Adaptations to implementation frameworks for minority ethnic groups to improve health equity: systematic scoping review

Background There are critical gaps within implementation science concerning health equity, particularly for minoritised ethnic groups. Implementation framework adaptations are important to facilitate health equity, which is especially relevant for psychiatry due to ethnic inequities in mental heal...

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Main Authors: Emma Mckenzie, Phoebe Barnett, Georgie Parker, Stephen Pilling
Format: Article
Language:English
Published: Cambridge University Press 2025-09-01
Series:BJPsych Open
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Online Access:https://www.cambridge.org/core/product/identifier/S2056472425100756/type/journal_article
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author Emma Mckenzie
Phoebe Barnett
Georgie Parker
Stephen Pilling
author_facet Emma Mckenzie
Phoebe Barnett
Georgie Parker
Stephen Pilling
author_sort Emma Mckenzie
collection DOAJ
description Background There are critical gaps within implementation science concerning health equity, particularly for minoritised ethnic groups. Implementation framework adaptations are important to facilitate health equity, which is especially relevant for psychiatry due to ethnic inequities in mental health; however, the range of potential adaptations has yet to be synthesised. Aims This systematic scoping review aimed to identify and map the characteristics of adaptations to implementation frameworks for minority ethnic groups to improve health equity. Method Bibliographic searches of the MEDLINE, Embase, PsycINFO and CINAHL databases were conducted, spanning the period from 2004 to February 2024 for descriptions of implementation frameworks adapted for minority ethnic groups. The characteristics of those meeting the criteria were narratively synthesised. Results Of the 2947 papers screened, six met the eligibility criteria. Three different types of implementation frameworks were adapted across the six papers: evaluation, process and determinant frameworks. Most of the adaptations were made by expanding the original framework, and by integrating it with another model, theory or framework with an equity focus. The adaptations primarily focused on putting equity at the forefront of all stages of implementation from intervention selection to implementation sustainability. No studies measured the effectiveness of the adapted framework. Conclusions The findings demonstrate that implementation frameworks are modifiable, and different elements can be adapted according to the implementation framework type. This review provides a starting point for how researchers and healthcare providers can adapt existing implementation frameworks to promote health equity for minoritised groups across a range of healthcare settings.
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spelling doaj-art-c051bd554f934f7b899be4bf0a3c20c12025-08-20T02:55:04ZengCambridge University PressBJPsych Open2056-47242025-09-011110.1192/bjo.2025.10075Adaptations to implementation frameworks for minority ethnic groups to improve health equity: systematic scoping reviewEmma Mckenzie0https://orcid.org/0000-0002-5213-2561Phoebe Barnett1https://orcid.org/0000-0001-6521-3101Georgie Parker2https://orcid.org/0000-0001-6767-1923Stephen Pilling3https://orcid.org/0000-0002-7361-8202Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UKCentre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UKCentre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UKCentre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK Background There are critical gaps within implementation science concerning health equity, particularly for minoritised ethnic groups. Implementation framework adaptations are important to facilitate health equity, which is especially relevant for psychiatry due to ethnic inequities in mental health; however, the range of potential adaptations has yet to be synthesised. Aims This systematic scoping review aimed to identify and map the characteristics of adaptations to implementation frameworks for minority ethnic groups to improve health equity. Method Bibliographic searches of the MEDLINE, Embase, PsycINFO and CINAHL databases were conducted, spanning the period from 2004 to February 2024 for descriptions of implementation frameworks adapted for minority ethnic groups. The characteristics of those meeting the criteria were narratively synthesised. Results Of the 2947 papers screened, six met the eligibility criteria. Three different types of implementation frameworks were adapted across the six papers: evaluation, process and determinant frameworks. Most of the adaptations were made by expanding the original framework, and by integrating it with another model, theory or framework with an equity focus. The adaptations primarily focused on putting equity at the forefront of all stages of implementation from intervention selection to implementation sustainability. No studies measured the effectiveness of the adapted framework. Conclusions The findings demonstrate that implementation frameworks are modifiable, and different elements can be adapted according to the implementation framework type. This review provides a starting point for how researchers and healthcare providers can adapt existing implementation frameworks to promote health equity for minoritised groups across a range of healthcare settings. https://www.cambridge.org/core/product/identifier/S2056472425100756/type/journal_articleHealth equityethnic inequitiesimplementation frameworkscultural adaptationsscoping review
spellingShingle Emma Mckenzie
Phoebe Barnett
Georgie Parker
Stephen Pilling
Adaptations to implementation frameworks for minority ethnic groups to improve health equity: systematic scoping review
BJPsych Open
Health equity
ethnic inequities
implementation frameworks
cultural adaptations
scoping review
title Adaptations to implementation frameworks for minority ethnic groups to improve health equity: systematic scoping review
title_full Adaptations to implementation frameworks for minority ethnic groups to improve health equity: systematic scoping review
title_fullStr Adaptations to implementation frameworks for minority ethnic groups to improve health equity: systematic scoping review
title_full_unstemmed Adaptations to implementation frameworks for minority ethnic groups to improve health equity: systematic scoping review
title_short Adaptations to implementation frameworks for minority ethnic groups to improve health equity: systematic scoping review
title_sort adaptations to implementation frameworks for minority ethnic groups to improve health equity systematic scoping review
topic Health equity
ethnic inequities
implementation frameworks
cultural adaptations
scoping review
url https://www.cambridge.org/core/product/identifier/S2056472425100756/type/journal_article
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AT phoebebarnett adaptationstoimplementationframeworksforminorityethnicgroupstoimprovehealthequitysystematicscopingreview
AT georgieparker adaptationstoimplementationframeworksforminorityethnicgroupstoimprovehealthequitysystematicscopingreview
AT stephenpilling adaptationstoimplementationframeworksforminorityethnicgroupstoimprovehealthequitysystematicscopingreview