Operationalising Equity Across Implementation Processes in Primary Prevention and Public Health: a Systematic Review of Empirical Practice

Equity is increasingly emphasised within implementation science, yet there remains limited empirical insight into how equity is operationalised across the full implementation process in real-world public health and primary prevention settings. Existing literature has largely focused on conceptual frameworks or equity-related outcomes, with less attention to how equity considerations are translated into concrete implementation decisions as interventions move from planning and delivery to evaluation, sustainment, and scale-up. This systematic review synthesises empirical, practice-oriented studies examining how equity is integrated across implementation processes within primary prevention and public health contexts, including lifestyle- and cancer-related risk prevention domains. The review will explore the implementation strategies through which equity is enacted, as well as the contextual determinants, organisational capacities, and reported barriers and facilitators that shape these processes over time. By conceptualising equity as a practice-based phenomenon unfolding across implementation phases, this review aims to advance empirical understanding of equity-focused implementation and to inform actionable guidance for integrating equity across the full implementation trajectory in prevention-oriented public health practice.