Dr. Gregory Aarons

Frontiers | Leveraging the dynamic adaptation process to address LGBTQ+ health equity in New Mexico high schools BackgroundReducing adolescent suicide in the United States is a public health priority, and lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth are...

We published the participatory community-engaged implementation strategy "Dynamic Adaptation Process" (DAP) in 2012 - here is a 2025 demonstration of the DAP to reduce factors related to adolescent #suicide in schools doi.org/10.3389/frhs...

Implementation of state health insurance benefit mandates for cancer-related fertility preservation: following policy through a complex system - Implementation Science Background A myriad of federal, state, and organizational policies are designed to improve access to evidence-based healthcare, but the impact of these policies likely varies due to contextual determinants of, reinterpretations of, and poor compliance with policy requirements throughout implementation. Strategies enhancing implementation and compliance with policy intent can improve population health. Critically assessing the multi-level environments where health policies and their related health services are implemented is essential to designing effective policy-level implementation strategies. California passed a 2019 health insurance benefit mandate requiring coverage of fertility preservation services for individuals at risk of infertility due to medical treatments, in order to improve access to services that are otherwise cost prohibitive. Our objective was to document and understand the multi-level environment, relationships, and activities involved in using state benefit mandates to facilitate patient access to fertility preservation services. Methods We conducted a mixed-methods study and used the policy-optimized exploration, preparation, implementation, and sustainment (EPIS) framework to analyze the implementation of California’s fertility preservation benefit mandate (SB 600) at and between the state insurance regulator, insurer, and clinic levels. Results Seventeen publicly available fertility preservation benefit mandate-relevant documents were reviewed. Interviews were conducted with four insurers; 25 financial, administrative, and provider participants from 16 oncology and fertility clinics; three fertility pharmaceutical representatives; and two patient advocates. The mandate and insurance regulator guidance represented two “Big P” (system level) policies that gave rise to a host of “little p” (organizational) policies by and between the regulator, insurers, clinics, and patients. Many little p policies were bridging factors to support implementation across levels and fertility preservation service access. Characterizing the mandate’s functions (i.e., policy goals) and forms (i.e., ways that policies were enacted) led to identification of (1) intended and unintended implementation, service, and patient outcomes, (2) implementation processes by level and EPIS phase, (3) actor-delineated key processes and heterogeneity among them, and (4) inner and outer context determinants that drove adaptations. Conclusions Following the midstream and downstream implementation of a state health insurance benefit mandate, data generated will enable development of policy-level implementation strategies, evaluation of determinants and important outcomes of effective implementation, and design of future mandates to improve fit and fidelity.

Study led by Irene Su, M.D. - EPIS framework illustrates when a legislative health policy is passed, it winds its way through a maze of insurance regulation, health insurer benefit design, and how health care organizations and patients navigate these structures and processes. doi.org/10.1186/s130...

Testing a multi-faceted strategy to support the implementation of ACEs screenings in primary care: results of a stepped-wedge pilot trial - Implementation Science Communications Background Adverse Childhood Experiences (ACEs) screenings are increasingly being used in primary care clinics to identify toxic stress and potential trauma in children. ACEs are negative life events (e.g., violence exposure) occurring before age 18, that can increase health risks when unaddressed. However, we lack evidence on the impact of ACEs screenings and how they can be feasibly implemented in community-based clinics. We partnered with federally qualified health clinics to test the impact of a multifaceted implementation strategy on ACEs screening reach and mental health referrals for children ages 0–5. Methods We conducted a Hybrid Type 2 pilot trial using a stepped-wedge design (2021–2024). Reach data was measured as the proportion of eligible children screened for ACEs, with data collected from Electronic Health Records. We also assessed the percentage of mental health service referrals among all eligible children. Study clinics (n = 3) switched from no ACEs screenings (control) to implementing ACEs screenings supported by the multi-faceted ACE implementation strategy (intervention). The tested strategy comprised personnel training (e.g., trauma-informed care), integrated technology, team-based screening workflows, and ongoing care team implementation support. Additional clinics (n = 2) implemented ACEs screenings as usual without the strategy and served as additional comparison sites for exploratory analyses. Log-binomial and robust Poisson regression models examined differences in screening reach and referrals and were adjusted for site and patient race. Results Screening reach rates increased in the intervention period, from 0.0% of patients screened during control to 11.2% screened during intervention. Mental health service referrals increased from 0.4% at control to 7.2% during the intervention, resulting in a risk difference (95% confidence interval) of 6.9% (6.0%, 7.7%). For both the reach and referral outcomes, risk differences were significantly greater for 18-to-60-month-old patients than for patients under 18-months-old. Discussion Healthcare policy efforts promoting ACEs screenings in primary care are commendable. We found that a multi-faceted implementation strategy informed by partners and designed to support ACEs screenings in community-based clinics was feasible. However, its impact was attenuated by policy requirements, clinics’ capacity to add ACEs screenings to strained workflows, and multiple impactful outer-context events related and unrelated to the COVID-19 pandemic. Trial registration Trial # NCT04916587 registered at clinicaltrials.gov on June 4, 2021, https://clinicaltrials.gov/study/NCT04916587

Adverse childhood experiences (ACES) are linked to lifespan physical & mental health problems. This study led by Monica Perez-Jolles improved ACES screening outcomes using a multi-faceted implementation strategy. @ucsd-disc.bsky.social @accordsresearch.bsky.social link.springer.com/article/10.1...

The University of Glasgow groundspeople are going to be quite annoyed when they come in to work tomorrow...

Site engagement in implementation research: Introducing SEAMLIS as a conceptual and measurement framework - Health & Justice Background Multisite implementation research in justice and health settings often does not systematically assess differential degrees of project involvement among participating sites, despite its impl...

New article led by Sarah Jones with an approach to site engagement in multisite #implementation research healthandjusticejournal.biomedcentral.com/articles/10....

San Diego #NoKings

📢 Join us for the June EPIS Office Hours! We’re excited to welcome Dr. Marisa Sklar as our guest host this month! Please note: June’s office hours will be held at only one time point (8-9 am PT) drop by to ask questions and connect with an EPIS expert. #EPISFramework

Frontiers | Leveraging the dynamic adaptation process to address LGBTQ+ health equity in New Mexico high schools BackgroundReducing adolescent suicide in the United States is a public health priority, and lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth are...

New study results on the Dynamic Adaptation Process #implementation strategy use for #EBPs for #LGBTQ+ youth and including #nurses in #schools

www.frontiersin.org/journals/hea...

It’s @arc-southlondon.bsky.social Implementation Science Masterclass time @kingscollegelondon.bsky.social Big thanks to our colleagues joining from all over the world to share their expertise including @drgregaarons.bsky.social @grahammoore.bsky.social and many more 🙏

Love Fog City
Diner. Glad that I went last fall when I was at a conference in SF. Will be missed...

I am so looking forward to this fun event with creative ways to communicate about implementation science!

“Going above and beyond” for implementation in the education sector: extension and validation of the School Implementation Citizenship Behavior Scale (SICBS) - Implementation Science Communications Background Employee behaviors that strategically support implementation (i.e., implementation citizenship behavior [ICB]) theoretically promote the adoption and high-fidelity use of evidence-based pra...

New paper led by @drcathycorbin.bsky.social the School Implementation Citizenship Behavior Scale. Strong #implementation #citizenship means that employees help others, keep informed, take initiative, & advocate for #EBP implementation. implementationsciencecomms.biomedcentral.com/articles/10....

Frontiers | An iterative approach to evaluating impact of CTSA projects using the translational science benefits model IntroductionDemonstrating the relevance and impact of translational research across diverse settings is crucial making the research-to-practice pipeline more...

Excited to share our new article led by Kera Swanson on using the Translational Science Benefits Model (TSBM) to demonstrate the real-world impact of #translational and #implementation #science @ucsd-disc.bsky.social @implementeic.bsky.social
www.frontiersin.org/journals/hea...

Mine and hope for more

Improving #implementation is key to overcoming #policy failure, write CEI experts Jane Lewis & Dr Robyn Mildon in a commentary for @schoolforgovt.bsky.social. #impsci #evidence #research #practice #scaling

please share with your networks@ucsd-disc.bsky.social @implementsci.bsky.social @implementeic.bsky.social @impact-swiss.bsky.social @washu-dandi.bsky.social

Implementation science grant terminations in the United States - Implementation Science

Please see our editorial led by @rsbeidas.bsky.social on the impact of US federal grant terminations on the field of implementation science in the US and globally. imphttps://implementationscience.biomedcentral.com/articles/10.1186/s13012-025-01434-7

So important to have strong, intelligent, caring and courageous women role models. Especially now when government forces try to minimize the roles and value of women in society and life.

Exclusive: NIH to suspend funds for research abroad as it overhauls policy Move by US biomedical agency threatens thousands of projects on infectious diseases, cancer and more.

Potential impact for global health research. www.nature.com/articles/d41...

Hey! We are not at war!!

BREAKING UPDATE:
Wisconsin Attorney General Josh Kaul is suing Elon Musk to block his $1 million bribes to voters.

www.pbs.org/newshour/pol...

White House withdraws Trump's pick Dave Weldon as CDC director pick The White House is withdrawing President Donald Trump's nomination of Republican former congressman and vaccine critic Dave Weldon to serve as director of the U.S. Centers for Disease Control and Prevention, a source briefed on the matter said on Thursday.

Trump just withdrew the bad CDC nominee after public blowback about the measles vaccine.

Scientists, we can achieve the same with the bad NIH nominee. Public pressure can force out Bhattacharya.
Your voices are needed now. Please take action. 🧪

@mcuban.bsky.social this is a long shot but my account is small & the losses to science are too great to not ask for favors. Please consider getting the word out about AHRQ & NIH funding cuts. We are losing a generation of scientists & American innovation. Thanks! 🤞🙏

🙏 Shameless ask: It’s my birthday. Scientists, please call your Congress peeps & tell them why AHRQ & NIH are critical to curing cancer, treating & preventing substance use, ensuring healthcare access in rural America, the list goes on. Without real #AHRQ & #NIH funding we will be a sicker country.

From 2010 to 2016 (latest data I have ), NIH research contributed to EVERY drug approved by the FDA

Sources inside NIH say DOGE is at one of their buildings right now.

If you have additional info, i’m marisakabas.04 on Signal.

Guidance on integrating mixed methods in MH research has been available for years (Palinkas et al 2013). link.springer.com/article/10.1.... Glad to see this latest article reminding us of its benefits and challenges.

👋 In case you missed it! February's DISC Seminar on "Team functioning and Implementation of Innovations in Healthcare and Human Service Settings" is now available on the DISC Website!

Special thanks to Dr. Elizabeth McGuier for a great presentation! 👏

🔗 youtu.be/I-qI5faiSaI