GACD only funds implementation research proposals. For more information about implementation research, including resources for crafting a high-quality proposal, please visit the GACD e-Hub.
Implementation Research Focus
GACD only funds implementation research proposals. For more information about implementation research, including resources for crafting a high-quality proposal, please visit the GACD e-Hub.
We publish descriptions of our completed and ongoing implementation research projects. Case studies illustrating the impact of completed GACD-funded projects are also available.
Study design
Study teams should focus on how to implement one or more evidence-based interventions known to prevent or to help manage non-communicable diseases. Teams should use an appropriate research design and framework, cluster randomised control trials (cRCTs), before and after studies, and additional implementation science classifications of study designs (e.g. hybrid designs) noting that the GACD do not limit applicants to any particular design. Research designs should be accompanied by appropriate statistical considerations, including sample size justification. For more information about hybrid designs see Curran et al 2012 and Landes et al 2019.
For more information regarding selection of implementation research frameworks, please see the GACD e-hub resources and the Fogarty International Centre Toolkit: Overcoming Barriers to Implementation in Global Health.
Examples of frameworks include (this list is not exclusive):
Consolidated Framework for Implementation Research (CFIR)
The context enhanced (RE-AIM) Reach, Effectiveness, Adoption, Implementation, Maintenance)
Practical Robust Implementation and Sustainability Model (PRISM) frameworks
Framework for Developing and Evaluating Complex Interventions.
Proposals are expected to generate evidence that is of direct relevance to policymakers, communities and practitioners. Projects will require a strategy to include the relevant policy makers, local authorities, as well as other stakeholders such as community groups, or other individuals or organizations involved in the implementation of the intervention, with co-creation from the development of the project through to the knowledge translation phase. Project partners should be engaged from the beginning to contribute to the sustainability of the intervention after the end of project. Proposals must demonstrate sustainability of the strategy, beyond the lifespan of the project.
Proposals must outline a plan for the pathway to impact, or the ability to sustain interventions following the period of implementation, especially for projects that focus on structural change interventions. Regarding sustainability, proposals should adhere to the principles of the Lusaka Agenda, to support intentional, robust and inclusive analysis and learning through health systems and implementation research, to inform and guide effective implementation of the Agenda at different levels.
Implementation research capacity building
Implementation research is a relatively young discipline and the GACD is keen to increase research capacity and capability in this field among researchers, health professionals, and public health leaders through skill building, knowledge sharing, and networking.
Applicants should indicate plans for capacity building within their project, especially, but not exclusively, for early career researchers and for team members from lower resourced environments, such as LMICs or Indigenous communities.
Applicants must budget for the travel and accommodation costs of having two team members, at least one of whom is based in an LMIC or other lower-resourced context, participate in the annual three day face-to-face meeting of the GACD Research Network (location to vary annually). Teams are also strongly encouraged to include one junior team member in each annual meeting for the duration of their research grant.
Outcome measures
The proposal’s primary outcome measures must be implementation research outcomes to assess implementation of strategies to tackle NCDs. With regard to NCDs, applicants are encouraged to explore any chronic condition or combination of chronic conditions, including mental health disorders and sleep disorders (depending on the specific call remit). The conditions selected should be justified using local or regional epidemiological data about their prevalence. Outcome measures should appropriately address implementation tackling NCDs. Applicants must also include appropriate interim outcomes and consider the feasibility of health outcomes.
Proposals should also contain a strategy for measuring other secondary outcomes (or proxy outcomes) that demonstrate the intervention’s real-world effectiveness in the local context and target populations. To improve data standardisation, wherever feasible applicants are encouraged to use measures developed by the GACD for monitoring patient-centred NCD outcomes in LMICs. Other health or non-health outcome measures, especially those identified as important by patient participants and/or critical for advancing Universal Health Coverage, are also welcome.
Health equity
Universal Health Coverage advocates for the availability of quality affordable health, across the life course, for everyone. Poverty, racism, ethnic discrimination, and other inequities are directly associated with reduced potential for equitable access to quality care. All projects should consider the social determinants of health and discuss their potential impact on the effective implementation of the intervention(s). If there is a focus on a particular population (e.g., gender, race and/or ethnicity), then the reason for this should be justified.
In order to promote health equity, studies should aim to address differences in intervention access, uptake, and effectiveness in socially disadvantaged groups and develop strategies for reducing inequities. To facilitate this process at the data analysis stage, studies should be designed to address such differences. At a minimum, studies should capture sex and/or gender differences. If feasible, a plan for capturing intersectional impacts on health outcomes should be included in the analysis strategy.
Sex and gender-responsive and intersectional analyses
Poverty, racism, ethnic discrimination, and other inequities are directly associated with reduced potential for health promotion. All projects should consider the social determinants of health and discuss their potential impact on the effective implementation of the intervention(s).
A lack of sex- and gender-disaggregated data worldwide has resulted in an incomplete picture on why disparities in health outcomes persist. Wherever projects do not focus on a single sex or gender, studies should aim to identify sex and/or gender differences in intervention access, uptake, and effectiveness, with the aim of developing strategies for reducing any identified inequities. To facilitate this process, studies should be designed to identify differences by sex and/or gender. For guidance on conducting sex and gender-responsive analyses, please consult the resources available from the World Health Organization and the European Institute for Gender Equality.
Where appropriate, researchers are also encouraged to conduct intersectional analyses, exploring differences beyond sex and gender, and identifying how sex and/or gender and other social determinants of health interact with each other to impact health equity. Guidance on conducting intersectional analyses is available from the World Health Organization and the Canadian Institutes for Health Research.
Working with underserved populations
The GACD expects that all project teams will uphold the highest level of ethical behaviour at all times. To this end, a governance plan will be in place for overseeing equitable, safe, and respectful interactions among all study participants at all stages of the project (from project planning, through project implementation, and into the knowledge translation phase).
Stakeholder engagement
Stakeholder engagement in research is the process of identifying the appropriate people, groups, and organisations and involving them throughout the research process. This includes responding to their input and ensuring that they can make use of the findings when the project in complete. Stakeholder engagement is critical to the success of implementation research projects. For implementation research to have a strong likelihood of being taken up into policy or practice and informing the scale up of effective interventions, it is vital that project teams engage the appropriate stakeholders. These include decision makers such as policymakers, ministry officials, non-governmental organisation leaders and community leaders. It is important to include stakeholders who can help sustain the project’s implementation, facilitate scale up, and use the knowledge generated from the project after the grant ends.
Stakeholders also include patients, their family members and carers. Their contributions should be nurtured through meaningful engagement from the outset, not only as participants in the research undertaken. Patient engagement throughout the research project is critical to developing patient-centred models of care.
Applicants are required to show evidence of appropriate stakeholder engagement in their proposal and include letters of support from proposed stakeholders where possible. All stakeholders should be engaged at every stage of the research project, from initial ideation of research questions, throughout the duration of the project, and afterwards during the knowledge translation phase. Applicants must also provide a clear plan for continuing to engage with stakeholders. Stakeholder engagement will be assessed in the scoring of the application, and thus appropriate engagement with stakeholders at the project planning phase will increase the likelihood of funding.
The GACD provides a learning collection on stakeholder engagement, available on our e-hub, which includes videos, publications, and toolkits related to effective and meaningful stakeholder engagement when studying the implementation of NCD programmes, policies, and practices. In addition, Research to Action provides a list of stakeholder mapping templates, which can be incorporated into your proposal.
Equitable research partnerships
Equitable collaboration refers to partnerships both within the research teams and between the team and community partners. Resources for planning equitable research partnerships are available in our stakeholder engagement webpages as well as on the UKCDR & ESSENCE’s Equitable Partnerships Resource Hub.
Equity considerations also extend to the governance of project teams, in order to ensure fair and equal collaboration, especially between HIC–LMIC and non-Indigenous–Indigenous partners (both collaborations within the research teams and with community partners).
Proposals should outline equitable governance arrangements in place for your projects, provide evidence of joint leadership and management positions on the project team, and specify equitable approaches to data ownership.
Climate change and environmental sustainability
All project teams should endeavour to minimise the environmental footprints of their projects; for example, by replacing international flights with video calls where possible. Subject to the funder’s criteria, project teams may budget for carbon offset purchases for necessary flights.
Guidance for digital health interventions
Evidence-based interventions that incorporate a digital technology component are encouraged. In July 2021, the GACD held a workshop focusing on best practices for planning and delivering sustainable and equitable digital health interventions for NCDs in LMICs and Indigenous communities. You can access the summary report from the Digital Health Workshop here and the mERA checklist for projects involving Digital Health Interventions here. Projects with a focus on digital health interventions must include a completed copy of the mERA checklist with their application.
Use of Artificial Intelligence
GACD understand that the use of artificial intelligence (AI) tools in healthcare is a rapidly developing field. Applicants are requested to ensure any applications using AI tools comply with the rules set out by their funder. For example please check the Canadian Institutes of Health Research Guidance on the use of AI in the development and review of the research grant applications.
We recommend applicants take caution when using generative AI tools in the preparation of grant applications, given it may not be possible to monitor or manage subsequent use of information entered into generative AI databases. If you choose to use generative AI tools you ensure to acknowledge and cite the output of those tools in your work.
To reference AI-generated content in your proposal:
When you reference this content directly in your text, you should include an in-text citation, and an associated entry in your reference list.
If you have used AI tools for some part of your research, you should describe that use in your introduction or methods section and include the prompts that you used.
Compliance with international standards and best practices
It is expected that all research conducted under and funded by this initiative will comply with relevant internationally accepted standards and best practices. These include:
Standards for Reporting Implementation Studies (StaRI) Statement;
standards relevant to specific study designs including SPIRIT and CONSORT for clinical trials, and STROBE for observational studies. All standards can be found on the website of the EQUATOR Network;
ethics and other governance requirements as applicable in the countries where the research will be conducted;
registration of all systematic reviews in a publicly accessible registry before commencement of the review;
registration of all clinical trials before recruitment of the first trial participant in a publicly accessible registry that is acceptable to the WHO or the International Committee of Medical Journal Editors; and
reasonable measures to ensure that sponsors, researchers, and institutions publish or otherwise disseminate the analysis of data and interpretation of research results (i.e., the findings) in a timely manner without undue restriction.
Would this content be useful for a friend or colleague?