Local Implementation Research Articles

Horizon problem and capital expenditures: evidence from the public sector in Indonesia

PurposeThis study investigates whether horizon problems affect the allocation of capital budgets and their implementation in a government setting.Design/methodology/approachWe use data from 2005 to 2020 for local governments in Indonesia, which apply a limit of two five-year terms for mayors. We use regression analyses for panel data with total observations of 4,541 local government years from 448 unique local governments. We also use graphical analyses and t-tests to provide robustness to our results.FindingsMayors allocated lower capital expenditures in the second term than in the first. Capital budget allocation is lower for local governments whose mayors are older than 60. Our additional analysis shows that incumbents seeking re-election allocate more capital expenditure than those not seeking re-election.Research limitations/implicationsThis study contributes to the literature on the behavioral effect of term limits on local government's allocation and implementation of capital budgets. Limiting elected government officials to a certain number of terms will prevent the monopoly of power. However, it may negatively affect budget allocation on capital programs in their last term. Our findings should interest public policymakers in discerning the costs and benefits of term limits for elected offices.Originality/valueMost studies on horizon problems have focused on the corporate setting. This study provides evidence of the effects of horizon problems in the government setting, especially in Asia.

Abstract Su407: Implementing An Effective Standardized Bystander CPR Protocol For US Golf Courses

Background: A golf course is the fifth most common public place for cardiac arrest (CA). Informal interviews with golfers and golf course personnel revealed striking incomplete and variable knowledge about what to do in the event of a CA on a golf course in accordance with most current bystander resuscitation guidelines. Hypothesis: We hypothesized that the development and implementation of a standardized protocol (called “911-CPR-AED”) for the three most critical first steps to assure aperson’s survival of an on-golf course CA will improve chances of surviving if playing partners, caddies and club staff are well prepared to respond urgently and appropriately to such an emergency. Aim: To successfully implement the standardized “911-CPR-AED” protocol for 4 different golf clubs. Approach: We achieved full support and involvement of the Club Boards, professional staff, club management, grounds crew and membership as well as coordination with local Emergency Medical Systems (EMS) and communications to all golfers and caddies. We created a specific four-panel laminated infographic customized for each club and designed to fit easily into every golfer’s bag and caddy vest, assuring a readily available “911-CPR-AED” guide for lay bystanders to notify EMS and Club staff, immediately initiate chest compressions, ensure rapid delivery of an AED and BLS certified persons to the arrest site, and safely guide EMS on their arrival. We also staged live “dry run’ simulations on the golf courses with all key team members and timed each and every step of the simulation from start to finish. All aspects of this process were shared with leaders of the closest EMS and hospital emergency departments (EDs). Results: Within the past 2 years, we have successfully implemented a standardized emergency resuscitation protocol we call “911-CPR-AED” at 4 different golf clubs for immediate initiation of bystander CPR in the event of full CA on a golf course. Since implementation, we have witnessed 3 CA events and achieved successful full “on course” resuscitations that deployed this protocol for all three survivors who are now back to playing golf. We intend to share the details and many lessons learned for these ongoing efforts. Conclusion: An effective, standard bystander CPR protocol now exists for use at any US golf course. We intend to expand Implementation to 3 new golf courses and will continue to raise awareness and encourage widespread local implementation across the US.

From Trash to Treasure: Assessing the Effectiveness of the Green@Community Recycling Network in Hong Kong

Municipal solid waste (MSW) is a growing problem worldwide posing a variety of environmental and human health impacts. Despite recycling being one major strategy to alleviate MSW production, the effectiveness of recycling has been equivocally dependent on local policy implementation and citizen environmental behavior. To enhance recycling effectiveness in Hong Kong, the government has established Green@Community, a unified community-based network for recycling and public environmental education. Since its establishment, the number of visitors to and the amount of recyclable materials collected at the network increased steadily over time. Our study is the very first to investigate the effectiveness of this territory-wide recycling network. Through a questionnaire survey, we found that respondents’ recycling traits were stronger if they have accrued gift tokens through participating in recycling activities. Visiting a Green@Community facility could also enhance knowledge of the types of acceptable recyclables, and respondents who had visited a Green@Community facility agreed that education and publicity could increase the recycling rate in Hong Kong. These findings highlighted the effectiveness and uniqueness of this community-based recycling network, its role in raising recycling knowledge, and its implications for policymakers and urban planners of densely populated cities to leverage society’s recycling participation, but also called for more efforts on developing, promoting, and incentivizing the usage of such a network to further enhance recycling and alleviate MSW production in Hong Kong.

Do We Contribute to Women's Empowerment? Insights From a Nutrition-Sensitive Agriculture Project Implemented in Nong, Laos.

The gender-gap in power is still persistent around the globe. Nutrition-Sensitive Agriculture (NSA) interventions have been implemented to increase women's empowerment as a goal in itself, and as a pathway to food and nutrition security (FNS). However, contradicting evidence exists on whether the interventions, besides food security, realize women's empowerment. Furthermore, the concept of women's empowerment has different meanings across different cultures, regions, and countries. To assess the understanding of, and perspectives on, women's empowerment among different stakeholders in the context of an NSA project in Laos, and to assess whether this project contributes to women's empowerment and FNS. Semistructured interviews were conducted with local implementers of NSA interventions (n = 13) and senior program managers and advisors (n = 5). Six focus group discussions were conducted with community members (n = 46). Our findings reveal that community members had a materialistic understanding and local implementers an instrumental understanding, in contrast to senior program managers and advisors, who had an egalitarian understanding of women's empowerment. The level of women's empowerment in Nong was considered low by all respondents. Furthermore, respondents reported that the NSA interventions had a positive impact on FNS, but not on women's empowerment. In a community in which both women's empowerment and FNS are low, working with women may contribute to FNS, but not necessarily contribute to women's empowerment. Nevertheless, from an emic perspective, women do feel more empowered as the interventions contributed to increased household capacity to address FNS.

Long-Term Fine-Grained Forecasts of Emergency Demand Using EMS Big Data and Population Estimates

In recent years, Japan has been facing a super-aging society, impacting various sectors. The issues of overcrowded emergency medical services and the increase in emergency transport cases are particularly severe, necessitating urgent responses. The research group, in collaboration with the Kobe City Fire Department, is conducting a study focusing on long-term fine-grained forecasts of emergency demand. This study aims to provide indicators for the strategic deployment of emergency teams and the scaling of medical facilities. By utilizing regional mesh data, it can capture local characteristics far more precisely than previous city or district-level forecasts, offering significant advantages for local government policy implementation. In the prediction process, there are two stages to leverage national land numerical information and improve the accuracy of the forecast model. The results reveal regional disparities in future emergency demand, enabling optimal allocation of emergency resources and strategic planning for emergency services.

Commentary: Strengthening System Readiness for Health Interventions: Lessons for Implementing Interventions and Implementation Support in Low-And Middle-Income Countries.

In low- and middle-income countries (LMICs), barriers such as low system readiness, contextual mismatches, and resource limitations impede effective implementation of evidence-based interventions. This commentary offers insights into overcoming these challenges with a case study of the PRISM project, designed to reduce behavioral and psychological symptoms of dementia in older adults living in Thailand. The case highlights how combining two evidence-based models - the Reducing Disability in Alzheimer's Disease clinical intervention and the Getting To Outcomes implementation science process enhances program success. Using interviews with stakeholders across various health system levels, we identify factors critical to successful program implementation: (1) integrating interventions into policy frameworks, (2) empowering local implementers, (3) fostering collaborative learning, and (4) adapting interventions to local contexts. The case demonstrates that building system readiness through local engagement and ownership is central to scaling up health programs in LMICs. This commentary's contribution lies in its emphasis on the role of implementation science as a vehicle for translating research into practice. It presents a practical, adaptive model for embedding interventions into routine health systems, thereby offering a pathway for successfully scaling up evidence-based programs in LMICs. Such findings provide lessons for overcoming barriers to implementation in resource-limited environments.

Development of International Green Building Rating Systems And Local Implementation

Development of International Green Building Rating Systems And Local Implementation

Multilevel Environmental Governance in Indonesia: Analysis of Implementation Pathways and Institutional Dynamics

This study examines Indonesia's environmental governance framework, focusing on the complex interplay between global environmental imperatives and local implementation challenges. Through a qualitative analytical approach utilizing comprehensive secondary data, the research investigates how Indonesia navigates environmental governance while balancing economic development priorities. The study analyzes the integration of traditional ecological knowledge with modern environmental management approaches and examines the effectiveness of adaptive governance mechanisms in addressing diverse environmental challenges. The findings reveal that Indonesia's multilevel governance system, while facing coordination challenges, demonstrates significant potential in developing comprehensive environmental frameworks. The research highlights the critical role of institutional capacity building and stakeholder engagement in environmental governance, particularly in balancing economic development with environmental protection. The study also identifies key challenges in implementing environmental policies across Indonesia's diverse archipelagic territory, including intergovernmental coordination issues and resource allocation barriers. Furthermore, the research emphasizes the importance of context-specific approaches in environmental governance, particularly in integrating traditional knowledge systems with modern environmental management practices. This study contributes to the broader understanding of environmental governance in developing nations and provides valuable insights for policymakers seeking to enhance environmental governance effectiveness while maintaining sustainable development objectives.

What Makes Local Planning Effective in a Megacity? The Overlapping Agendas and Scale Inconsistencies in Developing Buenos Aires’ Affordable Land Markets

In limited-resourced Latin-American cities, adapting urban regulations and capturing value offers great potential for developing affordable land. We explored what counts for the significant variance in local land management implementation within Buenos Aires Metropolitan Region. Analysed municipalities successfully developed high-quality instruments to expand affordable land markets. However, local planning effectiveness does not find limits in the quality of planning itself. Depending on the municipalities’ relative location within the metro area, the national-level pipeline infrastructure plans, the politically driven finance choices, and divergent administration protocols favour or hinder the capacity to implement an effective urban land development strategy at local levels.

Exploring methodologies and frameworks for best practice transfer at the primary care level

Abstract Background In Feb 2023, the EU’s Joint Action on the transfer of best praCtices In pRimary CarE (CIRCE-JA) was launched with the objective of effectively transferring and implementing six best practices (BPs) among Member States (MS). Transferability from one primary care (PC) setting to another can be challenging given organizational, legal, cultural, social, economic, and environmental factors, requiring robust a methodological framework to guide the transfer process. A scoping review was conducted to identify conceptual models and methodological frameworks for context-relevant and evidence-informed BP transfer in PC settings. Methods The study aimed to identify models or frameworks to guide BP transfer in PC settings, whilst maximizing transferability. The JBI methodology was used, and an extensive search was conducted in PubMed (time limit: Jan ‘13-May ‘23). All publications of original research, systematic reviews, and text and opinion papers in English were eligible for inclusion. Key exclusion criteria were set, i.e., intervention type, level of care and reporting quality. The search was supplemented by gray literature review. Results From a total of 369 publications, 9 met eligibility criteria, reporting on 10 conceptual and methodological models/framework largely varying. These included transfer models applicable to all BPs as well as elements specific to some BPs, i.e., addressing integration, patient-centered care, care coordination, and health promotion. Strengths and weaknesses were identified for all. Conclusions Transferability of health interventions is complex, requiring systematic consideration of setting and intervention characteristics to inform and support local adaptation, implementation, and decision-making. Key elements identified can support the CIRCE-JA BP transfer and are largely relevant for further BP transfer across PC settings in EU MS, incl. for local adaptation, stakeholder engagement and effective implementation monitoring. Key messages • Innovative BPs are successfully deployed in many EU MS. To best support transformation for strong EU primary care and resilient health systems, it is important to ensure evidence-informed BP transfer. • This review reports on the selection of appropriate frameworks and models, and key elements thereof, to allow successful transfer of CIRCE-JA BPs and other BP transfer across PC settings in Europe.

Needs Assessment for Primary Care for Best Practice Implementation: The CIRCE Joint Action

Abstract Introduction CIRCE is a Joint Action (JA) supporting the transfer of six best practices (BPs) to new primary care settings in Europe. High-quality needs assessment can set the foundation for strong planning and implementation of the CIRCE-JA best practices in these new primary care settings. Methods A needs assessment tool was developed based on the TO-REACH knowledge transfer framework and learnings from a scoping review of international knowledge transfer frameworks. The needs assessment provides structured tool for local sites to self-assess the alignment of the BP with local priorities, readiness of the local site to successfully implement the BP, the availability of necessary leadership, resources and partnerships, and an examination of barriers to local BP implementation and mitigation strategies. Results Twenty-six CIRCE-JA teams completed the needs assessments. Local teams identified the CIRCE-JA BPs were value-adding and aligned with local priorities. Cross-cutting barriers were identified which were common among the six CIRCE-JA best practices across five thematic areas: (1) provider level, (2) intervention level, (3) health system/policy level, (4) partnership and physical resources and (5) information technology. The needs assessment supported primary care sites with a structured approach to planning for transfer of BPs to their local setting that is based on established international best practices and knowledge transfer frameworks including early identification of barriers and mitigating strategies. Conclusions The needs assessment has supported teams with conducting a self-assessment and informing initial planning for adoption of the BP in their local primary care practice. Given the importance of the local needs assessment to high quality implementation of BP the CIRCE-JA experience with local needs assessment may provide learnings for future BP transfer initiatives. Key messages • Local needs assessment supports the transfer of best practices to primary care settings, which is a critical component of service transformation during the post-COVID-19 period. • For successful transfer of best practices in primary care, it is vital to give to examine such as provider capacity, available human resources, health policy, and information technology.

Human Health Adaptation Strategies to Climate-Induced Extreme Weather Events: A Systematic Review

This systematic review evaluates the health impacts of climate-induced extreme weather events and the effectiveness of various adaptation strategies. Seventeen studies were analyzed, focusing on adaptation measures such as agricultural adjustments, renewable energy, ecosystem restoration, infrastructure redesign, and public health interventions. Significant health impacts were identified, including increased morbidity and mortality due to heatwaves, floods, and vector-borne diseases. The success of adaptation strategies was found to be highly dependent on local context, implementation capacity, and sustainability. This review underscores gaps in data quality, the generalizability of findings, and the integration of adaptation measures into public health policies. An urgent need exists for interdisciplinary approaches and community engagement to ensure sustainable, equitable health outcomes in the face of climate change. Future research should focus on these areas to strengthen public health resilience.

Examining purchasing strategies in public food procurement: Integrating sustainability, nutrition, and health in Spanish school meals and social care centres

Sustainable Public Food Procurement (SPFP) is pivotal in advancing sustainable and healthier food systems. However, practical gaps persist in understanding how policies function at the local implementation. This study addresses these gaps by analysing 22 SPFP contracts for school meals and social care centres in Spain, focusing on implementation while contextualizing findings within the broader policy cycle. This research categorizes SPFP criteria in tenders and evaluate their potential for actionability across sustainability, nutrition, & health dimensions. It also explores how these criteria are combined into purchasing strategies to achieve simultaneous or individual goals. Key findings reveal a strong use of product quality criteria, particularly organic foods, supported by policy and ease of implementation. However, non-ambitious targets, market constraints and procurement officers’ limited knowledge hinder progress. The study highlights significant adoption of nutritional & health criteria, though non-mandatory policies and varying regional targets impede consistent implementation and reveal gaps in promoting healthy and sustainable dietary practices. Environmental criteria are widely used signalling policy priorities within the EU policy framework. In contrast, proximity and social criteria are underutilized due to regulatory constraints and insufficient guidance. Despite these challenges, innovative local procurement strategies are utilized to overcome barriers. At the strategy level, the study reveals diverse approaches to SPFP implementation, highlighting adaptability but underscoring the need for flexible frameworks that accommodate local variations while aligning with broader EU or national goals. This research advocates for a holistic approach to SPFP that addresses both the practical challenges of implementation and the systemic issues present in the earlier stages of policy development.

48 Evaluation without representation: Paediatric residents perspectives on CBME

Abstract Background Paediatrics transitioned in 2021 to Competence By Design (CBD), a postgraduate education model spearheaded by the Royal College of Physicians and Surgeons of Canada (Royal College). CBD replaced a time-based training system with one based on competencies demonstrated through regular observations of trainee performance. Although intended to be learner-centered, resident voices have been underrepresented in CBD’s design. Objectives We sought to (1) understand how paediatric residents perceived CBD as impacting their education and evaluation, and (2) explore their ideas to improve its implementation. Design/Methods We compared three Canadian postgraduate paediatric residency programs. First, we reviewed Royal College and program-specific documents regarding CBD to understand local and national priorities for its implementation. Program directors and local education leads were then interviewed to understand local priorities and implementation practices at these programs. Lastly, we conducted interviews with paediatric residents that began residency the year that CBD was launched. We used reflexive, inductive analysis to analyze their perspectives on how CBD has affected their education and develop learner-informed recommendations for improvement. Results We interviewed six program directors and CBD leads. Identified programmatic benefits included improved trainee surveillance, facilitated curriculum change, and competency committees. Challenges included untrained faculty, workplace-based assessment tensions, and administrative burden on residents and staff. Subsequent interviews with ten paediatric residents demonstrated CBD as having limited benefit to their education, leading to a checklist mentality of EPA completion and disengagement with the CBD system. These perceptions were influenced by (1) administrative burden, (2) poor quality feedback from disengaged staff with limited coaching experience, and (3) a lack of collaborative communication between the residents, their programs, and the Royal College. Residents suggested improvements, including: decreasing the number of assessments to alleviate time burden on both residents and faculty; implementing formal coaching instruction for residents and staff; and improving dialogue between Royal College, competency committees, and residents and physician evaluators to build buy-in with the system and facilitate continuing process improvement. Conclusion If we are to effectively adapt postgraduate educational systems to equip learners with the skills to meet the needs of the societies they serve, centering resident voices in curricular revision is paramount to maximize learner buy-in, minimize unintended administrative burden, and guide the development of necessary institutional supports (e.g., formal coaching) to ensure successful system transformation.

Generating and translating evidence for safe and effective medication management in aged care homes.

Generating and translating high-quality evidence is integral to providing safe and effective medication management for residents of aged care homes. Residents are often under-represented in trials of medication effectiveness and safety. This paper reviews opportunities and challenges for generating and translating evidence for safe and effective medication management in aged care homes. There are an increasing number of randomized controlled trials (RCTs) being conductedin aged care homes. Observational studies can also help address the evidence-practice gap arising from underrepresentation of residents in RCTs. Stepped-wedge and helix counterbalanced designs may help overcome limitations of traditional RCTs for evaluating medication management interventions in the aged care setting. Strategies for generating evidence include building effective partnerships with aged care homes and organizations, using novel trial designs, leveraging existing data and knowledge sharing through international platforms. Strategies for translating evidence include using quality indicators for audit and feedback, provision of education and training, engaging internal and external stakeholders, and development of local action plans and guideline implementation tools. There is an emerging interest in the role of knowledge brokers to facilitate knowledge translation. Future directions for generating and translating evidence include strengthening international research collaboration, industry partnerships, standardizing aged care home data to support national and international comparisons, and optimizing the use of technology. Initiatives may include improving access to routinely collected administrative health and medication data for conducting high-quality observational studies. Future studies should assess outcomes prioritized by residents to ensure that medication management strategies are tailored to their needs.

Implementation of a tailored multifaceted antibiotic stewardship intervention to improve antibiotic prescribing for urinary tract infections in frail older adults (ImpresU) in four European countries: a process evaluation alongside a pragmatic cluster randomized controlled trial

BackgroundWe previously performed a pragmatic cluster randomized controlled trial (RCT) in general practices and older adult care organizations in Poland, the Netherlands, Norway, and Sweden. We found that a multifaceted antibiotic stewardship intervention (ASI) substantially reduced antibiotic use for suspected urinary tract infections (UTIs) in frail older adults compared with usual care. We aimed to evaluate the implementation process of the ASI to provide recommendations for clinical practice.MethodsWe conducted a process evaluation alongside the cluster RCT. The ASI consisted of a decision-tool and a toolbox, which were implemented using a participatory-action-research (PAR) approach with sessions for education and evaluation. We documented the implementation process of the intervention and administered a questionnaire to health care professionals (HCPs) from participating organizations in the intervention and usual care clusters. We evaluated the multiple components of the intervention and its implementation following a structured framework.ResultsThe questionnaire was completed by 254 HCPs from the 38 participating clusters. All components were largely delivered according to plan and evaluated as useful. The decision-tool and toolbox materials were reported to facilitate decision-making on UTIs. Regarding the PAR approach, educational sessions focusing on the distinction between UTIs and asymptomatic bacteriuria were held in all 19 intervention clusters. In 17 out of these 19 clusters, evaluation sessions took place, which were reported to help remind HCPs to implement the ASI. During both sessions, HCPs valued the reflection that took place and the resulting awareness of their behavior. It allowed them to explore implementation barriers and to tailor their local implementation process to overcome these. For example, HCPs organized extra educational sessions or revised local policies to incorporate the use of the decision-tool. Various HCPs took key roles in implementation. Staff changes and the COVID-19 pandemic were important contextual barriers.ConclusionsWe found each component of the multifaceted ASI and its implementation to have added value in the process to improve antibiotic prescribing for suspected UTIs in a heterogeneous older adult care setting. We recommend using a multifaceted, multidisciplinary approach that enables HCPs to reflect on their current practice and accordingly tailor local implementation.Trial registrationClinicalTrials.gov NCT03970356. Registered on May 31, 2019.

The Enactment of Sustainable Development Goals at a Local Scale Leads to Various Implications

The hallmark of global sustainable development efforts is the Millennium Development Goals (MDGs) initiative, so the SDGs were proposed after this. Early initiatives highlighted the need for a more comprehensive and globally applicable set of goals, thus laying the groundwork for the SDGs. Among them are sustainability, ecological environment protection and so on. This article explores the local implementation and impact of the United Nations Sustainable Development Goals (SDGs). The main questions are how to effectively implement SDGs policies in different social cultures, and the role of local government and community organizations is carefully analyzed. These are also areas where SDGs can be effectively promoted at the local level through muti-stakeholder collaboration, inclusive policies and innovative approaches. And there are three field examples to prove its effectiveness. For example, sustainable transport and energy management in Barcelona, participatory planning in Kerala and community conservation in Kenya. The significance of the study highlights the key role of local action in achieving the global Sustainable Development Goals, and provides concrete cases for analysis.

Deciding climate change adaptation implementation at the local level – a tale of two cities in the Netherlands

The implementation of adaptation to climate change lags behind necessary adaptation. Implementation of adaptation often takes place at the local level, influenced by local factors and mechanisms producing mainstreamed or standalone adaptation outcomes. Because mainstreaming adaptation is seen as accelerating adaptation, understanding this process is crucial for expediting its implementation. The lack of insight into the influence of context on mainstreaming and its respective outcomes hinders the transfer of lessons between different contexts. To address this gap, we investigate the question “Why do municipal policy processes lead to either standalone or mainstreamed adaptation implementation decisions?” We apply the Multiple Streams Framework to explain local adaptation implementation decisions to compare adaptation in Enschede and Zwolle, two Dutch adaptation frontrunners. We conclude that issue-linking with locally salient issues facilitates adaptation mainstreaming in a case without problem urgency, whereas a focusing event leads to standalone adaptation implementation if crisis-framing is applied.

Forging Paths of Compassion

In the United States, Florida leads the nation in prosecuting minors, from direct file to reinforcing systems like the school-to-prison pipeline. While the Department of Juvenile Justice has made an active effort to move away from the punitive avenues to address juvenile delinquency, the local implementation framework outlined in Florida Statute 985 results in variability in utilization across jurisdictions, influencing the treatment and consequences faced by justice-involved youth. The study unveils the influence of congregation-based community organizations, particularly within the Direct Action Research Training network (DART), in advocating for the expansion of civil citation programs. Through comparative analysis and qualitative interviews, it demonstrates the effectiveness of congregational advocacy in shaping juvenile justice policies. The findings underscore the necessity of statewide standards to ensure consistency and address local challenges in implementation. Additionally, the study highlights the importance of further research into the impact of socio-demographic and contextual factors on program effectiveness and youth outcomes, providing valuable insights for policy development.

Building locally anchored implementation science capacity: the case of the adolescent HIV implementation science alliance-supported local iS alliances.

The Fogarty International Center-led Adolescent HIV Implementation Science Alliance (AHISA) supports region-/country-specific implementation science (IS) alliances that build collaborations between research, policy, and program partners that respond to local implementation challenges. AHISA supported the development of seven locally-led IS alliances: five country-specific (i.e., Kenya, South Africa, Tanzania, Uganda, and Zambia), one in Central and West Africa, and one with youth researchers. This article outlines the aims, activities, and outcomes of local alliances, demonstrating how they enhance sustainable IS activities to address local challenges. We conducted a desk review of each alliance's funding applications, reports, and data from the initial findings of a larger AHISA evaluation. The review analyzes common approaches, highlights their local relevance, and summarizes initial outcomes. The local alliances have a common goal: to expand implementation of successful interventions to improve adolescent HIV. We identified four overarching themes across the local alliances' activities: capacity building, priority setting, stakeholder engagement, and knowledge dissemination. Research capacity building activities include long-term mentorship between junior and senior researchers and short-term training for non-research partners. Setting priorities with members identifies local research needs and streamlines activities. Alliances incorporate substantial engagement between partners, particularly youth, who may serve as leaders and co-create activities. Dissemination shares activities and results broadly. Local IS alliances play a key role in building sustainable IS learning and collaboration platforms, enabling improved uptake of evidence into policy and programs, increased IS research capacity, and shared approaches to addressing implementation challenges.