An integrative review of implementation science in climate change and health adaptation research

Introduction: As climate change accelerates, reducing associated health risks requires uptake of effective approaches to adaptation at scale. However, translating climate change and health adaptation (CCHA) interventions into practice remains a persistent challenge for both researchers and practitioners. Implementation science provides tools to study methods and strategies that facilitate the adoption and sustainability of interventions into practice, but its application in the CCHA domain has not yet been examined. Methods: In response, this integrative literature review identifies how implementation science has been applied to assess determinants, strategies, and outcomes of CCHA interventions, and to evaluate gaps, strengths, and limitations in the existing literature. Nineteen articles were identified through systematic searches of four databases and expert recommendations. Discrete data domains, defined a priori, were extracted and synthesized across articles. Results: Findings demonstrated wide variability in the use of implementation frameworks, the identification and assessment of implementation strategies and outcomes, and the overall conceptualization of CCHA interventions. Findings highlight a critical opportunity to leverage implementation science as a tool to strengthen the assessment and uptake of CCHA efforts in public health practice. Conclusion: In the face of the accelerating climate crisis, there is an urgent need for implementation science and climate change and health experts to work together to overcome conceptual and operational challenges to the use of implementation science frameworks and methods to advance the field.