Various factors can keep people and systems from changing their behavior when it comes to environmental health. One issue is access, as people may not have access to resources or environments that are healthy for them. Another challenge is knowledge, as scientists do not always know what specific actions will promote healthier lives. But then there are situations where it is clear what the right thing is to do, and it is still not being done, Meghan Lane-Fall, M.D., explained during her Jan. 10 Keystone Science Lecture.

“That's where implementation science shines,” said Lane-Fall, a physician-scientist and executive director of the Penn Implementation Science Center. “Implementation science is really about bridging the gap between evidence and practice.”

During her talk, Lane-Fall provided an overview of implementation science, highlighted the principles of environmental justice, and discussed potential synergies between the two fields.

The lecture was hosted by Lindsey Martin, Ph.D., a health scientist administrator in the NIEHS Population Health Branch. Martin is a medical anthropologist and supports a broad portfolio focused on environmental health disparities, social and environmental determinants of health, community-engaged research, and implementation science.

“Dr. Lane-Fall is a true leader in implementation science, where her work advances the field through collaborative projects, pioneering methodology, and capacity building,” said Martin.

The next step

“Researchers often follow a ‘Field of Dreams’ mentality, believing ‘if we built it, they will come,’” Lane-Fall said. “The idea is if we figure out all the environmental exposures, all the mechanisms of disease, then the community will take that knowledge and run with it, and everything will get better. But we know that’s not often true.”

Implementation science focuses on taking that next step, investigating how research discoveries and interventions can be successfully applied in the real world. Lane-Fall presented a decision tree that she and her colleagues developed to help researchers determine whether their research question “counts” as implementation science. The schematic looks like a color-coded subway map and provides a series of structured questions that guide researchers as they contemplate implementation studies of evidence-based interventions.

“Sometimes researchers get tripped up in all of the jargon of implementation science and that makes the field feel not accessible,” said Lane-Fall [see sidebar].

Focused on change

Both implementation science and environmental justice are complex, action-oriented fields of study.

“I see them as complementary fields, because they're both trying to achieve change,” said Lane-Fall.

In simple terms, environmental justice is a social movement that combines the principles of civil rights with environmental protection.

“There are so many interventions we already know work for environmental justice, whether you're talking about housing quality exposures, air pollution, water pollution, heat exposure, noise exposure, or green space,” said Lane-Fall. “The question then becomes: how do you scale them, how do you spread them, how do you sustain them? I think that’s where implementation science can be useful.”

To guide the discussion, Lane-Fall shared an environmental justice-focused version of the implementation science subway map that was recently published in the Annual Review of Public Health journal. She emphasized that researchers need to think about involving communities every step of the way, including study design, data collection, interpretation of results, and dissemination of results.

“Centering communities in everything we do is an important way to bring together these concepts of exposure science and environmental justice,” she said.

Lane-Fall outlined strategies for elevating environmental justice when reaching out to communities as follows.

• Remember past injustices.
• Reflect on present day implications.
• Restore and reclaim traditional knowledge and ecological health.
• Reinvest in BIPOC (Black, Indigenous, and Other People Of Color) communities.

“Just as implementation science has much to offer, it also has much to learn from environmental health and environmental justice,” said Lane-Fall.