World AIDS Day: Q&A with Dr Aaloke Mody
Published in Healthcare & Nursing, General & Internal Medicine, and Public Health
Why did you decide to go into your field of research?
I hadn’t always wanted to be a physician. During college, I was drawn towards medicine because of the prospect of working in global and public health as a strategy to combat the legacies of socioeconomic and political injustices and inequities. At that time, deaths from HIV were at their peak and global health efforts to combat HIV worldwide were really ramping up, so infectious diseases seemed like a natural choice. As I progressed through training, this choice was reified as I saw how the HIV field was very often at the forefront of acknowledging that so many factors beyond biomedical and clinical issues—like social determinants of health—were going to determine whether treatment was successful or not. If we couldn’t deliver care that supported individuals remaining retained in care and adherent to medications, and following through with treatment plans, our care would not achieve the desired outcomes regardless of how advanced our therapies had become and the clinical decisions we made. The first time I heard of “implementation science” was during my internal medicine residency training, and I realized that this was an academic home for the types of questions that I thought mattered most. How do we design care delivery to ensure that we are maximizing the population-level impact of the interventions and advances we have? Since then, I have been focused on building a research career on trying to help answer that question.
How has knowledge of HIV/AIDS developed over the course of your career?
The story of HIV over the past few decades is really a remarkable one. In the first 30 years, HIV went from an unknown virus to have multiple highly simple and highly efficacious medications available for both treatment and prevention (e.g., PrEP and treatment as prevention). In the past 15 years, I would say the global HIV treatment response has really evolved into understanding how to ensure we can get these remarkable and life-saving therapies to everyone in the world living with HIV. This has naturally drawn a lot of attention to learning how to best deliver care, including how to make sure it is more person-centered, flexible, and tailored for addressing barriers across diverse populations. These innovations have not only been important for HIV, but they have also helped make HIV care a model for chronic disease care delivery, even for diseases that have been around much longer like hypertension and diabetes. For example, challenges with retention and reengagement in care also significantly limit optimal health outcomes in other lifelong chronic diseases, but there are has historically been less attention on these issues. Although innovations in care delivery is where most of my research focus is, it is important to note other biomedical advances, particularly with long-acting injectable therapies. We are just seeing the first generation of these products, but full treatment regimens that can be administered once every 6 months are on the horizon and have potential to completely alter what is needed for successful care delivery.
What challenges do those from low- and middle-income countries in particular face?
There are both challenges and enormous promise from the HIV response in low- and middle-income countries. Many of the challenges are well-known and include inadequately funded public health infrastructure, limited access to new advances, particularly long-acting injectable therapies, reductions in global health funding as well as socioeconomic and political inequities driven by legacies of colonialism and racism, legal discrimination and punitive laws, and gender inequity and violence. At every level of society (global, country, city, neighborhood-level), inequalities continue to drive the HIV epidemic and equitable access to prevention and treatment services across all populations is needed. At the same time, I think there is a lot of promise in the HIV response in low- and middle-income countries. Many countries, particularly in Africa, have HIV care cascades (i.e., the proportion of the population with HIV who have been successfully diagnosed, started on medications, and achieved viral suppression) that indicate better outcomes than in high income countries like the US. Much of the innovation in care delivery is being driven by HIV research and programs in low- and middle-income countries, and they serve as a model for high-income countries to learn from.
What does public engagement look like in your field and how important do you think it is for researchers to make a societal impact with their work?
Active public engagement has always been a cornerstone of the HIV response. From the early days, there was a lot of activism in HIV to ensure that scientific advances actually led to impact in people’s lives, initially by speeding up the drug pipeline when no effective regimens were available and later around ensuring access to medications globally. Given my focus on implementation science, it is not surprising that I feel strongly that the research we do should have a fairly direct societal impact. It is critical at the inception to engage individuals and community in framing the important questions to be answered and designing the research study to ensure that it will yield results that will meet the needs and preferences of that community. In our work, we often employ methods like quantitative preference studies (e.g., discrete choice and best-worse scaling experiments), human centered design, and other mixed methods evaluations to ensure that our work is maximally relevant for the intended population. At the other end, I think the researcher’s role in helping to ensure that their findings get appropriately disseminated into policy and practice is also being increasingly recognized. In truth, there are many scientific questions regarding how to optimally disseminate research findings to ensure they have societal impact, and we are only at the beginning of the journey in answering them.
What are your hopes for progress in the future?
There are numerous, but broadly speaking, I am looking forward to seeing how lessons from HIV will be leveraged in building up person-centered care delivery systems that integrate care beyond typical disease silos. How do we ensure that care delivery systems are flexible enough to ensure they are accommodating to everyone’s needs and preferences, rather than the other way around. Also, there is already a growing body of research on integrating care for one or two other diseases with HIV, but I think these sets of questions can be taken several steps forward: what does an integrated person-centered health system that provides comprehensive care for HIV treatment and prevention, hypertension, diabetes, cancer screening, mental health, and beyond? Many of the building blocks are there but is yet to be seen how they all fit together across different contexts. In recent Seminar paper1 that we wrote, we actually discuss these issues more in depth our perspectives on the current state of the HIV response and where it is heading.
- Mody A, Sohn AH, Iwuji C, Tan RKJ, Venter F, Geng EH. HIV epidemiology, prevention, treatment, and implementation strategies for public health. The Lancet 2024; 403(10425): 471-92.
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Implementation Science Communications
An official companion journal to Implementation Science and a forum to publish research relevant to the systematic study of approaches to foster uptake of evidence based practices and policies that affect health care delivery and health outcomes, in clinical, organizational, or policy contexts.
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Learning From the Past and Shaping the Future
Implementation Science has published 2,197 papers since its inception in 2006 (as of May 27, 2026). Implementation Science Communications has published 938 papers since it began in 2019 (also as of May 27, 2026). In addition to papers published in these two journals, a larger number of papers focusing on implementation science in health care have been published in other journals over the last 20 years, conservatively around 22,300. This is based on a PubMed search using a specific search string[1], conducted on May 27, 2026. It is important to note that landmark papers in the field were published before 2006. Our purpose in marking this anniversary is to reflect on the field as a whole.
While much of the growth in the literature has come from high-income countries, there has been an increase in the number and scope of papers from lower and middle-income countries, fueling the overall growth.
Arguably, the growth in the literature and underlying research studies shows that the science and practice of implementation have moved from the periphery to mainstream health research. We are interested in papers that document and analyze the change over the last couple of decades—although the history of the field prior to 2006 is also of interest—and propose how this shapes the future of the field. This may be based on bibliographic or citation analysis, surveys among researchers, or other sources. Papers that only review the past, without analysis and future direction, will not be seen as responding to this call.
Examples of topics include, but are not limited to:
- Content analysis or systematic reviews of empirical publications from Implementation Science and/or Implementation Science Communications
- Content analysis of editorials and research agenda-setting articles from both journals, including papers focusing on implementation science published in other journals
- Bibliographic/citation analysis of publications over the 20 years of IS, including other papers published in other journals
- Analyses of geographic, disciplinary, authorship, funding, or institutional patterns in implementation science
Submissions should include critical interpretive analysis of existing literature and provide new insights, ideas, and thoughts from reflection on the existing literature.
This Collection welcomes submissions of a range of article types. Should you wish to submit to this Collection, please read the submission guidelines of the journal you are submitting to, i.e., Implementation Science or Implementation Science Communications, to confirm that the type is accepted by the journal you are submitting to.
Articles for this Collection should be submitted via our submission systems in Implementation Science or Implementation Science Communications. During the submission process, you will be asked whether you are submitting to a Collection. Please select "Learning From the Past and Shaping the Future" from the dropdown menu.
Articles will undergo the standard peer-review process of the journal in which they are considered, Implementation Science or Implementation Science Communications, and are subject to all of the journal’s standard policies. Articles will be added to the Collection as they are published.
The Editors have no competing interests with the submissions that they handle through the peer-review process. The peer review of any submissions for which the Editors have competing interests is handled by another Editorial Board Member who has no competing interests.
[1] ("Implementation Science"[Mesh] OR "implementation science"[tiab] OR "implementation research"[tiab] OR "dissemination and implementation"[tiab] OR "translation science"[tiab] OR "knowledge translation"[tiab]) AND 2006:2026[dp]
Publishing Model: Open Access
Deadline: Mar 09, 2027
Breaking Frameworks: Revisiting, Extending, Integrating, and Theorizing Implementation Frameworks
The field of implementation science has amassed a large number of frameworks3,4,5. These are sometimes also called models, but because the term “model” is used in many other contexts in research, we will use the term “framework.” While many of these frameworks express a goal of supporting research in the implementation of evidence-based practices and programs, researchers and especially new entrants to the field continue to express confusion and uncertainty about how to use existing frameworks and which to use for what purposes. New frameworks are often developed without clarity about how they fit within the existing corpus of frameworks.
Despite the large number of frameworks 4, their use often reflects a lack of deep understanding of the content of the frameworks. Implementation researchers often describe frustration with existing frameworks while continuing to use them. A major issue is that once published in a peer-reviewed venue, there is no clear path to suggest changes or updates to the frameworks. A few, such as the Consolidated Framework for Implementation Research (CFIR)6, the Exploration, Preparation, Implementation, Sustainment (EPIS) framework7,8, and the RE-AIM framework9, have been updated through processes determined by a relatively small group of researchers10; others remain essentially fixed as they were published, or updated once but not again11,12. This can lead to reification of the frameworks in their original form. These issues may constitute a major “sticking point” for advancing the science of implementation, as well as contributing to complexity for implementation practitioners who use frameworks as tools developed through the science. Emerging global health priorities, including health equity, structural racism, coloniality, climate and planetary health, digital transformation, and policy implementation, raise questions about whether existing frameworks adequately capture power, history, resource constraints, political economy, community agency, and cross-setting adaptation13. The increased geographic scope of published studies adds to concerns about whether theories and frameworks current in the literature support the broader scope.
We also note the importance of understanding the function of existing frameworks, most clearly addressed in the seminal 2015 paper by Nilsen describing an initial taxonomy of theories, models, and frameworks in implementation science5. We note that this paper is now over a decade old. Proposing additional taxonomic categories of frameworks, models, and theories is an important step yet to be taken.
This background informs this collection proposal. We are calling for manuscripts to address the issues, which may include methods (what methods can be used to update or extend existing frameworks), perspective or commentary manuscripts (why is this important), and empirical papers offering new insights, updates, and extensions of existing frameworks. We would also welcome papers that explicitly focus on theorizing based on existing frameworks, focusing on prediction and explanation rather than description14. However, manuscripts proposing new frameworks will be considered only if they clearly demonstrate how the proposed contribution builds on, revises, synthesizes, tests, or challenges existing frameworks, and why a new framework or a substantial extension is necessary. The existing body of frameworks and models within implementation science and practice constitutes an important catalog of knowledge. Our goal is to build on that existing knowledge.
Examples of topics include, but are not limited to:
- Innovative papers that develop new substantive theories or significant theoretical extensions to existing theories
- Methods for classifying and categorizing existing frameworks
- Proposing new domains and constructs for existing determinant frameworks
- Synthesizing across existing process frameworks to describe common elements and areas of departure
- Practical guidance on how to use existing tools such as the “Assess the Dissemination and Implementation Models Webtool” or useful new tools and approaches to help people select and use existing frameworks (these are likely to be assessed for Implementation Science Communications rather than Implementation Science)
This Collection welcomes submissions of a range of article types. Should you wish to submit to this Collection, please read the submission guidelines of the journal you are submitting to, i.e., Implementation Science or Implementation Science Communications, to confirm that the type is accepted by the journal you are submitting to.
Articles for this Collection should be submitted via our submission systems in Implementation Science or Implementation Science Communications. During the submission process, you will be asked whether you are submitting to a Collection. Please select "Breaking Frameworks: Revisiting, Extending, Integrating, and Theorizing Implementation Frameworks" from the dropdown menu.
Articles will undergo the standard peer review process of the journal in which they are considered, Implementation Science or Implementation Science Communications, and are subject to all of the journal’s standard policies. Articles will be added to the Collection as they are published.
The Editors have no competing interests with the submissions that they handle through the peer-review process. The peer review of any submissions for which the Editors have competing interests is handled by another Editorial Board Member who has no competing interests.
Publishing Model: Open Access
Deadline: Mar 09, 2027
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