Toward the sustainability of health care innovations to "transform our world": current status and the road ahead.

abstractInadequate sustainability of health care innovations or evidence-based interventions has led to calls from policymakers, researchers, and funders for research on how sustainability can be optimized to avoid research waste. In this discussion paper, we argue that research on health care innovation sustainability needs to be advanced. We critically examine the literature on the concept of sustainability and propose that research should address the fundamental question: How can we advance knowledge on health care innovation sustainability? We provide examples of important work undertaken in the field of implementation science, including definitions and conceptualizations of sustainability. We also highlight theories, models, and frameworks that have been proposed to inform sustainability research and guide how to plan for sustainability. Our analysis of the literature reveals a growing interest in the sustainability of health care innovations but also confirms that implementation science has yet to put sustainability at the center of its research endeavors. To assist this shift, we identify priority research gaps and use the United Nations 2030 Agenda for Sustainable Development as a road map for an implementation science research agenda to drive health care innovation sustainability. We propose three new research directions that, overall, aim for "better health for all, leaving no one behind." These directions include: (1) advancing substantive research on sustainability while avoiding duplication; (2) identifying barriers, facilitators, and strategies to sustain engagement with multiple partners; and (3) advancing methods and tools to support monitoring, evaluation, and revision of strategies over time. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A323.