In environmental health, various factors may prevent people and systems from changing their behavior. One of the issues is access, as people may not have access to resources or environments that are beneficial to their health. Another challenge is knowledge, since scientists don’t always know what specific actions can promote healthier living. But Meghan Lane-Fall, MD, explained during a Jan. 10 Keystone Science Lecture that there are situations where you know what you should do but still don’t do it.
![Megan Lane-Fall, MD](https://factor.niehs.nih.gov/sites/niehs-factor/files/2024/01/science-highlights/implementation-science-enviro-justice-body1.jpg)
“This is where implementation science shines,” said Ryan Fore, a physician scientist and executive director of the Center for Implementation Science at the University of Pennsylvania. “Implementation science is really about bridging the gap between evidence and practice.”
During his presentation, 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 presented by Dr. Lindsey Martin, Health Scientist Administrator in the NIEHS Division of Population Health. Martin is a medical anthropologist who supports a broad range of research 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 the field of implementation science, and her work has advanced the field through collaborative projects, pioneering methods and capacity building,” said Martin.
Next step
“Researchers often follow a ‘Field of Dreams’ mentality, believing that ‘if we build it, they will come,'” Lane-Full said. “The idea is that if we figure out all the environmental exposures, all the disease mechanisms, then communities will take that knowledge and apply it, and everything will be better. But we know that’s not the case.”
Implementation science focuses on taking the next step and examining how research findings and interventions can be successfully applied to the real world. Lane-Fall presented a decision tree she and colleagues developed to help researchers determine whether their research questions “count” as implementation science. The schematic looks like a color-coded subway map and provides a series of structured questions to guide researchers considering implementation studies of evidence-based interventions.
“Sometimes researchers get tripped up by all the jargon of implementation science, which can make the field feel inaccessible,” Lane-Fall said (see sidebar).
focus on change
Implementation science and environmental justice are both complex, action-oriented fields of study.
“I think they are complementary areas because they are both trying to effect change,” Lane-Full said.
Simply put, environmental justice is a social movement that combines civil rights principles with environmental protection.
“We already know there are a lot of interventions that promote environmental justice, whether it’s housing quality exposure, air pollution, water pollution, heat exposure, noise exposure or green space,” Lane-Full said. “Then the question becomes: How do you scale them, how do you spread them, how do you sustain them? I think that’s where implementation science can come into play.”
![Megan Lane-Fall, MD](https://factor.niehs.nih.gov/sites/niehs-factor/files/2024/01/science-highlights/implementation-science-enviro-justice-body2_0.jpg)
To guide the discussion, Lane-Fall shared a version of the Environmental Justice-focused Implementation Science Metro Map, recently published in the journal Annual Review of Public Health. She emphasized that researchers need to consider involving communities every step of the way, including study design, data collection, interpretation of results, and dissemination of results.
“Everything we do puts the community at the center and is an important way to bring together the concepts of exposure science and environmental justice,” she said.
Lane-Fall outlines strategies for promoting environmental justice when reaching out to communities as follows.
- Remember the injustices of the past.
- Reflect on today’s impact.
- Restore and restore traditional knowledge and ecological health.
- Reinvest in BIPOC (Black, Indigenous and other people of color) communities.
“Just as implementation science has a lot to offer, it also has a lot to learn from environmental health and environmental justice,” Lane-Fall said.
(Dr. Marla Broadfoot is a contract writer in the NIEHS Office of Communications and Public Liaison.)