Abstract for: Group Model Building Scripts for Selecting and Tailoring Implementation Strategies

Environmental health risks like household air pollution create some of the highest global disease burdens and while evidence-based interventions exist, they face a number of complex implementation challenges in community settings. Implementation scientists have proposed the use of system dynamics (SD) to understand the complexity of implementation dynamics and selecting and tailoring context-specific implementation strategies. While SD has been used to understand a wide variety of issues in public health, there are relatively few examples focused on environmental health implementation and little practical guidance on how to use group model building (GMB) to select and tailor implementation strategies. This paper reports on the GMB scripts developed to tailor implementation strategies in a case example of scaling clean fuels to reduce household air pollution in communities in India. The GMB approach allowed for nuanced exploration of implementation dynamics and tailoring of implementation strategies. This paper describes the connection between new and existing scripts, identifies their potential contribution to implementation science, and discusses the implications of competing paradigms of structure elicitation processes for implementation applications. Script development is a first step for future applications using SD and GMB for implementation in environmental health, as well as other implementation challenges in different fields.