Faculty Bibliography

BACKGROUND:The potential for implementation science (IS) to address health inequities is limited by insufficient attention to power. Although the field emphasizes context, it remains unclear how best to examine and intervene on power relations related to the implementation of evidence-based interventions (EBIs). This scoping review aimed to determine: 1) To what extent do research projects studying EBI implementation explicitly examine power? 2) In these studies, how is power conceptualized, defined, operationalized, and understood? 3) What opportunities exist to examine and intervene upon power through IS research? METHODS:Following established procedures, we undertook a six-step process: 1) articulating research question and purpose; 2) identifying relevant studies; 3) selecting studies; 4) extracting data; 5) summarizing data; and 6) reporting results. We characterized studies' attention to power using Fung's power framework, which attends to everyday, policy, structural, and ethical power. Based on publications available as of February 2022, we included English-language EBI implementation studies from clinical, community, and public health settings that explicitly attended to power. Data extraction included study context, IS frameworks used, definitions and measures of power, and characterizations of how power influenced implementation processes and outcomes. RESULTS:Of 3,531 articles screened, 28 papers explicitly discussed power in relation to EBI implementation and 11 presented a formal definition of power. Most studies explored everyday and structural power, with far less attention to policy power and almost none to ethical power. Conceptualizations and operationalizations of power varied widely, and few studies reported grounding in IS frameworks. Explicit strategies to intervene upon power were limited. Most studies focused on short-term integration goals, with limited discussion of how power dynamics shape what counts as evidence, whose interests are served, or opportunities for systems transformation. CONCLUSIONS:Researchers have the opportunity to explicitly integrate power theories and frameworks into conceptual models for IS studies to reshape IS efforts and build this evidence base. This will allow the field to move towards critical, systems-focused perspectives that examine how power shapes and can be used to reshape the evidence base, implementation systems, implementation strategies, and implementation, health, and system outcomes.

Retinopathy of prematurity (ROP) is a leading cause of childhood blindness that arises from disrupted retinal vascular development in premature infants. Oxygen exposure remains a central driver of treatment-warranted ROP, as higher saturation levels suppress early retinal vascular growth and later promote pathological neovascularization. Large, randomized trials of oxygen targeting show that lower oxygen saturation ranges reduce the incidence of treatment-requiring ROP, though with trade-offs in mortality. Observational cohorts, including the CRYO-ROP, ETROP, and e-ROP trials, consistently report lower rates of treatment-warranted ROP and reduced treatment need among Black infants despite similar or greater prematurity risk. Multiple explanations have been proposed to account for the paradoxically lower rates of treatment-warranted ROP observed among Black infants. Although biologic variations in angiogenic pathways have been proposed, evidence suggests that structural and clinical factors may offer an alternative explanation for these patterns. Black race is strongly correlated with residence in neighborhoods with greater socioeconomic disadvantage, which is associated with increased risk of prematurity and missed ROP follow-up visits. In addition, pulse oximeters may overestimate oxygen saturation in individuals with darker skin pigmentation, potentially altering targeted oxygen exposure. Survival-related selection bias may further contribute to this paradox, as infants at the highest risk of both mortality and treatment-warranted ROP may not survive long enough to develop treatment-requiring disease. This review examines racial differences in ROP severity and examines how oxygen exposure and structural factors may contribute to these disparities, while acknowledging the limited evidence supporting biologic explanations.

The goal of this study was to clarify the contribution of prefrontal cortex activity to men's appraisals, affect states, and decision making in the context of hypothetical heterosexual dating scenarios lacking clear consent. Transcranial direct stimulation (tDCS) was applied to the prefrontal cortex to examine whether it would modify and reduce the likelihood of hypothetical dating violence. Participants (n = 102) responded to first-person vignettes wherein a woman responded either ambiguously or with a refusal to their sexual advance. While responding to the vignettes, participants received sham or active tDCS to modulate prefrontal cortex-mediated responding. Neuromodulation interacted with the communication response type of the woman in the vignette (e.g. ambiguous vs. refusal responses) to influence participants' reports of negative affect (F = 9.57, P = 0.002, Cohen's f²