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BACKGROUND: Active travel to school contributes to multiple physical and psychosocial benefits for youth, yet population rates of active travel to school are alarmingly low in the USA and many other countries. Though walking school bus interventions are effective for increasing rates of active travel to school and children's overall physical activity, uptake of such interventions has been low. The objective of this study was to conduct a mixed methods implementation evaluation to identify contextual factors that serve as barriers and facilitators among existing walking school bus programs. METHODS: Semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR) were conducted with leaders of low-sustainability (n = 9) and high-sustainability (n = 11) programs across the USA. A combination of quantitative (CFIR-based) coding and inductive thematic analysis was used. The CFIR-based ratings were compared between the low- and high-sustainability programs and themes, subthemes, and exemplary quotes were provided to summarize the thematic analysis. RESULTS: In both the low- and high-sustainability programs, three of the 15 constructs assessed were commonly rated as positive (i.e., favorable for supporting implementation): student/family needs and resources, implementation climate, and planning. Three constructs were more often rated as positive in the high-sustainability programs: organizational incentives and rewards, engaging students and parents, and reflecting and evaluating. Three constructs were more often rated as positive in the low-sustainability programs: student/family needs and resources - built environment, available resources, and access to knowledge and information. Four themes emerged from the thematic analysis: planning considerations, ongoing coordination considerations, resources and supports, and benefits. CONCLUSIONS: Engagement of students, parents, and community members were among the factors that emerged across the quantitative and qualitative analyses as most critical for supporting walking school bus program implementation. The information provided by program leaders can help in the selection of implementation strategies that overcome known barriers for increasing the long-term success of community-based physical activity interventions such as the walking school bus.
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PROBLEM: Dissemination and implementation (D&I) science provides the tools needed to close the gap between known intervention strategies and their effective application. The authors report on the Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) program-a D&I training program for postdoctoral or early-career cancer prevention and control scholars. APPROACH: MT-DIRC was a 2-year training institute in which fellows attended 2 annual Summer Institutes and other conferences and received didactic, group, and individual instruction; individualized mentoring; and other supports (e.g., pilot funding). A quasi-experimental design compared changes in 3 areas: mentoring, skills, and network composition. To evaluate mentoring and D&I skills, data from fellows on their mentors' mentoring competencies, their perspectives on the importance of and satisfaction with mentoring priority areas, and their self-rated skills in D&I competency domains were collected. Network composition data were collected from faculty and fellows for 3 core social network domains: contact, mentoring, and collaboration. Paired t tests (mentoring), linear mixed models (skills), and descriptive analyses (network composition) were performed. OUTCOMES: Mentors were rated as highly competent across all mentoring competencies, and each mentoring priority area showed reductions in gaps between satisfaction and importance between the 6 and 18 months post-first Summer Institute. Fellows' self-rated skills in D&I competencies improved significantly in all domains over time (range: 42.5%-52.9% increase from baseline to 18 months post-first Summer Institute). Mentorship and collaboration networks grew over time, with the highest number of collaboration network ties for scholarly manuscripts (n = 199) in 2018 and for research projects (n = 160) in 2019. NEXT STEPS: Building on study findings and existing literature, mentored training of scholars is an important approach for building D&I skills and networks, and thus to better applying the vast amount of available intervention evidence to benefit cancer control.
Subject(s)
Biomedical Research/organization & administration , Delivery of Health Care/organization & administration , Information Dissemination/methods , Mentoring/organization & administration , Neoplasms/prevention & control , Research Personnel/education , Translational Research, Biomedical/education , Adult , Curriculum , Education, Medical, Continuing/organization & administration , Female , Humans , Male , Mentors , Middle Aged , Translational Research, Biomedical/organization & administrationABSTRACT
Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC) is part of California Breast Cancer Research Program's (CBCRP) Initiative strategic priority to disseminate and implement high-impact, population-based primary prevention interventions. CLASP-BC is informed by six years of funded program dissemination and implementation (D&I) research and evaluation conducted by the Canadian Partnership Against Cancer (CPAC) through its Coalitions Linking Action and Science for Prevention (CLASP). In its second phase, CLASP-BC will fund multi-sector, multi-jurisdictional initiatives that integrate the lessons learned from science with the lessons learned from practice and policy to reduce the risk of developing breast cancer and develop viable and sustainable infrastructure models for primary prevention breast cancer programs and research evidence implementation. Applications will be solicited from research, practice, policy, and community teams to address one or more of the intervention goals for the 23 risk factors identified in Paths to Prevention: The California Breast Cancer Primary Prevention Plan (P2P), expanding upon existing primary prevention efforts into two or more California jurisdictions, focused on disadvantaged, high risk communities with unmet social needs. The lessons learned from CLASP-BC will be widely disseminated within the participating jurisdictions, across California and, where applicable, to jurisdictions outside the state.
Subject(s)
Breast Neoplasms , Primary Prevention , Breast Neoplasms/prevention & control , California , Humans , Public Health , Risk FactorsABSTRACT
PURPOSE AND OBJECTIVES: Walking school bus programs increase children's physical activity through active travel to school; however, research to inform large-scale implementation of such programs is limited. We investigated contextual factors, implementation outcomes, and student outcomes in existing walking school bus programs in the United States and internationally. INTERVENTION APPROACH: Walking school bus programs involve a group of children walking to school together with an adult leader. On the trip to school, these adults provide social support, address potential traffic and interpersonal safety, and serve as role models to the children while children increase their physical activity levels. EVALUATION METHODS: We conducted surveys with existing walking school bus programs identified through internet searches, referrals, and relevant email listservs. Leaders from 184 programs that operated at least 1 trip per week completed the survey. We used regression analyses to compare differences in contextual factors by area income and location, associations between contextual factors and implementation outcomes, and associations between implementation outcomes and student outcomes. RESULTS: Walking school bus programs in low-income communities had more route leaders and engaged in more active travel to school-related activities of being sustained than those in higher income. Programs that had no external funding, multiple route leaders, and coordination by a school or district staff member (as opposed to a parent) had greater student participation than other programs. Providing more trips than other programs per week was associated with reduced tardiness, reduced bullying, and improved neighborhood walkability. The greatest barriers to implementation were recruiting and maintaining students and identifying and maintaining route leaders. IMPLICATIONS FOR PUBLIC HEALTH: Walking school bus programs can be implemented successfully in many contexts using various models. The involvement of several people in leadership roles is critical for sustainability. Evidence-based implementation strategies that overcome barriers can improve reach, implementation, and sustainability of walking school bus programs and can increase children's physical activity.
Subject(s)
Exercise , Program Development/methods , Students/statistics & numerical data , Walking/statistics & numerical data , Child , Female , Humans , Male , Program Evaluation , Schools/statistics & numerical data , Surveys and QuestionnairesABSTRACT
Given the lack of progress in breast cancer prevention, the California Breast Cancer Research Program (CBCRP) plans to apply current scientific knowledge about breast cancer to primary prevention at the population level. This paper describes the first phase of Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC). The foci of Phase 1 are building coalitions and coalition capacity building through community engagement in community-based participatory research (CBPR) and dissemination and implementation (D&I) research training. Based on the successful implementation and evaluation of Phase 1, the foci of Phase 2 (presented separately in this special issue) will be to translate the California Breast Cancer Prevention Plan overarching goal and specific intervention goals for 23 breast cancer risk and protective factors strategies into evidence-informed interventions (EIIs) that are disseminated and implemented across California. CLASP-BC is designed to identify, disseminate and implement high-impact, population-based prevention approaches by funding large scale EIIs, through multi-jurisdictional actions, with the intent to decrease the risk of breast cancer and other chronic diseases (sharing common risk factors), particularly among racial/ethnic minorities and medically underserved populations in California.
Subject(s)
Breast Neoplasms , Community-Based Participatory Research , Primary Prevention , Animals , Breast Neoplasms/prevention & control , Capacity Building , Chronic Disease , Health Knowledge, Attitudes, Practice , Humans , Rabbits , Risk FactorsABSTRACT
BACKGROUND: Mentored training approaches help build capacity for research through mentoring networks and skill building activities. Capacity for dissemination and implementation (D&I) research in cancer is needed and mentored training programs have been developed. Evaluation of mentored training programs through quantitative approaches often provides us with information on "what" improved for participants. Qualitative approaches provide a deeper understanding of "how" programs work best. METHODS: Qualitative interviews were conducted with 21 fellows of the National Cancer Institute-funded Mentored Training for Dissemination and Implementation in Cancer to gain understanding of their experiences with mentoring received during the program. Fellows were selected from all 55 trained participants based upon their gain in D&I research skills (highest and lowest) and number of collaborative connections in the program network (highest and lowest) reported in previous quantitative surveys. Phone interviews were recorded with permission, transcribed verbatim, and de-identified for analysis. Codes were developed a priori to reflect interview guide concepts followed by further development and iterative coding of three common themes that emerged: 1) program and mentoring structure, 2) importance of mentor attributes, and 3) enhanced capacity: credentials, confidence, credibility and connections. RESULTS: Interviews provided valuable information about program components that worked best and impacts attributed to participation in the program. Fellows reported that regular monthly check-in calls with mentors helped to keep their research moving forward and that group mentoring structures aided in their learning of basic D&I research concepts and their application. Accessible, responsive, and knowledgeable mentors were commonly mentioned by fellows as a key to their success in the program. Fellows mentioned various forms of impact that they attributed to their participation in the program including gaining credibility in the field, a network of peers and experts, and career developments (e.g., collaborative publications and grant funding). CONCLUSIONS: These findings suggest that mentored training works best when mentoring is structured and coupled with applied learning and when respected and dedicated mentors are on board. Increased scientific collaborations and credibility within a recognized network are important trainee experiences that should be considered when designing, implementing, and sustaining mentored training programs.
Subject(s)
Mentoring , Neoplasms , Delivery of Health Care , Humans , Mentors , Program Evaluation , Qualitative ResearchABSTRACT
BACKGROUND: There is a continued need to evaluate training programs in dissemination and implementation (D&I) research. Scientific products yielded from trainees are an important and objective measure to understand the capacity growth within the D&I field. This study evaluates our mentored training program in terms of scientific productivity among applicants. METHODS: Post-doctoral and early-career cancer researchers were recruited and applied to the R25 Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) between 2014 and 2017. Using application details and publicly available bibliometric and funding data, we compared selected fellows with unsuccessful applicants (nonfellows). We extracted Scopus citations and US federal grant funding records for all applicants (N = 102). Funding and publication abstracts were de-identified and coded for D&I focus and aggregated to the applicant level for analysis. Logistic regression models were explored separately for the odds of (1) a D&I publication and (2) US federal grant funding post year of application among fellows (N = 55) and nonfellows (N = 47). Additional models were constructed to include independent variables that attenuated the program's association by 5% or more. Only US-based applicants (N = 87) were included in the grant funding analysis. RESULTS: Fellows and nonfellows were similar across several demographic characteristics. Fellows were more than 3 times more likely than nonfellows to have grant funding after MT-DIRC application year (OR 3.2; 95% CI 1.1-11.0) while controlling for time since application year; the association estimate was 3.1 (95% CI 0.98-11.0) after adjusting for both cancer research area and previous grant funding. For publications, fellows were almost 4 times more likely to publish D&I-focused work adjusting for time (OR 3.8; 95% CI 1.7-9.0). This association lessened after adjusting for previous D&I publication and years since undergraduate degree (OR 2.9; 95% CI 1.2-7.5). CONCLUSIONS: We document the association of a mentored training approach with built-in networks of peers to yield productive D&I researchers. Future evaluation efforts could be expanded to include other forms of longer-term productivity such as policy or practice change as additional objective measures. D&I research trainings in the USA and internationally should consider common evaluation measures.
Subject(s)
Biomedical Research/organization & administration , Implementation Science , Information Dissemination/methods , Medical Oncology/organization & administration , Mentors/education , Female , Humans , Male , Peer Group , Research Support as Topic/statistics & numerical dataABSTRACT
BACKGROUND: Knowledge syntheses that use a realist methodology are gaining popularity. Yet, there are few reports in the literature that describe how results are summarised, shared and used. This paper aims to inform knowledge translation (KT) for realist reviews by describing the process of developing a KT strategy for a review on pathways for scaling up complex public health interventions. METHODS: The participatory approach used for the realist review was also used to develop the KT strategy. The approach included three main steps, namely (1) an international meeting focused on interpreting preliminary findings from the realist review and seeking input on KT activities; (2) a targeted literature review on KT for realist reviews; and (3) consultations with primary knowledge users of the review. RESULTS: The international meeting identified a general preference among knowledge users for findings from the review that are action oriented. A need was also identified for understanding how to tailor findings for specific knowledge user groups in relation to their needs. The literature review identified four papers that included brief descriptions of planned or actual KT activities for specific research studies; however, information was minimal on what KT activities or products work for whom, under what conditions and why. The consultations revealed that KT for realist reviews should consider the following: (1) activities closely aligned with the preferences of specific knowledge user groups; (2) key findings that are sensitive to factors within the knowledge user's context; and (3) actionable statements that can advance KT goals, activities or products. The KT strategy derived from the three activities includes a planning framework and tailored KT activities that address preferences of knowledge users for findings that are action oriented and context relevant. CONCLUSIONS: This paper provides an example of a KT strategy for realist reviews that blends theoretical and practical insights. Evaluation of the strategy's implementation will provide useful insights on its effectiveness and potential for broader application.
Subject(s)
Delivery of Health Care , Health Planning , Public Health , Research Design , Review Literature as Topic , Stakeholder Participation , Translational Research, Biomedical , Decision Making , Evidence-Based Medicine , Humans , Knowledge , Population Health , Problem SolvingABSTRACT
BACKGROUND: As the field of D&I (dissemination and implementation) science grows to meet the need for more effective and timely applications of research findings in routine practice, the demand for formalized training programs has increased concurrently. The Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) Program aims to build capacity in the cancer control D&I research workforce, especially among early career researchers. This paper outlines the various components of the program and reports results of systematic evaluations to ascertain its effectiveness. METHODS: Essential features of the program include selection of early career fellows or more experienced investigators with a focus relevant to cancer control transitioning to a D&I research focus, a 5-day intensive training institute, ongoing peer and senior mentoring, mentored planning and work on a D&I research proposal or project, limited pilot funding, and training and ongoing improvement activities for mentors. The core faculty and staff members of the MT-DIRC program gathered baseline and ongoing evaluation data regarding D&I skill acquisition and mentoring competency through participant surveys and analyzed it by iterative collective reflection. RESULTS: A majority (79%) of fellows are female, assistant professors (55%); 59% are in allied health disciplines, and 48% focus on cancer prevention research. Forty-three D&I research competencies were assessed; all improved from baseline to 6 and 18 months. These effects were apparent across beginner, intermediate, and advanced initial D&I competency levels and across the competency domains. Mentoring competency was rated very highly by the fellows--higher than rated by the mentors themselves. The importance of different mentoring activities, as rated by the fellows, was generally congruent with their satisfaction with the activities, with the exception of relatively greater satisfaction with the degree of emotional support and relatively lower satisfaction for skill building and opportunity initially. CONCLUSIONS: These first years of MT-DIRC demonstrated the program's ability to attract, engage, and improve fellows' competencies and skills and implement a multicomponent mentoring program that was well received. This account of the program can serve as a basis for potential replication and evolution of this model in training future D&I science researchers.
Subject(s)
Biomedical Research/methods , Capacity Building/methods , Health Services Research/methods , Information Dissemination/methods , Mentoring , Mentors , Neoplasms/prevention & control , Research Personnel/education , Translational Research, Biomedical/methods , Biomedical Research/organization & administration , Delivery of Health Care , Female , Health Services Research/organization & administration , Humans , Male , Pilot Projects , Research Personnel/psychology , UniversitiesABSTRACT
Brief structured physical activity in the classroom is effective for increasing student physical activity. The present study investigated the association between implementation-related contextual factors and intervention implementation after adoption of a structured classroom physical activity intervention. Six elementary-school districts adopted structured classroom physical activity programs in 2013-2014. Implementation contextual factors and intervention implementation (structured physical activity provided in past week or month, yes/no) were assessed using surveys of 337 classroom teachers from 24 schools. Mixed-effects models accounted for the nested design. Availability of resources (yes/no, ORs = 1.91-2.93) and implementation climate z-scores (ORs = 1.36-1.47) were consistently associated with implementation. Teacher-perceived classroom behavior benefits (OR = 1.29) but not student enjoyment or health benefits, and time (OR = 2.32) and academic (OR = 1.63) barriers but not student cooperation barriers were associated with implementation (all z-scores). Four implementation contextual factor composites had an additive association with implementation (OR = 1.64 for each additional favorable composite). Training and technical assistance alone may not support a large proportion of teachers to implement structured classroom physical activity. In addition to lack of time and interference with academic lessons, school climate related to whether administrators and other teachers were supportive of the intervention were key factors explaining whether teachers implemented the intervention. Evidence-based implementation strategies are needed for effectively communicating the benefits of classroom physical activity on student behavior and improving teacher and administrator climate/attitudes around classroom physical activity.
Subject(s)
Exercise , Health Promotion , Schools , Academic Success , Child , Child Behavior , Evidence-Based Practice , Female , Health Knowledge, Attitudes, Practice , Health Plan Implementation , Health Promotion/methods , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , Organizational Culture , School Teachers , Students/psychology , Surveys and Questionnaires , Time FactorsABSTRACT
INTRODUCTION: Dissemination and implementation research training has great potential to improve the impact and reach of health-related research; however, research training needs from the end user perspective are unknown. This paper identifies and prioritizes dissemination and implementation research training needs. METHODS: A diverse sample of researchers, practitioners, and policymakers was invited to participate in Concept Mapping in 2014-2015. Phase 1 (Brainstorming) gathered participants' responses to the prompt: To improve the impact of research evidence in practice and policy settings, a skill in which researchers need more training is The resulting statement list was edited and included subsequent phases. Phase 2 (Sorting) asked participants to sort each statement into conceptual piles. In Phase 3 (Rating), participants rated the difficulty and importance of incorporating each statement into a training curriculum. A multidisciplinary team synthesized and interpreted the results in 2015-2016. RESULTS: During Brainstorming, 60 researchers and 60 practitioners/policymakers contributed 274 unique statements. Twenty-nine researchers and 16 practitioners completed sorting and rating. Nine concept clusters were identified: Communicating Research Findings, Improve Practice Partnerships, Make Research More Relevant, Strengthen Communication Skills, Develop Research Methods and Measures, Consider and Enhance Fit, Build Capacity for Research, and Understand Multilevel Context. Though researchers and practitioners had high agreement about importance (r =0.93) and difficulty (r =0.80), ratings differed for several clusters (e.g., Build Capacity for Research). CONCLUSIONS: Including researcher and practitioner perspectives in competency development for dissemination and implementation research identifies skills and capacities needed to conduct and communicate contextualized, meaningful, and relevant research.
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Health Plan Implementation , Information Dissemination , Public Health Practice , Research/education , Cluster AnalysisABSTRACT
PURPOSE: Despite the potential for reducing the cancer burden via state policy change, few data exist on how best to disseminate research information to influence state legislators' policy choices. We explored: (1) the relative importance of core framing issues (source, presentation, timeliness) among policymakers who prioritize cancer and those who do not prioritize cancer and (2) the predictors of use of research in policymaking. METHODS: Cross-sectional data were collected from US state policymakers (i.e., legislators elected to state houses or senates) from January through October 2012 (n = 862). One-way analysis of variance was performed to investigate the association of the priority of cancer variable with outcome variables. Multivariate logistic regression models examined predictors of the influence of research information. RESULTS: Legislators who prioritized cancer tended to rate characteristics that make research information useful higher than those who did not prioritize cancer. Among differences that were statistically significant were three items in the "source" domain (relevance, delivered by someone respected, supports one's own position), one item in the "presentation" domain (telling a story related to constituents) and two items in the "timeliness" domain (high current state priority, feasible when information is received). Participants who prioritized cancer risk factors were 80 % more likely to rate research information as one of their top reasons for choosing an issue on which to work. CONCLUSIONS: Our results suggest the importance of narrative forms of communication and that research information needs to be relevant to the policymakers' constituents in a brief, concise format.
Subject(s)
Health Policy , Neoplasms , Policy Making , Research , Cross-Sectional Studies , HumansABSTRACT
BACKGROUND: This paper reports core competencies for dissemination and implementation (D&I) grant application writing and provides tips for writing a successful proposal. METHODS: Two related phases were used to collect the data: a card sorting process among D&I researchers and an expert review among a smaller set of researchers. Card sorting was completed by 123 respondents. In the second phase, a series of grant application writing tips were developed based on the combined 170 years of grant review experience of the writing team. RESULTS: The card sorting resulted in 12 core competencies for D&I grant application writing that covered the main sections in a grant application to the US National Institutes of Health: (a) specific aims that provide clear rationale, objectives, and an overview of the research plan; (b) significance that frames and justifies the importance of a D&I question; (c) innovation that articulates novel products and new knowledge; and (d) approach that uses a relevant D&I model, addresses measurement and the D&I context, and includes an analysis plan well-tied to the aims and measures. CONCLUSIONS: Writing a successful D&I grant application is a skill that can be learned with experience and attention to the core competencies articulated in this paper.
Subject(s)
Financing, Organized , Research Support as Topic , Translational Research, Biomedical/organization & administration , Writing/standards , Data Collection , National Institutes of Health (U.S.) , Research Personnel , Translational Research, Biomedical/economics , United StatesABSTRACT
Healthy public policy plays an essential role in a comprehensive public health approach to preventing cancer and chronic disease. Public policies spread through the 'policy diffusion' process, enabling governments to learn from another's enacted policy solutions. The Prevention Policies Directory (the Directory), an online database of municipal, provincial/territorial, and federal cancer and chronic disease prevention policies from across Canada, was developed to facilitate the diffusion of healthy public policies and support the work of prevention researchers, practitioners, and policy specialists. This information technology solution was implemented, through a participatory engagement approach, as a communication channel or policy knowledge transfer tool. It also addressed the intrinsic shortcomings of environmental scanning for policy surveillance and monitoring. A combination of quantitative web metrics and qualitative anecdotal evidence have illustrated that the Directory is becoming an important tool for healthy public policy surveillance and policy diffusion in Canada.
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INTRODUCTION: Until recently, health care systems in the United States often lacked a unified approach to prevent and manage chronic disease. Recent efforts have been made to close this gap through various calls for increased collaboration between public health and health care systems to better coordinate provision of services and programs. Currently, the extent to which the public health workforce has responded is relatively unknown. The objective of this study is to explore health care system collaboration efforts and activities among a population-based sample of state public health practitioners. METHODS: During spring 2013, a national survey was administered to state-level chronic disease public health practitioners. Respondents were asked to indicate whether or not they collaborate with health care systems. Those who reported "yes" were asked to indicate all topic areas in which they collaborate and provide qualitative examples of their collaborative work. RESULTS: A total of 759 respondents (84%) reported collaboration. Common topics of collaboration activities were tobacco, cardiovascular health, and cancer screening. More client-oriented interventions than system-wide interventions were found in the qualitative examples provided. Respondents who collaborated were also more likely to use the Community Guide, use evidence-based decision making, and work in program areas that involved secondary, rather than primary, prevention. CONCLUSION: The study findings indicate a need for greater guidance on collaboration efforts that involve system-wide and cross-system interventions. Tools such as the Community Guide and evidence-based training courses may be useful in providing such guidance.
Subject(s)
Chronic Disease/therapy , Cooperative Behavior , Primary Prevention , Public Health Practice , Adult , Community Health Planning , Decision Making , Evidence-Based Practice/education , Female , Health Services Needs and Demand , Humans , Male , Middle Aged , Multivariate Analysis , Qualitative Research , Self Report , Socioeconomic Factors , State Government , Surveys and Questionnaires , Tobacco Use Cessation , United States , Young AdultABSTRACT
BACKGROUND: Cancer and other chronic diseases reduce quality and length of life and productivity, and represent a significant financial burden to society. Evidence-based public health approaches to prevent cancer and other chronic diseases have been identified in recent decades and have the potential for high impact. Yet, barriers to implement prevention approaches persist as a result of multiple factors including lack of organizational support, limited resources, competing emerging priorities and crises, and limited skill among the public health workforce. The purpose of this study is to learn how best to promote the adoption of evidence based public health practice related to chronic disease prevention. METHODS/DESIGN: This paper describes the methods for a multi-phase dissemination study with a cluster randomized trial component that will evaluate the dissemination of public health knowledge about evidence-based prevention of cancer and other chronic diseases. Phase one involves development of measures of practitioner views on and organizational supports for evidence-based public health and data collection using a national online survey involving state health department chronic disease practitioners. In phase two, a cluster randomized trial design will be conducted to test receptivity and usefulness of dissemination strategies directed toward state health department chronic disease practitioners to enhance capacity and organizational support for evidence-based chronic disease prevention. Twelve state health department chronic disease units will be randomly selected and assigned to intervention or control. State health department staff and the university-based study team will jointly identify, refine, and select dissemination strategies within intervention units. Intervention (dissemination) strategies may include multi-day in-person training workshops, electronic information exchange modalities, and remote technical assistance. Evaluation methods include pre-post surveys, structured qualitative phone interviews, and abstraction of state-level chronic disease prevention program plans and progress reports. TRIAL REGISTRATION: clinicaltrials.gov: NCT01978054.
Subject(s)
Chronic Disease/prevention & control , Diffusion of Innovation , Evidence-Based Practice , Neoplasms/prevention & control , Public Health Practice , Cluster Analysis , Humans , Self Report , State Government , United StatesABSTRACT
CONTEXT: Funding for transdisciplinary chronic disease prevention research has increased over the past decade. However, few studies have evaluated whether networking and knowledge exchange activities promote the creation of transdisciplinary teams to successfully respond to requests for proposals (RFPs). Such evaluations are critical to understanding how to accelerate the integration of research with practice and policy to improve population health. OBJECTIVE: To examine (1) the extent of participation in pre-RFP activities among funded and nonfunded transdisciplinary coalitions that responded to a RFP for cancer and chronic disease prevention initiatives and (2) levels of agreement in proposal ratings among research, practice, and policy peer reviewers. DESIGN/SETTING: Descriptive report of a Canadian funding initiative to increase the integration of evidence with action. PARTICIPANTS: Four hundred forty-nine representatives in 41 research, practice, and policy coalitions who responded to a RFP and whose proposals were peer reviewed by a transdisciplinary adjudication panel. INTERVENTION: The funder hosted 6 national meetings and issued a letter of intent (LOI) to foster research, practice, and policy collaborations before issuing a RFP. RESULTS: All provinces and territories in Canada were represented by the coalitions. Funded coalitions were 2.5 times more likely than nonfunded coalitions to submit a LOI. A greater proportion of funded coalitions were exposed to the pre-RFP activities (100%) compared with coalitions that were not funded (68%). Overall research, practice, and policy peer reviewer agreement was low (intraclass correlation 0.12). CONCLUSIONS: There is widespread interest in transdisciplinary collaborations to improve cancer and chronic disease prevention. Engagement in networking and knowledge exchange activities, and feedback from LOIs prior to submission of a final application, may contribute to stronger proposals and subsequent funding success. Future evaluations should examine best practices for transdisciplinary peer review to facilitate funding of proposals that on balance have both scientific rigor and are relevant to the real world.
Subject(s)
Chronic Disease/prevention & control , Cooperative Behavior , Health Services Research/organization & administration , Interprofessional Relations , Peer Review, Research/methods , Canada , Community Health Planning/organization & administration , Community Participation/methods , Financing, Government/organization & administration , Health Services Research/standards , Humans , Peer Review, Research/standardsABSTRACT
Evidence-based interventions (EBIs) are not broadly implemented, despite widespread availability of programs, policies, and guidelines. Systematic processes for integrating EBIs with community preference remain challenging for cancer control and prevention, as well as other areas. The Cancer Control P.L.A.N.E.T. (P.L.A.N.E.T) Web portal provides a platform to access data, EBIs, and resources to foster local partnerships and assist public health researchers and practitioners design, implement, and evaluate evidence-based cancer control programs. This article summarizes the evolution of P.L.A.N.E.T. and describes effective and innovative Web 2.0 strategies to increase Web visits, create more interactive platforms for researchers and practitioners to integrate evidence-based resources, community preferences, and the complex context in which programs and policies are implemented. Lessons learned could benefit public health settings and reach low-income, high-risk communities. Researchers, community practitioners, and government partnerships should continue to develop and test innovative ways to address pressing issues in cancer control, health disparities, and health delivery.
Subject(s)
Evidence-Based Medicine/methods , Internet , Neoplasms/prevention & control , Translational Research, Biomedical/methods , Biomedical Research/methods , Biomedical Research/trends , Delivery of Health Care/methods , Delivery of Health Care/trends , Humans , Information Dissemination/methods , Neoplasms/diagnosis , Neoplasms/therapy , Reproducibility of ResultsABSTRACT
Cancer is a leading cause of death worldwide, accounting for approximately 7.6 million deaths (13% of all deaths) in 2008. Cancer mortality is projected to increase to 11 million deaths in 2030, with the majority occurring in regions of the world with the least capacity to respond. However, cancer is not only a personal, societal and economic burden but also a potential societal opportunity in the context of functional life - the years gained through effective prevention and treatment, and strategies to enhance survivorship. The United Nations General Assembly Special Session in 2011 has served to focus attention on key aspects of cancer prevention and control. Firstly, cancer is largely preventable, by feasible means. Secondly, cancer is one of a number of chronic, non- communicable diseases that share common risk factors whose prevention and control would benefit a majority of the world's population. Thirdly, a proportion of cancers can be attributed to infectious, communicable causal factors (e.g., HPV, HBV, H.pylori, parasites, flukes) and that strategies to control the burden of infectious diseases have relevance to the control of cancer. Fourthly, that the natural history of non-communicable diseases, including cancer, from primary prevention through diagnosis, treatment and care, is underwritten by the impact of social, economic and environmental determinants of health (e.g., poverty, illiteracy, gender inequality, social isolation, stigma, socio-economic status). Session 1 of the 4th International Cancer Control Congress (ICCC-4) focused on the social, economic and environmental, as well as biological and behavioural, modifiers of the risk of cancer through one plenary presentation and four interactive workshop discussions. The workshop sessions concerned 1) the Global Adult Tobacco Survey and social determinants of tobacco use in high burden low- and middle-income countries; 2) the role of diet, including alcohol, and physical activity in modifying the risk of cancer and other non-communicable diseases; 3) the role of infections in modifying the risk of cancer; and 4) the public policies and actions that can be implemented to effectively reduce the risk of cancer at population levels. Workshop discussions highlighted the need for high quality data on the prevalence of modifiable factors in different settings, as well as the social, economic and environmental drivers of these factors, in order to inform prevention and control programs. For some factors, further work needs to be done to develop simple and valid measurement tools. Given that many of these factors are common to both cancer and other non-communicable diseases, cancer prevention should be viewed within the broader perspective of the prevention of non-communicable diseases and should engage all relevant actors, including the general public, health and other professionals, workplaces and institutions, the media, civil society, schools, governments, industry, and multinational bodies. Many policies and plans have been implemented in various settings to control the drivers of modifiable factors and promote health and well-being. Mapping, analysis, and contextualization of those policies that are relevant would be helpful to promote action around cancer prevention in different settings.