HIV Implementation Outcomes Crosswalk


Implementation Outcomes for Hiv Interventions
  • Presented Oct. 30th, 2020
  • Dennis Li, Northwestern University
  • Carolyn Audet, Vanderbilt University
  • Sheree Schwartz, Johns Hopkins University
  • PDF of slides


What is this crosswalk?

The HIV Implementation Outcomes Outcomes Crosswalk is a translational tool to help EHE-funded HIV researchers and implementation partners identify and operationalize relevant implementation outcomes for their implementation research projects. It is a living document that will continue to be refined as we receive more feedback on its use.

Implementation outcomes: The effects of deliberate and purposive actions to implement new treatments, practices, and services (Proctor et. al., 2011).

Why was this crosswalk developed?

Compared to outcomes in efficacy and effectiveness research, implementation outcomes cover a much broader scope of concepts, often involving multiple actors at different levels. Although conceptual frameworks existthere is limited guidance on how to operationalize implementation outcomes for HIV research studies.  

Additionally, EHE is an opportunity to harmonize measurement of outcomes across funded projects to improve reproducibility of findings and create generalizable knowledge about HIV intervention implementation. Coordination among funders, researchers, and implementers can also help to fortify the use of implementation science and achieve consensus on best practices for implementing evidence-based HIV interventions 

How was the crosswalk developed?

The domains and individual outcomes in the tool come from two frameworks: the Proctor et al. (2011) model and RE-AIM (Glasgow et al., 2019). We drew extensively from Kessler et al. (2013) for guidance on operationalization. 

Drafts of the guide were iteratively refined through meetings with EHE Y1 supplement projects, consultation with representatives from CDC and HRSAand discussion with a panel of HIV implementation science experts. The experts also rated the importance/relevance of each outcome across different stages of implementation research (e.g., implementation preparation, piloting a strategy, taking an intervention to scale). 

How can you use this crosswalk in your work?

The guide is a menu from which you can choose the most appropriate outcomes for your specific context, HIV intervention, and research question. It can serve you as you develop a proposal, execute it, or refine it for further inquiry. 

The full list of constructs can seem overwhelming; however, not all will be feasible for every study or relevant/important for your stage of research. Three major factors to consider in making your selections are as follows: 

  • The outcomes are grouped by the specific research questions that they answer. You can select outcomes that align with your broader research agenda. 
  • Outcomes are rated on relevance (e.g., required, recommended) by several stages of implementation research (i.e., implementation preparation, piloting an implementation strategy, taking an intervention/strategy to scale). By identifying the stage that is closest to your project, you can narrow down the list to the most important outcomes. 
  • Different outcomes are measured at different levels of implementation, from the patient/client to the clinician/provider to the clinic/organization/site. For outcomes that you select, ensure that your project is assessing individuals at the correct levels. 


Additional factors that may influence your selection of outcomes include your study design, target population, data sources, and implementation partner acceptability and capacity.  

Feel free to reach out to your IS Consultation Hub for further assistance in using this tool. 

Resources that informed the crosswalk

  • Glasgow, R. E., Harden, S. M., Gaglio, B., Rabin, B., Smith, M. L., Porter, G. C., Ory, M. G., & Estabrooks, P. A. (2019). RE-AIM planning and evaluation framework: Adapting to new science and practice with a 20-year review. Frontiers in Public Health7, 64. doi: 10.3389/fpubh.2019.00064 
  •  Kessler, R. S., Purcell, E. P., Glasgow, R. E., Klesges, L. M., Benkeser, R. M., & Peek, C. J. (2013). What does it mean to “employ” the RE-AIM model?. Evaluation & the health professions, 36(1), 44-66. 
  • Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R. & Hensley, M. (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65-76. 

Related Articles:

  • Cox, J., Gutner, C., Kronfli, N., Lawson, A., Robbins, M., Nientker, L., … & Jessen, H. (2019). A need for implementation science to optimise the use of evidence-based interventions in HIV care: A systematic literature review. PloS one, 14(8), e0220060. 
  • Smith, J. D., Li, D. H., Hirschhorn, L. R., Gallo, C., McNulty, M., Phillips, G., … & Baral, S. (2019). Landscape of HIV implementation research funded by the national institutes of health: a mapping review of project abstracts. AIDS and Behavior, 1-9.
  • Schackman, B. R. (2010). Implementation science for the prevention and treatment of HIV/AIDS. Journal of acquired immune deficiency syndromes (1999), 55(Suppl 1), S27. 

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