The space between intention and accomplishment is the domain of Active Implementation science.
In this commentary we separate current intention from accomplishment, highlight the need for active implementation, and describe the critical functions of implementation teams to establish and sustain a national health response to current and future challenges.
The intentions to conduct testing, support those who are forced from their jobs, and so on are good intentions. The lack of accomplishment nationally spotlights the need to employ active implementation science to respond to the coronavirus pandemic. The historian David Jones recalls past epidemics and notes common official actions marked by reluctance, recognition, and response as each new epidemic unfolds. Reluctance by non-believers or active resistors to health advice, recognition by those who grasp and accept the conditions in play, and response by those who initiate action to protect and defend the wellbeing of everyone in a population. Jones states, “Epidemics eventually resolve, whether succumbing to societal action or having exhausted the supply of susceptible victims.”
Q: What societal action is required to limit the damage of the novel coronavirus?
A: Universal testing is required to limit the spread of the virus, whether early on to “flatten the curve” or later on to “get back to work.”
Q: Where is the highest probability of infection and contagion? Who is most vulnerable?
A: Answers to these questions tell Community Health Teams where to start testing while pursuing universal screening and testing. Eventually, each individual must be tested, often repeatedly.
To assure effective societal action (active implementation), Implementation Teams must be established to support the development and services of Community Health Teams in neighborhoods and communities across the country.
Purposeful, active, and effective implementation work (making it happen) is done by Implementation Teams. The functions of the Teams described in the handout below (see link) are required to establish or sustain a healthy, functioning society whether or not a COVID-19 vaccine is developed. Once in place, the teams stand ready to take on current and future challenges.
Download: Community Health Teams and Implementation Teams for National Health Response (Handout 2)