Byron Powell, a leading scholar in the field of implementation science and an associate professor in the Brown School at Washington University in St. Louis, is featured in a newly published article in the Proceedings of the National Academy of Sciences (PNAS), a peer-reviewed journal of the National Academy of Sciences. In the piece, Powell reflects on the rapid growth of implementation science and outlines its future directions.
Implementation science, the study of how evidence-based practices are integrated into routine practice, has grown significantly over the past two decades. Once considered a niche area, it now plays a central role in improving healthcare delivery and public health outcomes.
The article highlights several key milestones in the field’s evolution, including a 2015 project led by Powell and colleagues, including Enola Proctor, a research professor at the Brown School. The team addressed what Powell calls the field’s “Tower of Babel” problem, where similar implementation strategies were described using different terms and different strategies were described with similar terms. Their work resulted in a compilation of 73 implementation strategies, which Powell said, “provided a standardized language and has been widely used.”
Powell, who also serves as associate dean for research at the Brown School, is a central figure in advancing implementation science at WashU. He is associate director of the Implementation Research Institute (IRI), a co-director of both the Dissemination and Implementation Science Innovation Research Network and the Center for Mental Health Services Research, and co-editor-in-chief of Implementation Research and Practice.
In the PNAS article, Powell engages with a central debate in implementation science: must strategies be tailored – or “bespoke” – to each clinical setting, or can standardized approaches work across diverse contexts? He notes a growing consensus that common strategies can often be applied broadly. Yet, he also highlights collaborative work led by Vivian Go (a former IRI Fellow) and Bill Miller, both professors from the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health, who compared the effects of a tailored approach to a “one-size-fits-all” approach to implementing a systems navigation and psychosocial counseling intervention for people with HIV who inject drugs in Vietnam. The tailored approach proved more effective, improving both intervention fidelity and viral suppression. Powell further underscores a shift in the field – from simply testing strategies to unpacking the mechanisms by which they succeed or fail, offering new insights into how strategies might be more effectively tailored and applied.
The article also traces the roots of the field and acknowledges the institutional support that has contributed to its rise. Among the key contributors is WashU’s IRI, directed by Proctor and funded by the National Institute of Mental Health. The IRI has trained hundreds of early-career researchers and remains a national hub for implementation science.