guidelines and for implementation research more broadly.
AB - With highly effective diagnostic, prevention, and treatment innovations available in HIV programs globally, the HIV field is increasingly turning to implementation and service delivery questions. • Developing guidelines for implementation of interventions is markedly challenged by limitations in primary implementation research design and reporting, as well as difficulties in application of evidence synthesis and guideline development tools originally developed to appraise evidence for efficacy. • Drawing on the processes of developing the WHO HIV service delivery guidelines for testing and treatment between 2018 and 2021, we present challenges and identify areas for future methodological development to improve the incorporation of implementation research across the full spectrum of the evidence generation continuum. • We highlight gaps in design, measurement, and reporting of primary implementation research, as well as underreporting of relevant program data. • We describe how routine application of current evidence synthesis tools may not sufficiently answer implementation questions and propose that methodological tools be optimized to identify high-quality non-randomized evidence and reduce penalization for heterogeneity in meta-analysis of implementation research. • These findings serve as a blueprint for further methodological work to strengthen existing evidence synthesis and guideline development tools for HIV service delivery guidelines and for implementation research more broadly.
UR - http://www.scopus.com/inward/record.url?scp=85150751310&partnerID=8YFLogxK
U2 - 10.1371/journal.pmed.1004168
DO - 10.1371/journal.pmed.1004168
M3 - Article
C2 - 36877738
AN - SCOPUS:85150751310
SN - 1549-1277
VL - 20
JO - PLoS medicine
JF - PLoS medicine
IS - 3 March
M1 - e1004168
ER -