Table 3 Implementation outcomes and health equity considerations. N.B. ‘Priority population’ is used to identify population groups who experience health inequities

Acceptability

Perception of key stakeholders (e.g. health professionals, patients, community members, members of the priority population, other stakeholders) that the intervention is agreeable, palatable or satisfactory

• Is the intervention acceptable for the priority population?

• Is the intervention acceptable for improving health equity?

Adoption

Intention, decision or action to implement an intervention

• Is adoption of the intervention equitable across different settings/contexts? If not, why might this be?

• Are there any differences between settings relating to adoption of the intervention, e.g. high and low resource settings?

• What equity-specific strategies are/could be utilised in the implementation pathway to achieve equitable adoption? And, if tested, how successful were these?

Appropriateness

Perceived fit, relevance, or compatibility of the intervention for a given setting, provider, or consumer, and/or to address a particular issue or problem

• Is the intervention appropriate for the priority population and the implementation setting/context?

• Is the intervention appropriate for addressing health inequities?

• Is the intervention culturally appropriate?

Penetration/Coverage

Integration of a practice within a service setting

• Is the intervention’s reach, access, service spread or effective coverage (combines coverage and fidelity) equitable for the eligible/priority population(s)?

• Who is not reached by the intervention and why?

• How can those who are eligible for, but not receiving, the intervention be reached?

Feasibility

Extent to which a new intervention can be successfully used or carried out in a given setting

• Does the intervention allow for health equity barriers to be reduced?

• What is the practicability of implementing the intervention in a given setting, especially among priority populations?

• What adaptations are required to improve feasibility of intervention implementation for the priority population(s)?

Fidelity

Degree to which an intervention was implemented as originally described or intended

• To what degree is the intervention delivered as intended?

• To what degree is implementation equity-focused as originally intended?

Implementation cost

Costs associated with an implementation effort

• What is the cost of implementation in priority populations (and the general population, if applicable)? Are the implementation costs equitable?

• What is the final adjusted cost-effectiveness evaluation?

Sustainability

Extent to which a newly implemented intervention is/can be maintained as part of a service’s routine operations

• Is the intervention being equitably maintained/sustained?

• In which settings and populations is the intervention being sustained? Do all settings/populations have the capacity and partnerships to sustain intervention delivery?

• Are the benefits of the intervention being sustained? Are the sustained benefits equitable? If not, why?

• Are health inequities reduced or increased by adaptations to the intervention?

• Which strategies (short, medium and long-term) could ensure the maintenance, continuation, durability/embedding or scale up of the intervention in the priority population(s)?