Implementation research for advancing health equity: Design and competency-based assessment of a short-term implementation research training program focused on health equity in global health

Figures Abstract Implementation research (IR) provides tools to address health inequities and complex global health issues, facilitating real-world health impact at scale. Limited training opportunities exist for applying IR to health inequities. The 2024 Sparkman Center for Global Health Summer Institute (SI) in the School of Public Health, University of Alabama at Birmingham, provided a one-week intensive workshop that introduced concepts, methodologies, and applications of IR in global health settings, explicitly targeting health inequities. This paper describes a competency-based assessment of SI. We utilized the reliability- and validity-tested Self-evaluation of Implementation Research Competencies and Objective Assessment questionnaires. Analyses included pre/post-SI comparisons of self-assessed knowledge, self-efficacy, and objective knowledge scores; associations between participant characteristics and changes in knowledge/self-efficacy scores; and explored psychometric properties of the objective assessment tool to estimate item difficulty and discrimination parameters. Open-ended questions were analyzed thematically to reveal participant experiences, perceived relevance of the training, and suggestions for future improvement. SI was completed by 28 participants from 12 countries working on various global health topics. Equity considerations within projects focused on social/structural barriers, differentiating outcomes, and strategies to target disadvantaged groups within IR. Significant improvements were observed across IR domains, with the mean self-assessed knowledge increasing from 57.67% [Confidence interval (CI):43.78; 71.55] to 87.68% (CI: 76.96;98.41), p = 0.003, and the largest improvements in competencies related to stakeholder engagement, scientific inquiry, and the application of IR strategies to real-world problems. Objective assessment scores demonstrated modest, nonsignificant improvement, increasing from 65.35% (CI: 61.28;69.41) to 68.18% (CI: 64.38;71.97), p = 0.324). Participants reported high satisfaction with SI’s structure, content, and delivery, highlighting its practical focus on stakeholder engagement, real-world case studies, mentorship, networking, calling for continued mentorship engagement and further training. This evaluation will be used to improve the impact of IR training in global health settings, emphasizing importance of hands-on application of IR concepts in tackling health inequities. Citation: Helova A, Owuor K, Durham C, Tech E, Alonge O (2026) Implementation research for advancing health equity: Design and competency-based assessment of a short-term implementation research training program focused on health equity in global health. PLOS Glob Public Health 6(6): e0006007. https://doi.org/10.1371/journal.pgph.0006007 Editor: Dvora Joseph Davey, University of California, Los Angeles and University of Cape Town, South Africa, SOUTH AFRICA Received: February 2, 2026; Accepted: May 12, 2026; Published: June 1, 2026 Copyright: © 2026 Helova et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: The data that support the findings of this study are available in the Open Science Framework at https://doi.org/10.17605/OSF.IO/26BQZ. Funding: The author(s) received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist. Introduction Implementation Research (IR) addresses questions pertaining to implementation of evidence-supported health interventions (ESI) to achieve population health impact [1]. IR has been criticized for not paying sufficient attention to issues of health equity [2], that is, “everyone having a fair and just opportunity to be as healthy as possible” [3] – which is much needed to achieve widespread population health impact in global health settings [2,4,5]. Similarly, while there are several degrees and training programs in implementation research relevant to global health, there are very few that explicitly target issues of health inequities contextualized to global health settings [6]. Global health settings include resource-limited settings where the world’s most vulnerable and least disadvantaged populations live, and are not restricted to low- and middle-income countries (LMICs) [7,8]. Beyond the lack of a specific focus on equity issues, trainings in implementation research are inaccessible or not as impactful for many practitioners and researchers due to several reasons: inaccessibility of long-term, in-person academic programs due to costs and time and other logistical reasons, focus on basic IR principles with no real-life application, limited content/geographic location focus, limited contextual validity of content for a diversified audience, and lack of clear linkage into a career pipeline. These reasons disproportionately affect all trainees in global health settings [9–11]. Additionally, while competency-based training in global health is considered highly valuable [12,13], many IR training programs in global health settings fail to clarify the competencies they teach and may not cover advanced competencies needed to tackle health inequities [14]. Moreover, there are limited standardized and validated methodologies for evaluating the impact of competency-based training programs in IR, particularly in global health settings [15]. To address some of these gaps, the Sparkman Center for Global Health (SCGH) Summer Institute (SI) offers an annual one-week intensive workshop that introduces implementation research (IR) in global health settings and provides competency-based training in applying IR concepts and methods to address health inequities in global health research and practice. The first Institute was a one-week residential workshop held in Birmingham, Alabama, in July 2024. The SI aimed to equip participants to: (1) articulate key principles of IR; (2) distinguish how IR differs in global health from non-global health settings; (3) apply relevant IR approaches to global health and practice; and (4) operationalize IR to address health inequity in a global setting. The training format included a mix of lectures, moderated discussions, breakout groups, and cultural experiences in Birmingham, Alabama, given the city’s historical role in confronting issues of racial inequities in the United States. The week concluded with case presentations from all trainees and structured feedback to improve their proposals. The objective of this paper is to describe methods and findings from a competency-based assessment of the 2024 SCGH Summer Institute in Implementation Research in Global Health with a focus on health equity. The paper follows methods described for competency-based assessment of implementation research training programs in low- and middle-income countries [15]. This paper aims to provide insights into the impact of competency-based IR training programs for researchers and practitioners, and how these programs can be designed to address advanced competencies in IR, including tackling health equity and other gaps identified in the literature. The findings from this paper will contribute to methods and tools for competency-based assessment of short-term IR training and will be used to improve future iterations of the SCGH Summer Institute and similar training programs in global health settings. Methods Ethics statement Setting and recruitment The SCGH 2024 Summer Institute was held at the UAB School of Public Health (SOPH) in the heart of Birmingham, Alabama, a city established in 1871 with a rich civil rights history in the United States. Lectures and discussions were organized in SOPH classrooms equipped with high-tech facilities. Participants were accommodated in UAB dormitories, hotels, or on their own, based on their preferences and budget, all within walking distance of the SOPH facilities. Approach The SCGH Summer Institute (SI) was designed and curriculum developed by the senior author, OA, drawing on his experience and expertise teaching and conducting research in implementation science and health equity in global health settings, with the support of other IR experts and facilitators (Table 1), including IR experts with expertise in implementation science (IS) and equity research in diverse geopolitical settings, educational background, methodological approaches, and topics. Table 1 provides details on the topics covered, the competencies addressed, and the pedagogical strategies applied to address each topic. Topics covered included IR in global health; IS theories, models, and frameworks relevant to global health; application of selected IR methods to global health research and practice; and how to leverage IR for health equity in global health. The workshop combined four pedagogical strategies, including high-level lectures, case examples, a problem-solving clinic, and visit to the Birmingham Civil Rights Institute (BCRI) to provide contexts for discussion on equity. The SI concluded with case presentations of proposals for research/practice-related projects from all trainees developed before and during the Institute, through knowledge gain, peer-to-peer engagements, and faculty-led discussions. To guide systematic identification and assessment of equity considerations throughout their project’s lifecycle, equity analysis frameworks and worksheet were developed, and participants were guided on how to apply them [2]. These frameworks and worksheets make equity considerations explicit in IR design and reporting, ensuring equity across different populations, inclusion of vulnerable populations, and integration of structural and contextual factors as part of IR research/practice agenda [16]. Most participants stayed in the same location, further facilitating ongoing peer discussions. A welcome packet was developed and distributed prior to the SI to provide logistical details. A secure folder using the UAB Box platform was established to share lectures, readings, and other resources with participants prior to and during the workshop. Daily information emails were distributed to highlight the daily schedule and logistical details. The SCGH continues to engage with participants to build upon SI training and projects and recruit participants for subsequent SIs. Data collection and assessment tools We utilized the competency-based assessment data collection tools for IR training programs in low- and middle-income countries (LMICs), developed by Alonge, et al. [15], which in turn are based on a framework of IR core competencies in LMICs [14]. Briefly, the data collection tools included pre- and post-SI assessments, utilizing: (a)the Self-evaluation of Implementation Research Competencies and b) the Objective Assessment questionnaires. The Self-evaluation questionnaires consist of (1) a 16-item self-assessment scale for IR knowledge evaluated across six IR themes (working with stakeholders, scientific inquiry, implementation strategies, resources for IR competencies, communication and advocacy, and cross-cutting themes, including contexts and ethical considerations); (2) a 16-item self-assessment scale for IR self-efficacy to assess confidence of application of six IR themes included in the IR knowledge scale; (3) ten questions assessing prior experience in application or training others in IR competencies; and (4) a post-SI survey comprising of seven structured questions assessing participants satisfaction and perceived quality of the SI training – all rated on a Likert scale from 1 = strongly disagree to 7 = strongly agree. Moderate to high knowledge and/or confidence across IR competencies was defined as a rating of 5 or higher on the Likert scale. Similarly, moderate to high satisfaction was defined as a rating of 5 or higher. The Objective Assessment consists of 40 true-false statements assessing knowledge across six IR themes focused on IR principles, concepts, and methodologies. A prepared answer key was used to determine the correct response to each question. Both the self-evaluation and objective assessment tools report high validity and reliability based on exploratory factor analyses and a one-parameter logistic model study to establish construct validity and internal consistency of the tools [15]. For the SCGH SI, the tools were additionally adapted as follows: The pre-SI questionnaire assessing IR competencies included questions about the participant’s number of years working in global health, current professional position, and an open-ended question about any previous IR courses taken, and the post-SI assessment included optional open-ended questions to gather feedback on the quality and content of the training. All assessments were disseminated to the participants via a password-protected Qualtrics dashboard. Contact information provided during the SI registration was used to generate a unique identifier for accessing Qualtrics surveys. Each participant received an email containing this unique identifier, not related to or derived from information that identifies the participant. The pre-Institute assessments were sent via the Qualtrics platform a week before the SI. The post-SI assessments were sent at the conclusion of the SI. Automatic reminders during the week prior to SI and three weeks after the SI were sent to ensure high response rates. Within the Qualtrics platform, all questions were set to require a response to avoid omissions by mistake and to maintain the reliability and validity of the instruments. Participants could select “Not Applicable, N/A” if a question was not relevant. Safeguards were put in place to protect the privacy of study participants, and all identifiable data was scrubbed from the dataset before analysis. Data missingness was examined to identify any patterns or potential bias. There were no material benefits for the participants in this study. All data have been stored in the UAB Box. This study was exempt as non-human subject research by the UAB research ethics board. Ethical approval for this study has been obtained from the Institutional Review Board at the University of Alabama at Birmingham, protocol number IRB-300013258. The data were accessed for research purposes on November 5, 2024. Authors have not had access to information that could identify individual participants during or after data collection. Evaluation design and data analysis A pre- and post-quantitative evaluation design was used to assess participant knowledge and self-efficacy. Quantitative data collected from pre- and post-SI assessments were analyzed using Stata 18 (StataCorp, College Station, TX, USA). Descriptive statistics, including means and standard deviations for continuous variables and frequencies and percentages for categorical variables, were used to summarize participant demographic characteristics and baseline knowledge and self-efficacy in IR competencies. Self-assessed knowledge, objectively assessed knowledge, and self-efficacy scores were compared before and after the SI using t-tests for normally distributed variables and ranksum tests when normality assumptions were not met. In addition, the correlation of self-assessed and objectively assessed knowledge scores was estimated before and after the SI using Pearson’s correlation. Due to an error in capturing unique identifiers, pre- and post-assessments could not be linked at the individual level, and analyses were conducted using independent group comparisons. This limits causal inference regarding individual-level change. Associations between participant characteristics and changes in knowledge or self-efficacy scores were assessed using chi-square or Fisher’s exact tests for categorical variables and independent samples t-tests or Mann–Whitney U tests for continuous variables. To evaluate the psychometric properties of the objective assessment tool in the context of the SCGH SI, a one-parameter logistic model (Rasch model) was applied separately to pre- and post-assessment data to estimate item difficulty and discrimination parameters. Stability in item difficulty across assessments was used to assess the construct validity of the tool. Missing data were minimal (<5%) and analyses were based on available cases without imputation. Additionally, responses to open-ended survey questions were analyzed thematically [17,18], allowing for the identification of recurring themes related to participant experiences, perceived relevance of the training, and suggestions for future improvement. Results Overall, 28 participants from 12 countries attended the Sparkman Center for Global Health Summer Institute in July 2024 (Table 2). Women constituted 46.4% (n = 13) of participants. Over 40% of participants reported 5 or more years of global health experience at baseline, and approximately half had prior exposure to IR coursework, mainly at the introductory level. During the SI, participants developed their projects. The topical focus, geographic area, IR theories, models, and frameworks (TMFs) utilized and equity considerations for those projects are listed in Box 1. Most projects were set in LMICs, particularly in the African Region and Southeast Asia. Topically, most projects focused on maternal and child health, infectious diseases (HIV in particular), non-communicable diseases including cardiovascular issues, various types of cancer, and mental health. Most trainees used the Consolidated Framework for Implementation Research (CFIR) [19], Exploration, Preparation, Intervention, Sustainment (EPIS) [20], and Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) frameworks [21], often combined with other theoretical models/frameworks, e.g., Health Beliefs or the Socioecological Model. Equity considerations addressed vulnerable populations in low-resource settings globally, particularly those residing in rural communities. Self-evaluation of Implementation research competencies Pre-SI self-assessment data revealed that over half of participants reported a moderate confidence in engaging stakeholders (Table 3). However, confidence levels were notably lower for competencies related to conducting IR robustly and rigorously. Participants showed marked improvements in both self-assessed IR knowledge and self-efficacy across all six thematic domains after the IR course (Table 3). Statistically significant gains (p < 0.05 for all items) were observed in most competencies of IR knowledge: scientific inquiry, implementation strategies, resources for IR, and communication and advocacy. Similarly, statistically significant gains (p < 0.05) were observed in most competencies of self-efficacy: scientific inquiry, implementation strategies, and communication and advocacy. Post-SI assessment data showed a significant overall improvement observed across all self-assessed domains (Table 4) with the mean self-assessed knowledge and confidence increasing by 30.01 percentage points [from 57.67% (95% ci: 43.78 - 71.55) to 87.68% (95% ci: 76.96 - 98.41), p = 0.003]. Objective assessment questionnaire Objective assessment scores also demonstrated improvement. The percentage mean score on the 40-item objective test increased by 2.83 percentage points [from 65.35% (95% ci: 61.28 69.41) before to 68.18% (95% ci: 64.38 -71.97) after the IR workshop, p = 0.324] [Table 5]. The modest and non-significant increase in objective scores may reflect limited statistical power, potential ceiling effects inherent in the true-false format, and the short duration of follow-up. Item Response Theory (IRT) analysis showed that item difficulty parameters remained stable between the pre- and post-assessments, supporting the structural validity of the objective tool [Figs 1 and 2]. However, the discrimination parameter decreased from 0.79 before the IR workshop to 0.63 after the workshop, suggesting reduced ability of the tool to discriminate between high and low-ability participants after training. Overall, participants reported a high level of satisfaction with the SI, with over 94% expressing that the course was implemented with high quality and was directly applicable to their professional work. At baseline, the correlation between self-assessed knowledge and objectively assessed knowledge was low (r = 0.05, p = 0.804), indicating limited agreement between perceived and actual competence. Post-SI feedback from participants highlighted high satisfaction with the IR workshop structure, content, and delivery. Common suggestions included allocating more time for practical exercises, providing ongoing mentorship opportunities, and offering additional follow-up sessions to reinforce learning and support application in participant work contexts. Participants highlighted the practical focus on stakeholder engagement and the use of real-world case studies. Discussion IR is widely recognized as a tool to bridge the gap between research and practice, ensure appropriate contextual adaptations, provide solutions to complex global health challenges, increase efficiency, capacity, and sustainability of implemented programs, and provide evidence-based data for global health practice and policymakers [22]. Despite a number of available trainings in IR [23–25], ranging from in-person or remote webinars to short courses and academic programs, many are inaccessible or fail to have a real impact on participant competencies and confidence in applying presented material in real-life settings. Additionally, a few programs are provided in the global health space [23] with a focus on equity issues. SCGH SI provided a one-week intensive workshop that introduced IR in global health settings and delivered training on the application of IR concepts and methods to address health inequities in global health research and practice. The design of SCGH SI and assessments focused on increasing competencies across various IR and confidence in the application of presented methodologies in real-life settings. SCGH SI was associated with significant improvements in self-reported competencies and high participant satisfaction, although objective knowledge gains were modest. Competency-based training [12,13] is recognized as a path to the effective application and training of global health practitioners to achieve impact at scale; however, many trainings fail to achieve an increase in competencies or achieve impact across important competency domains. For example, evaluation of an established brief virtual IS training program reported improvement across domains, particularly in areas of definition, background, and rationale, while the competencies related to design and analysis showed the lowest improvement [26]. Evaluation suggests lower confidence in the application of IR and suggests the need for more case-based learning. Many training courses also fail to apply relevant and validated assessments to evaluate changes in competency-based skill development during the training. In the context of SCGH SI, the pre-SI self-assessments showed that more than half of the participants had already attended some courses introducing IR methodology. Further, many participants expressed some knowledge and confidence in certain IR competencies, particularly in stakeholder engagement and basic IR theories. However, the pre-SI objective assessment revealed gaps in competencies across domains. The post-assessments and projects developed within the SI highlighted the importance of training in the application of IR strategies to real-world solutions as emphasized by other training courses [23]. During SCGH SI, participants had the opportunity to apply newly acquired or enhanced skills in IR and equity to their projects and contexts and present their projects to peers and field expert trainers. This aspect of the SI – practical application of IR methodologies – was reflected in the self-assessed and objectively assessed increased knowledge and confidence in the utilization of IR concepts. Projects were developed by participants before attending the SI, often based in their geographical area and field. Given the residence and research fields, it is not surprising that most projects were set in LMICs, particularly in the African Region and Southeast Asia. The majority of topics focused on many priority areas in global health and health equity, and the focus of the Sustainable Development Goals (SDGs) [27], including maternal and child health, infectious diseases (particularly HIV), non-communicable diseases (cardiovascular issues, various types of cancer), mental health, and more, as well as crosscutting issues. Most participants in the SI were already established experts in their fields and were comfortable and confident in utilizing the methodology. Throughout SI discussions, participants expressed that they see the IR and equity framework as a path for addressing methodological and theoretical gaps in their research and practice, which they have not been able to fully address within their current field and existing methodologies. During the SI, the issues addressed and geopolitical areas indicate why these participants would be interested in developing competencies in IR methodologies with a particular focus on health equity [4]. In their projects, most participants selected to utilize the Consolidated Framework for Implementation Research (CFIR), Exploration, Preparation, Intervention, Sustainment (EPIS), and Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) frameworks. These were often in combination with other theoretical models and frameworks, including Health Beliefs and the Socioecological Model. Participants thus thoughtfully adapted and built upon their expertise and existing theories, models, and frameworks of their field to take advantage of IR and simultaneously advance IS [4]. While these theories, models, and frameworks were correctly applied, they may have been utilized because of the explicit coverage during the SI training and developed confidence in the application of these particular approaches. Additionally, participants expressed the need for further training and advanced methodologies that can be adapted and are suitable for their settings and contexts. SI participants were also explicitly trained and required to incorporate equity considerations into their projects. Most approached it by examining their populations and vulnerable geopolitical settings as indicators of potential health inequities. As discussed, projects were set in LMICs, a vulnerable setting in its own right. However, participants uncovered vulnerabilities within LMICs, including marginalized communities, socioeconomically disadvantaged populations, remote and rural hard-to-access populations, people living with stigmatized conditions, and health system vulnerabilities. While literature is evolving around the use of IR in global health and LMIC settings, critical gaps remain in how to specifically tackle various global health challenges, and few studies explicitly examine health inequities. However, it has become clear that IR must evolve to produce contextually grounded methodologies suitable for LMIC and resource-limited settings [4]. Some proposed approaches to address inequities through IR include explicating and monitoring outcomes for vulnerable groups, participatory approaches involving vulnerable groups in defining and implementing the IR agenda, and strategies addressing social and structural determinants of health – consistent with approaches suggested in the literature [2,5]. This paper further addresses gaps that exist in the objective assessment of the impact of IR trainings [23], particularly in the context of short-term training, by utilizing and validating tools for competency-based assessments of IR training explicitly developed for the low- and middle-income country settings [15]. The SCGH SI created a collaborative and enriching environment with diverse topics and geographic focus, facilitating networking opportunities and potential partnerships for future programs. This aspect of SCGH SI training is reflected by significant increases in scores across domains such as project co-design and stakeholder engagement. The positive collaborative setting during SCGH SI reflected high satisfaction with SI’s structure, content, and delivery. Participants emphasized the need for continued collaboration between SCGH SI trainers and peers. Furthermore, IR methodologies and applications are rapidly developing, underscoring the need for continuous IR training development and enhancement of new areas and aspects. Consideration of further competencies will be identified as critical in the effective application of IR. In addition to the need to provide training beyond basic concepts and short-term delivery, further resources and training may be developed to maintain competencies gained. While SCGH SI was provided in-person, accessibility of online and free-source resources for further impact is necessary to achieve impact on a global scale. Future assessments may provide valid comparisons of the impact of online versus in-person delivery. Strengths and limitations To our knowledge, this is one of the first studies that rigorously evaluates IR training in global health and equity, utilizing competency-based assessment adapted for LMIC settings, and providing further insight into an effective design of such training. This study was not without limitations. The assessments utilized have not shown a correlation between self-assessed and objectively assessed knowledge of IR concepts. The training reduced key competency gaps, suggesting that training reduced competency gaps, resulting in higher scores and a more uniform distribution. However, the assessment tool may require recalibration using a larger study sample to better discriminate at higher competency levels. Further, the True/false format may have introduced a ceiling effect, which could affect the accuracy of the discrimination parameter. The modest objective gain is qualitatively important considering the totality of evidence, given the statistically significant improvement in the self-reported knowledge and self-efficacy despite the small sample size. It is probably that with a larger sample size and power, the study may produce a statistically significant increase in objective score, and this warrants further study. Further, the modest objective gain may be due to a combination of factors, in addition to the small sample size, including factors related to the training (e.g., breadth and depth of the training content, course delivery and pedagogical style) and measurement limitation (e.g., ceiling effect with the True/false format, issues with data collection), and this warrants further investigation. The sample attrition pre-post may be due to data collection limitation – the pre samples were collected at the beginning of the training, on site, with all participants fully engaged while the post samples were collected a few days after the participants had departed the training site A paired analysis was not feasible given an error in capturing unique identifiers for some participants, who therefore could not be matched. For future assessments, we will implement an approach to assign personalized links that will allow a paired analysis and a more accurate assessment at an individual level, as well as association with personal and professional characteristics and prior experience with IR concepts. This paper aims to provide insights into the impact of competency-based IR training programs for researchers and practitioners, and how these programs can be designed to address advanced competencies in IR, including tackling health equity [23,26]. The findings from this paper also contribute to the methods and tools for competency-based assessment of IR training and will be used to improve the SCGH SI and similar training programs in global health settings. In the future, the SCGH SI aims to increase its impact and evaluation including (1) expanding the reach to practitioners going beyond academia-based researchers, offering the SI in other geopolitical locations, and online/hybrid delivery; (2) offering more personalized training based on the participant pre-SI competency level by offering simultaneous beginner and intermediate/advanced blended course with adaptations and level-based activities or separate beginner and advanced level trainings, and expanding competencies; (3) developing a rigorous plan for continuous engagement with trainees post-SI; (4) training the participants to lead SI in their locations; and (5) continuing to refine assessments and assessing long-term impact of SCGH SI, e.g., in the area of competency retainment, funding, and publications. Conclusions Implementation science is uniquely positioned to target inequity-reducing strategies and fast-track progress toward global health and meeting the SDGs. This evaluation suggests that the provision of a short-term, equity-focused intensive workshop focused on IS and equity with intentional hands-on practice and support from mentors and peers is feasible and may enhance perceived competencies for implementers of global health solutions across various settings and topical areas. Further studies using paired designs, larger samples, and longer follow-up are needed to assess sustained and objectively measurable impacts. Continued refining of assessment tools may further contribute to the effective design and implementation of research training in global health. Acknowledgments We acknowledge the support of the UAB School of Public Health and especially our Summer Institute participants. References - 1. Peters DH, Adam T, Alonge O, Agyepong IA, Tran N. Implementation research: what it is and how to do it. BMJ. 2013;347:f6753. pmid:24259324 - 2. Alonge O. How to leverage implementation research for equity in global health. Glob Health Res Policy. 2024;9(1):43. pmid:39420430 - 3. Braveman P, Arkin E, Orleans T, Proctor D, Plough A. What is health equity and what difference does a definition make?. Princeton, NJ: Robert Wood Johnson Foundation. 2017. - 4. Alonge O, Brooks MB. Implementation science derived from low- and middle-income countries is essential for advancing global health. BMC Glob Public Health. 2025;3(1):84. pmid:40983963 - 5. Alonge O. Using causal models and theories to achieve equitable implementation science in global health. BMC Glob Public Health. 2025;3(1):85. pmid:41029768 - 6. Woodward EN, Singh RS, Ndebele-Ngwenya P, Melgar Castillo A, Dickson KS, Kirchner JE. A more practical guide to incorporating health equity domains in implementation determinant frameworks. Implement Sci Commun. 2021;2(1):61. pmid:34090524 - 7. Welten VM, Dabekaussen K, Melnitchouk N. Global Health 101. Clin Colon Rectal Surg. 2022;35(5):355–61. pmid:36111085 - 8. Koplan JP, Bond TC, Merson MH, Reddy KS, Rodriguez MH, Sewankambo NK, et al. Towards a common definition of global health. Lancet. 2009;373(9679):1993–5. pmid:19493564 - 9. Chambers DA, Emmons KM. Navigating the field of implementation science towards maturity: challenges and opportunities. Implement Sci. 2024;19(1):26. pmid:38481286 - 10. Brownson RC, Cabassa LJ, Drake BF, Shelton RC. Closing the gap: advancing implementation science through training and capacity building. Implement Sci. 2024;19(1):46. pmid:38961482 - 11. Penkunas MJ, Ross B, Scott CP, Thorson A, Baron LF, Rebai WK, et al. Barriers to Applying Knowledge Gained Through an Implementation Research Massive Open Online Course: An Explanatory Qualitative Study. Inquiry. 2024;61:469580241284916. pmid:39548770 - 12. Schleiff MJ, Mburugu PM, Cape J, Mwenesi R, Sirili N, Tackett S. Training curriculum, skills, and competencies for global health leaders: good practices and lessons learned. Ann Glob Health. 2021;87(1):64. pmid:34307067 - 13. Hansoti B, Hahn E, Dolive C, Akridge A, Atwell M, Mishra A, et al. Training Global Health Leaders: A Critical Review of Competency Gaps. Ann Glob Health. 2021;87(1):65. pmid:34307068 - 14. Alonge O, Rao A, Kalbarczyk A, Maher D, Gonzalez Marulanda ER, Sarker M, et al. Developing a framework of core competencies in implementation research for low/middle-income countries. BMJ Glob Health. 2019;4(5):e001747. pmid:31544004 - 15. Alonge O, Rao A, Kalbarczyk A, Ibisomi L, Dako-Gyeke P, Mahendradhata Y, et al. Multimethods study to develop tools for competency-based assessments of implementation research training programmes in low and middle-income countries. BMJ Open. 2024;14(7):e082250. pmid:39013650 - 16. Eslava-Schmalbach J, Garzón-Orjuela N, Elias V, Reveiz L, Tran N, Langlois EV. Conceptual framework of equity-focused implementation research for health programs (EquIR). Int J Equity Health. 2019;18(1):80. pmid:31151452 - 17. Kiger ME, Varpio L. Thematic analysis of qualitative data: AMEE Guide No. 131. Med Teach. 2020;42(8):846–54. pmid:32356468 - 18. Braun V, Clarke V. What can “thematic analysis” offer health and wellbeing researchers?. Int J Qual Stud Health Well-being. 2014;9:26152. pmid:25326092 - 19. CFIR Research Team C for CMR. Consolidated Framework for Implementation Research (CFIR). https://cfirguide.org - 20. Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011;38(1):4–23. pmid:21197565 - 21. Holtrop JS, Estabrooks PA, Gaglio B, Harden SM, Kessler RS, King DK, et al. Understanding and applying the RE-AIM framework: Clarifications and resources. J Clin Transl Sci. 2021;5(1):e126. pmid:34367671 - 22. Theobald S, Brandes N, Gyapong M, El-Saharty S, Proctor E, Diaz T, et al. Implementation research: new imperatives and opportunities in global health. Lancet. 2018;392(10160):2214–28. pmid:30314860 - 23. Davis R, D’Lima D. Building capacity in dissemination and implementation science: a systematic review of the academic literature on teaching and training initiatives. Implement Sci. 2020;15(1):97. pmid:33126909 - 24. Baumann AA, Carothers BJ, Landsverk J, Kryzer E, Aarons GA, Brownson RC, et al. Evaluation of the Implementation Research Institute: Trainees’ Publications and Grant Productivity. Adm Policy Ment Health. 2020;47(2):254–64. pmid:31667667 - 25. Means AR, Phillips DE, Lurton G, Njoroge A, Furere SM, Liu R, et al. The role of implementation science training in global health: from the perspective of graduates of the field’s first dedicated doctoral program. Glob Health Action. 2016;9:31899. pmid:27846928 - 26. Van Pelt AE, Bonafide CP, Rendle KA, Wolk C, Shea JA, Bettencourt A, et al. Evaluation of a brief virtual implementation science training program: the Penn Implementation Science Institute. Implement Sci Commun. 2023;4(1):131. pmid:37932840 - 27. Rasanathan K, Diaz T. Research on health equity in the SDG era: the urgent need for greater focus on implementation. Int J Equity Health. 2016;15(1):202. pmid:27938374