Promoting equity for children and adolescents through implementation processes in health and social care: a scoping review.

backgroundDespite the many existing implementation methods, theories, and frameworks, implementation science is insufficiently closing the research-to-practice gap. Bridging this gap is critical to achieving healthy and thriving communities globally, and requires implementation processes that promote equity and reach diverse populations, especially those most in need. The aim of this scoping review was to identify, thematically analyse, categorise, and provide examples of implementation processes described in equity-focused literature, with a focus on health and social care interventions for children and adolescents from birth to 18 years of age.

methodsA comprehensive search of literature was undertaken across six electronic databases (Medline, Embase, Cinahl, Scopus, PsycInfo, and Proquest) and Google Scholar, seeking peer-reviewed articles published in English between January 2018 and April 2024. All articles were double-screened at abstract and full text stage. Implementation processes were identified then thematically analysed.

resultsA total of 14,374 articles were screened; 80 articles (59 health, 21 social care) were included in the analysis. Seven main themes were identified: (1) foster trusting relationships; (2) dismantle top-down approaches and redistribute power; (3) invest with intention; (4) respect and value community-defined evidence; (5) tailor according to context; (6) broaden perspectives beyond practice norms; and (7) use strengths- and value-based approaches. Twenty-six sub-themes and 140 implementation processes were identified, including examples of how these can be operationalised in practice.

conclusionThis is the first review of equity-focused implementation processes in health and social care. By offering practical examples of the identified implementation processes, the review synthesises findings from published literature into tangible actions directly relevant to implementation practice. However, while these processes show promise, further research is required as their effectiveness remains largely untested and most evidence is from high-income countries. To promote health and social care equity for all children and adolescents, the evidence-base for effective equitable implementation work must be strengthened by, and reflective of, globally diverse voices and experiences.