Integrating Implementation Science into Environmental Justice: A Systematic Review of Equity-Centered Strategies for Sustainable and Scalable Health Interventions

Background Environmental hazards, such as air and water pollution, substandard housing, heat islands, and insufficient greenspace, are disproportionately affecting economically impoverished, Indigenous, Black, and other communities of color that are experiencing structural imbalances. Despite the availability of evidence-based environmental health remedies, their equitable application is inconsistent, which may result in unintended consequences, such as green gentrification.Objectives This systematic study evaluates the integration of implementation science into environmental justice initiatives, with a focus on solutions that enhance sustainability, scalability, and equity in areas that are disproportionately affected.Methods We conducted a search of MEDLINE, Embase, and Scopus (January 2000–July 2023) in accordance with PRISMA criteria to identify peer-reviewed studies that addressed environmental exposures through interventions that were based on implementation science. Mixed-methods research, participatory methodologies, quasi-experimental studies, and randomized controlled trials (RCTs) were all considered eligible designs. Two examiners employed design-specific instruments to conduct data extraction and quality assessment in a separate manner. Environmental quality, health equity indicators, and implementation results (acceptability, adoption, fidelity, sustainability) comprised the outcomes.Results The inclusion criteria were met by 87 studies out of 3,274 entries. Housing quality, noise pollution, urban heat, air and water contamination, and verdant spaces were the focus of interventions. Technical remediation was combined with policy lobbying and community-based participatory research in effective initiatives. Hybrid effectiveness-implementation designs have demonstrated potential for the simultaneous evaluation of both results and processes. Early community involvement, equality-focused frameworks, and continuous financing were the primary facilitators. However, obstacles included the irregular incorporation of equity, insufficient cost-effectiveness statistics, and brief follow-up durations (<2 years). Equity-focused implementation strategies were specifically implemented by a tiny minority.Conclusions The uptake, sustainability, and health equality of interventions are enhanced by the integration of implementation science and environmental justice initiatives, particularly when structural variables and community governance are prioritized. Standardized equity criteria, extended longitudinal follow-up, and testing for worldwide applicability are important additional measures. Environmental improvements may either maintain or increase existing imbalances in the absence of intentional equitable integration.