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Open research questions in Health Policy Implementation Science

156 unresolved questions extracted from the limitations and future-work sections of 2,476 Health Policy Implementation Science papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • The approach could be replicated in other CAMHS, turning them into a network of living labs that could assess many different interventions simultaneously. Despite these constraints, Inishowen illustrates how a small team can test ideas rapidly, reflect collectively, and adapt care processes, offering a model that could be replicated in the broader mental health system and in other specialties.

    Inishowen Child and Adolescent Mental Health Service: Developing a Learning Health Microsystem · 2026 · DOI

  • targeted that that strategy emerging integrated equity-focused There are several strengths of our study that advances previous research. First, an important strength of this work was the research-practice partnership constituent engagement throughout implementation planning and delivery. As opposed to traditional clinical trials that deploy a fixed intervention, ALTA’s relied on implementation continuous engagement with frontline staff, FQHC leadership, and the centralized QI team to tailor workflows, training approaches, and facilitation strategies to the realities of safety- net primary care practices. This participatory approach is consistent with implementation frameworks (e.g., IM4Equity, Digital Health Equity-Focused Implementation Research Model) (14–17) emphasizing the implementation strategies with the importance of aligning priorities, organizational capacities, and lived experience of medically underserved communities and settings. Second, it provides one of the first multidimensional evaluations of implementation fidelity for a multilevel intervention in resource- limited settings serving medically underserved populations. By evaluating fidelity at the implementer level, the study offers robust insights into how specific components of a multilevel model are integrated into routine practice. Moreover, tracking program differentiation enabled alignment with an existing hypertension initiative, allowing for seamless integration into clinical workflows without added burden—an advantage that may not have been achievable without intentionally tracking this dimension. Third, this work adds to the growing but still limited evidence base on practice facilitation by demonstrating how tailored, hands-on support can strengthen implementation fidelity. Practice facilitators helped primary care teams adapt workflows, train staff, and effectively use digital health tools, ensuring consistent delivery of the ALTA components and hypertension management protocols. Fourth, study employed a multi-method approach that used both structured fidelity metrics the EHR and qualitative reports and interviews that allowed us to document the contextual and organizational factors that drove variations in the fidelity dimensions. Embedding fidelity metrics into the EHR also enabled a pragmatic method to continuously monitor the implementation process in real-time without disrupting clinic workflows. This approach overcame limitations of prior studies that relied on subjective measures of fidelity assessed within a limited time point (often after implementation has ended), which can introduce recall bias and social desirability (29).

    Bridging evidence and practice: multi-method evaluation of implementation fidelity of a multilevel hypertension intervention in a federally qualified health center · 2026 · DOI

  • Limited research has explored how patients, relatives, and healthcare professionals perceive the content and delivery of SDM for managing SAPS in primary care.

    Exploring stakeholder perspectives on the content, delivery, and contextual delivery of shared decision-making for people living with subacromial pain syndrome: a multimethod study with future workshops and interviews · 2026 · DOI

  • Although the present study has offered new perspectives around CHRC roles and functions, adding to extant knowledge, it is not without methodological limitations. The first one is that, as a qualitative study, it may shed light on the features of a phenomenon but cannot quantify the trends at large, thus remaining limited in its generalizability. Additionally, we conducted a detailed examination of the recollection of experiences by respondents who had been involved in prior research; those recollections may be open to biases such as recall bias and prosocial bias. Finally, our highly targeted population groups allowed us to attain a rather large overview of what works and what does not work when it comes to optimizing a CHRC among diverse, vulnerable, and challenging population groups; but it is not a complete overview. FUTURE DIRECTIONS We plan to propose pilot study components in future CTSI-funded projects, where different CHRC profiles would be debated, co-created, and co-implemented by URs and CRs. Those partnerships will allow us to quantify and refine our understanding of how to operationalize the CHRC position in a variety of projects; such contrasts will help focus and refine the CHRC figures that work across specified community contexts and university structures.

    Co-Designing the Role of a Community Health Research Champion: A Grounded Theory Assessment of University and Community Perspectives · 2026 · DOI

  • Marshall Allen, MPA1, David M. Craig, Ph.D.2,3, Gerardo Maupomé, Ph.D.3,4 1 African American and African Diaspora Studies, Indiana University Bloomington, 2 Religious Studies, Indiana University Indianapolis, 3 Community Health Partnerships, Indiana Clinical and Translational Sciences Institute, 4 Richard M.

    Co-Designing the Role of a Community Health Research Champion: A Grounded Theory Assessment of University and Community Perspectives · 2026 · DOI

  • We plan to propose pilot study components in future CTSI-funded projects, where different CHRC profiles would be debated, co-created, and co-implemented by URs and CRs. Those partnerships will allow us to quantify and refine our understanding of how to operationalize the CHRC position in a variety of projects; such contrasts will help focus and refine the CHRC figures that work across specified community contexts and university structures.

    Co-Designing the Role of a Community Health Research Champion: A Grounded Theory Assessment of University and Community Perspectives · 2026 · DOI

  • Results: Barriers were consistent across both institutions, including technical challenges (connectivity and hardware issues), knowledge deficits (insufficient clinician training), patient-level factors (low health literacy, language barriers, medical mistrust, privacy concerns), and organizational constraints (poor EHR integration, lack of standardized protocols, regulatory limitations).

    1939-P: Clinician Perspectives on Implementing Continuous Glucose Monitoring in the Hospital and Discharge Settings · 2026 · DOI

  • These challenges are even more pronounced in data science, particularly within large-scale research, where PPIE is often underreported, leaving the field without a clear framework for meaningful implementation.

    Beyond the dataset: integrating public voices in data science · 2026 · DOI

  • While the Learning Health System (LHS) is a unifying platform developed to accelerate knowledge cycles, evidence generation, testing, and application, its role in governing translational flows across different organization types remains insufficiently specified.

    Knowledge Traffic in Learning Health Systems: A Conceptual Framework for Organizational Phenotyping and Translational Governance · 2026 · DOI

  • system; resource Also, there are certain contextual limitations of this study including challenges posed by the systemic fragmentation of the health limited infrastructure, workforce shortages, medication stock-outs, and digital literacy disparities; policy and governance constraints; stigma and community engagement related challenges.

    Integrating screening and management of mental disorders, including substance use disorders into other non-communicable disease care: insights from theory-informed implementation strategies creation for implementation model M0 in Faridabad, India as part of ICMR-MINDS project · 2026 · DOI

  • The cross-cultural adaptation methodology developed for the implementation science glossary has not been tested or validated for applicability to other languages or disciplinary contexts with dense theoretical terminology, limiting evidence for methodological generalizability.

    Cross-cultural adaptation of an implementation science glossary into simplified Chinese: study protocol · 2026 · DOI

  • Real-world impact evaluation is needed to explore how glossary use influences knowledge uptake, interdisciplinary communication, and stakeholder perceptions of usability and relevance in applied implementation science settings across Chinese-speaking contexts.

    Cross-cultural adaptation of an implementation science glossary into simplified Chinese: study protocol · 2026 · DOI

  • The study lacks a formal field pretest with downstream user validation through research integration into teaching, graduate training, stakeholder workshops, or practical application in implementation science research and practice settings across Chinese-speaking contexts.

    Cross-cultural adaptation of an implementation science glossary into simplified Chinese: study protocol · 2026 · DOI

  • The content validity index (CVI) and face validity index (FVI) assessments are limited to a relatively small panel of academically-trained experts from establishment IS frameworks, potentially missing the interpretive perspectives of frontline practitioners, policymakers, and users across diverse Chinese-speaking regions and implementation science subfields.

    Cross-cultural adaptation of an implementation science glossary into simplified Chinese: study protocol · 2026 · DOI

  • The glossary adaptation process does not critically interrogate whether all implementation science constructs are equally relevant or transferable across Chinese-speaking systems, which would require empirical investigation of construct applicability and epistemological fit within local institutional, organizational, and policy contexts.

    Cross-cultural adaptation of an implementation science glossary into simplified Chinese: study protocol · 2026 · DOI

  • Results: This study highlighted the rarely reported perspectives of executives and institutional partners, shedding light on the organizational components that are essential to the deployment and sustainability of Project ECHO.

    Exploring the Implementation of Multiple Telementoring ECHO Programs From an Institutional and Organizational Perspective: Qualitative Study · 2025 · DOI

  • Despite a growing body of evidence supporting its effectiveness, little is known about the implementation processes of multiple ECHO programs within an institution from the perspective of executives and institutional leaders.

    Exploring the Implementation of Multiple Telementoring ECHO Programs From an Institutional and Organizational Perspective: Qualitative Study · 2025 · DOI

  • When empirical evidence is lacking, theory and frameworks should guide the equity assessments in four areas: 1) understanding historical context, meaning root causes of disparities and inequity; 2) understanding intervention design and intended beneficiaries; 3) understanding differential impact and intersectionality; and 4) understanding community context before implementing or scaling interventions.

    Centering Equity in Evidence‐Informed Decision Making: Theoretical and Practical Considerations · 2025 · DOI

  • Analysis of the program's evolution reveals critical elements to its development and implementation, including but not limited to adaptive learning environments that respond to emerging needs, cross-sectoral collaboration fostered through mentorship, and balanced instructional formats that combine theoretical depth with practical application.

    A national curriculum and community of practice for health services and policy research training: Insights from the Health System Impact Fellowship National Cohort Training Program ( <scp>HSIF NCTP</scp> ) · 2025 · DOI

  • While the field recognises that pre- and posttest evaluation do not sufficiently capture the complex dynamics around OHP interventions, complex multi-level OHP interventions are still scarce in the literature.

    Opportunities and challenges in designing and evaluating complex multilevel, multi-stakeholder occupational health interventions in practice · 2024 · DOI

  • A limitation of this study is that the research was designed based on the traditional (generic) structure of research studies or theses without considering the specific features of all types of research (Paltridge and Starfield 2020). The issue of premature closure of data collection has been pinpointed by several scholarly works, which recommended justifying thoroughly the reasons behind inadequate samples, showing transparently how the phenomenon was not fully investigated, and, correspondingly, making specific suggestions on how to address this in future research (Morse 2015b; Patton 2015; Wagner et al.

    Purposive sampling in qualitative research: a framework for the entire journey · 2024 · DOI

  • Symptoms of asthma are often underrecognized in children from South Asian communities in the UK, contributing to increased disease severity and increased attendance at the emergency department compared to White British children.

    Key considerations when involving children in health intervention design: reflections on working in partnership with South Asian children in the UK on a tailored Management and Intervention for Asthma (MIA) study · 2022 · DOI

  • Although there is insufficient information on sustainability of successfully implemented interventions, it is estimated that it takes an average of 17 years to move an efficacious intervention from inception towards system sustainability (Balas & Boren, 2000).

    Embracing Implementation Science: A Paradigm Shift for Nursing Research · 2019 · DOI

  • CONTEXT: Adult primary care practices of accountable care organizations (ACOs) are adopting a range of patient engagement strategies, but little is known about how these strategies are related to patient-reported outcomes (PROs) and how relational coordination among team members aids implementation.

    Linking Practice Adoption of Patient Engagement Strategies and Relational Coordination to Patient‐Reported Outcomes in Accountable Care Organizations · 2019 · DOI

  • Results indicated that an explicit model or organizing framework is rarely used to plan, implement, and/or evaluate TA; specific TA tasks performed vary widely across studies; TA is rarely delivered to recipients who are seeking to sustain innovations subsequent to adoption and implementation; however, there is systematic attention to relationships and relationship-building.

    Technical Assistance to Enhance Prevention Capacity: a Research Synthesis of the Evidence Base · 2016 · DOI

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156 open questions have been extracted from the limitations and future-work passages of 2,476 Health Policy Implementation Science papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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