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Allen JD, Shelton RC, Kephart L, Tom LS, Leyva B, Ospino H, Cuevas AG. Examining the external validity of the CRUZA study, a randomized trial to promote implementation of evidence-based cancer control programs by faith-based organizations. Transl Behav Med 2021; 10:213-222. [PMID: 30496532 DOI: 10.1093/tbm/iby099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The CRUZA trial tested the efficacy of an organizational-level intervention to increase capacity among Catholic parishes to implement evidence-based interventions (EBIs) for cancer control. This paper examines the external generalizability of the CRUZA study findings by comparing characteristics of parishes that agreed to participate in the intervention trial versus those that declined participation. Sixty-five Roman Catholic parishes that offered Spanish-language mass in Massachusetts were invited to complete a four-part survey assessing organization-level characteristics that, based on the Consolidated Framework for Implementation Research (CFIR), may be associated with EBI implementation. Forty-nine parishes (75%) completed the survey and were invited to participate in the CRUZA trial, which randomized parishes to either a "capacity enhancement intervention" or a "standard dissemination" group. Of these 49 parishes, 31 (63%) agreed to participate in the trial, whereas 18 parishes (37%) declined participation. Parishes that participated in the CRUZA intervention trial were similar to those that did not participate with respect to "inner organizational setting" characteristics of the CFIR, including innovation and values fit, implementation climate, and organizational culture. Change commitment, a submeasure of organizational readiness that reflects the shared resolve of organizational members to implement an innovation, was significantly higher among the participating parishes (mean = 3.93, SD = 1.08) as compared to nonparticipating parishes (mean = 3.27, SD = 1.08) (Z = -2.16, p = .03). Parishes that agreed to participate in the CRUZA intervention trial were similar to those that declined participation with regard to organizational characteristics that may predict implementation of EBIs. Pragmatic tools to assess external generalizability in community-based implementation trials and to promote readiness among faith-based organizations to implement EBIs are needed to enhance the reach and impact of public health research. Clinical Trial information: The CRUZA trial identifier number with clinicaltrials.gov is NCT01740219.
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Affiliation(s)
| | | | | | - Laura S Tom
- Community Health, Tufts University, Medford, MA
| | - Bryan Leyva
- Community Health, Tufts University, Medford, MA
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Garland SN, Trevino K, Liou KT, Gehrman P, Spiguel E, MacLeod J, Walker DAH, Glosik B, Seluzicki C, Barg FK, Mao JJ. Multi-stakeholder perspectives on managing insomnia in cancer survivors: recommendations to reduce barriers and translate patient-centered research into practice. J Cancer Surviv 2021; 15:951-960. [PMID: 33606188 DOI: 10.1007/s11764-021-01001-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/06/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Insomnia is a debilitating symptom experienced by nearly 60% of cancer survivors. Building on our prior research showing the clinical benefit of cognitive behavioral therapy for insomnia (CBT-I) and acupuncture, we organized a workshop of patient advocates and clinician stakeholders to understand the barriers and develop recommendations for the dissemination and implementation of these interventions. METHODS Participants completed a pre-workshop survey assessing their experiences with insomnia and barriers to insomnia treatment and participated in a workshop facilitated by professionals and patient experts. Responses from the survey were tabulated and the discussions from the workshop were content-analyzed to extract relevant factors that may influence dissemination and implementation. RESULTS Multidisciplinary and stakeholder workshop participants (N = 51) identified barriers and proposed solutions and future recommendations for dissemination and implementation of evidence-based interventions to improve sleep health in cancer survivors. Barriers were identified in four categories: patient (e.g., knowledge, time, cost), clinician (e.g., education, time, capacity), institutional (e.g., space, insurance reimbursement, referrals), and societal (e.g., lack of prioritization for sleep issues). Based on these categories, we made six recommendations for dissemination and implementation of research findings to improve clinical sleep management in oncology. CONCLUSION Dissemination and implementation efforts are necessary to translate research into clinical practice to improve patient care. IMPLICATIONS FOR CANCER SURVIVORS Sleep needs to be prioritized in cancer care, but patient, provider, and institutional/societal barriers remain. Dedicated effort and resources at each of these levels are needed to help millions of people affected by cancer manage their insomnia and improve their quality of life.
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Affiliation(s)
| | - Kelly Trevino
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kevin T Liou
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Jodi MacLeod
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Betsy Glosik
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Schneider M, Mehari K, Langhinrichsen-Rohling J. What Caregivers Want: Preferences for Behavioral Health Screening Implementation Procedures in Pediatric Primary Care. J Clin Psychol Med Settings 2020; 28:562-574. [PMID: 33048313 DOI: 10.1007/s10880-020-09745-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 01/04/2023]
Abstract
There has been a national push for universal psychosocial prevention screening in pediatric primary care. Implementation science highlights the importance of considering patients' perspectives when developing such procedures; however, minimal studies have examined this. The present study employed a mixed-methods design to examine caregivers of pediatric patients' (n = 149) preferences and comfort with psychosocial screening procedures. A subset of participants (n = 20) were interviewed to better understand reasons for responses. Results indicated that caregivers rated screening for physical health, development, emotion and behavior, caregiver adverse childhood experiences (ACEs), and child ACEs within primary care as important or very important. The majority of caregivers were not comfortable completing screenings in the waiting room and preferred the exam room. Caregivers primarily preferred the primary care provider to administer screenings and communicate results and recommendations. Parents also preferred the behavioral health provider to provide recommendations on emotion and behavior, parent ACEs, and child ACEs. Qualitative reasons for responses included relationship quality, knowledge of child, expertise, and desire for direct communication. Findings have implications for developing family-centered, trauma-informed practices within primary care, particularly among those within under-resourced rural communities.
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Affiliation(s)
- Mallory Schneider
- Department of Psychology, University of South Alabama, 307 N University Blvd, UCOM 1000, Mobile, AL, 36606, USA.
| | - Krista Mehari
- Department of Psychology, University of South Alabama, 307 N University Blvd, UCOM 1000, Mobile, AL, 36606, USA
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Trevino KM, Healy C, Martin P, Canin B, Pillemer K, Sirey JA, Reid MC. Improving implementation of psychological interventions to older adult patients with cancer: Convening older adults, caregivers, providers, researchers. J Geriatr Oncol 2019; 9:423-429. [PMID: 29759913 DOI: 10.1016/j.jgo.2018.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/23/2018] [Accepted: 04/25/2018] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Older adults with cancer (OACs) are a large and growing population. Psychological distress is prevalent in this population yet few OACs receive evidence-based psychological care. The purpose of this project was to identify barriers and strategies for the implementation of psychological interventions to OACs from the perspective of OACs, OAC caregivers, researchers, clinicians, and advocacy organization members. METHODS The Cornell Research-to-Practice (RTP) Consensus Workshop Model was used to organize and convene a consensus conference. The one-day conference consisted of small and large group discussions regarding barriers, facilitators, and strategies for the implementation of psychological interventions targeting OACs. A half-day roundtable meeting was subsequently conducted to organize data generated at the conference. De-identified transcriptions of the small group discussions were uploaded into NVivo 11 software and qualitatively analyzed using standard methods. RESULTS Thirty-five participants attended the consensus conference from across stakeholder groups. Three themes related to implementation barriers were identified: lack of knowledge about psychological interventions in patients and providers; personal and social factors associated with being an OAC; and institutional-level factors. Themes related to implementation strategies focused on increasing awareness, tailoring interventions for older adults, and modifying institutional-level factors. DISCUSSION Effective implementation of psychological interventions to OACs is complex and barriers exist across multiple levels of care. However, this project indicates that implementation can be improved in various ways that include all members of the healthcare system. Further clarification of implementation strategies and rigorous evaluation of their effectiveness is vital to improving care and care outcomes of OACs.
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Affiliation(s)
- Kelly M Trevino
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States.
| | - Charlotte Healy
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States
| | - Peter Martin
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States
| | | | - Karl Pillemer
- Cornell University, 144 East Ave., Ithaca, NY 14853, United States
| | - Jo Anne Sirey
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States
| | - M Cary Reid
- Weill Cornell Medicine, NewYork Presbyterian Hospital, 525 E. 68th Street, New York, NY 10065, United States
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Simon MA, Tom LS, Leung I, Wong E, Knightly EE, Vicencio DP, Yau A, Ortigara K, Dong X. The Chinatown Patient Navigation Program: Adaptation and Implementation of Breast and Cervical Cancer Patient Navigation in Chicago's Chinatown. Health Serv Insights 2019; 12:1178632919841376. [PMID: 31037032 PMCID: PMC6475834 DOI: 10.1177/1178632919841376] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 03/09/2019] [Indexed: 01/09/2023] Open
Abstract
Background As health care reform continues within the United States, navigators may play increasingly diverse and vital roles across the health care continuum. The growing interest in patient navigation programs for underserved populations calls for detailed descriptions of intervention components to facilitate implementation and dissemination efforts. Methods In Chicago's Chinatown, Chinese immigrant women face language, cultural, and access barriers in obtaining breast and cervical cancer screening and follow-up. These barriers spurred the research partnership between Northwestern University, the Chinese American Service League, Mercy Hospital & Medical Center, and Rush University Medical Center to formalize the Chinatown Patient Navigation Collaborative for adapting and implementing previously developed patient navigation models. Results In this report, we describe the adaptation of patient navigation to build the Chinatown Patient Navigation Collaborative's community-based patient navigation program for breast and cervical cancer. We offer insights into the roles of community patient navigators in safety net hospital and underserved Chinese immigrant communities, and describe implications for patient navigation initiatives to maximize community benefits by improving access to health care for vulnerable populations. Conclusions Our adaptation and implementation of a patient navigation intervention in Chicago's Chinatown illustrates promising approaches for future navigator research.
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Affiliation(s)
- Melissa A Simon
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Laura S Tom
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ivy Leung
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Chinese American Service League, Chicago, IL, USA
| | - Esther Wong
- Chinese American Service League, Chicago, IL, USA
| | - Eileen E Knightly
- University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | | | - Ann Yau
- Mercy Hospital & Medical Center, Chicago, IL, USA
| | | | - XinQi Dong
- Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Allen JD, Towne SD, Maxwell AE, DiMartino L, Leyva B, Bowen DJ, Linnan L, Weiner BJ. Meausures of organizational characteristics associated with adoption and/or implementation of innovations: A systematic review. BMC Health Serv Res 2017; 17:591. [PMID: 28835273 PMCID: PMC5569532 DOI: 10.1186/s12913-017-2459-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 07/18/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This paper identifies and describes measures of constructs relevant to the adoption or implementation of innovations (i.e., new policies, programs or practices) at the organizational-level. This work is intended to advance the field of dissemination and implementation research by aiding scientists in the identification of existing measures and highlighting methodological issues that require additional attention. METHODS We searched for published studies (1973-2013) in 11 bibliographic databases for quantitative, empirical studies that presented outcome data related to adoption and/or implementation of an innovation. Included studies had to assess latent constructs related to the "inner setting" of the organization, as defined by the Consolidated Framework for Implementation Research. RESULTS Of the 76 studies included, most (86%) were cross sectional and nearly half (49%) were conducted in health care settings. Nearly half (46%) involved implementation of evidence-based or "best practice" strategies; roughly a quarter (26%) examined use of new technologies. Primary outcomes most often assessed were innovation implementation (57%) and adoption (34%); while 4% of included studies assessed both outcomes. There was wide variability in conceptual and operational definitions of organizational constructs. The two most frequently assessed constructs included "organizational climate" and "readiness for implementation." More than half (55%) of the studies did not articulate an organizational theory or conceptual framework guiding the inquiry; about a third (34%) referenced Diffusion of Innovations theory. Overall, only 46% of articles reported psychometric properties of measures assessing latent organizational characteristics. Of these, 94% (33/35) described reliability and 71% (25/35) reported on validity. CONCLUSIONS The lack of clarity associated with construct definitions, inconsistent use of theory, absence of standardized reporting criteria for implementation research, and the fact that few measures have demonstrated reliability or validity were among the limitations highlighted in our review. Given these findings, we recommend that increased attention be devoted toward the development or refinement of measures using common psychometric standards. In addition, there is a need for measure development and testing across diverse settings, among diverse population samples, and for a variety of types of innovations.
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Affiliation(s)
- Jennifer D. Allen
- Department of Community Health, Tufts University, 574 Boston Avenue, Medford, MA 02155 USA
| | - Samuel D. Towne
- Texas A&M University, School of Public Health, 1266 TAMU, College Station, TX 77843-1266 USA
| | - Annette E. Maxwell
- University of California Los Angeles, Fielding School of Public Health, 650 Charles Young Drive South, Los Angeles, CA 90095-6900 USA
| | - Lisa DiMartino
- Department of Health Policy and Management CB#7411, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514-7411 USA
| | - Bryan Leyva
- Warren Alpert Medical School, Brown University, Providence, RI 02903 USA
| | - Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, 1107 ne 45th street #305, Seattle, WA 98105 USA
| | - Laura Linnan
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB 7440, Chapel Hill, NC 27599-7440 USA
| | - Bryan J. Weiner
- Department of Health Policy and Management, University of North Carolina Gillings School of Public Health, University of North Carolina at Chapel Hill, CB #7411, Chapel Hill, NC 27599-7400 USA
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Coury J, Schneider JL, Rivelli JS, Petrik AF, Seibel E, D'Agostini B, Taplin SH, Green BB, Coronado GD. Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics. BMC Health Serv Res 2017. [PMID: 28629348 PMCID: PMC5477281 DOI: 10.1186/s12913-017-2364-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The Plan-Do-Study-Act (PDSA) cycle is a commonly used improvement process in health care settings, although its documented use in pragmatic clinical research is rare. A recent pragmatic clinical research study, called the Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), used this process to optimize the research implementation of an automated colon cancer screening outreach program in intervention clinics. We describe the process of using this PDSA approach, the selection of PDSA topics by clinic leaders, and project leaders’ reactions to using PDSA in pragmatic research. Methods STOP CRC is a cluster-randomized pragmatic study that aims to test the effectiveness of a direct-mail fecal immunochemical testing (FIT) program involving eight Federally Qualified Health Centers in Oregon and California. We and a practice improvement specialist trained in the PDSA process delivered structured presentations to leaders of these centers; the presentations addressed how to apply the PDSA process to improve implementation of a mailed outreach program offering colorectal cancer screening through FIT tests. Center leaders submitted PDSA plans and delivered reports via webinar at quarterly meetings of the project’s advisory board. Project staff conducted one-on-one, 45-min interviews with project leads from each health center to assess the reaction to and value of the PDSA process in supporting the implementation of STOP CRC. Results Clinic-selected PDSA activities included refining the intervention staffing model, improving outreach materials, and changing workflow steps. Common benefits of using PDSA cycles in pragmatic research were that it provided a structure for staff to focus on improving the program and it allowed staff to test the change they wanted to see. A commonly reported challenge was measuring the success of the PDSA process with the available electronic medical record tools. Conclusion Understanding how the PDSA process can be applied to pragmatic trials and the reaction of clinic staff to their use may help clinics integrate evidence-based interventions into their everyday care processes. Trial registration Clinicaltrials.gov NCT01742065. Registered October 31, 2013.
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Affiliation(s)
- Jennifer Coury
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA.
| | - Jennifer L Schneider
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Jennifer S Rivelli
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Amanda F Petrik
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Evelyn Seibel
- Lean HealthCare West, 315 SW 5th Avenue, Suite 900, Portland, OR, 97204, USA
| | - Brieshon D'Agostini
- Multnomah County Health Department, 426 SW Stark St, 8th Floor, Portland, OR, 97204, USA
| | - Stephen H Taplin
- Process of Care Research Branch, Behavioral Research Program, National Cancer Institute, Division of Cancer Control and Population Sciences, Rockville, MD, USA
| | - Beverly B Green
- Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA
| | - Gloria D Coronado
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
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Scherr CL, Bomboka L, Nelson A, Pal T, Vadaparampil ST. Tracking the dissemination of a culturally targeted brochure to promote awareness of hereditary breast and ovarian cancer among Black women. PATIENT EDUCATION AND COUNSELING 2017; 100:805-811. [PMID: 27866793 PMCID: PMC5400706 DOI: 10.1016/j.pec.2016.10.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/23/2016] [Accepted: 10/30/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Black women have a higher rate of BRCA1 and BRCA2 (BRCA) mutations, compared with other populations, that increases their risk for hereditary breast and ovarian cancer (HBOC). However, Black women are less likely to know about HBOC and genetic testing. Based on a request from a community advisory panel of breast cancer survivors, community leaders and healthcare providers in the Black community, our team developed a culturally targeted educational brochure to promote awareness of HBOC among Black women. METHODS To reach the target population we utilized a passive dissemination strategy. Using Diffusion of Innovations (DOI) as a framework, we traced dissemination of the brochure over a five year period using self-addressed postcards contained inside the brochure that included several open-ended questions about the utility of the brochure, and a field for written comments. Closed-ended responses were analyzed using descriptive statistics and thematic analysis was conducted on the open-ended responses. RESULTS DOI captured the proliferation of the brochure among Black women across the US. PRACTICE IMPLICATIONS The use of passive dissemination strategies among pre-existing social networks proved to be a useful and sustainable method for increasing knowledge of HBOC among Black women.
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Affiliation(s)
- Courtney Lynam Scherr
- Northwestern University, Department of Communication Studies, Chicago, IL 60611, USA.
| | - Linda Bomboka
- Moffitt Cancer Center, Health Outcomes and Behavior, Tampa, FL 33612, USA
| | - Alison Nelson
- Moffitt Cancer Center, Health Outcomes and Behavior, Tampa, FL 33612, USA
| | - Tuya Pal
- Moffitt Cancer Center, Health Outcomes and Behavior, Tampa, FL 33612, USA
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Use of Evidence-Based Practices and Resources Among Comprehensive Cancer Control Programs. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2016; 21:441-8. [PMID: 24402431 DOI: 10.1097/phh.0000000000000053] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT While efforts to promote use of evidence-based practices (EBPs) for cancer control have increased, questions remain whether this will result in widespread adoption of EBPs (eg, Guide to Community Preventive Services interventions) by comprehensive cancer control (CCC) programs. OBJECTIVE To examine use of EBPs among CCC programs to develop cancer control plans and select interventions. DESIGN Conducted Web-based surveys of and telephone interviews with CCC program staff between March and July 2012. SETTING CCC programs funded by the Centers for Disease Control and Prevention's National Comprehensive Cancer Control Program (NCCCP). PARTICIPANTS Sixty-one CCC program directors. MAIN OUTCOME MEASURES 1) Use of and knowledge/attitudes about EBPs and related resources and 2) EBP-related technical assistance needs. RESULTS Seventy-five percent of eligible program directors reported use of EBPs to a moderate or great extent to address program objectives. Benefits of using EBPS included their effectiveness has been proven, they are an efficient use of resources, and they lend credibility to an intervention. Challenges to using EBPs included resource limitations, lack of culturally appropriate interventions, and limited skills adapting EBPs for local use. Most respondents had heard of and used Web sites for The Guide to Community Preventive Services (95% and 91%, respectively) and Cancer Control P.L.A.N.E.T. (98% and 75%, respectively). Training needs included how to adapt an EBP and its materials for cultural appropriateness (state 78%, tribe 86%, territory 80%) and how to maintain the fidelity of an EBP (state 75%, tribe 86%, territory 60%). CONCLUSIONS While awareness, knowledge, and use of EBPs and related resources are high, respondents identified numerous challenges and training needs. The findings from this study may be used to enhance technical assistance provided to NCCCP grantees related to selecting and implementing EBPs.
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Williams RS, Stollings JH, Bundy Ł, Haardörfer R, Kreuter MW, Mullen PD, Hovell M, Morris M, Kegler MC. A Minimal Intervention to Promote Smoke-Free Homes among 2-1-1 Callers: North Carolina Randomized Effectiveness Trial. PLoS One 2016; 11:e0165086. [PMID: 27806060 PMCID: PMC5091897 DOI: 10.1371/journal.pone.0165086] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 10/04/2016] [Indexed: 11/23/2022] Open
Abstract
This study examined the extent to which delivery of the minimal Smoke-Free Homes intervention by trained 2-1-1 information and referral specialists had an effect on the adoption of home smoking bans in low-income households. A randomized controlled trial was conducted among 2-1-1 callers (n = 500) assigned to control or intervention conditions. 2-1-1 information and referral specialists collected baseline data and delivered the intervention consisting of 3 mailings and 1 coaching call; university-based data collectors conducted follow-up interviews at 3 and 6 months post-baseline. Data were collected from June 2013 through July 2014. Participants were mostly female (87.2%), African American (61.4%), and smokers (76.6%). Participants assigned to the intervention condition were more likely than controls to report a full ban on smoking in the home at both 3- (38.1% vs 19.3%, p = < .001) and 6-month follow-up (43.2% vs 33.2%, p = .02). The longitudinal intent-to-treat analysis showed a significant intervention effect over time (OR = 1.31, p = .001), i.e. OR = 1.72 at 6 months. This study replicates prior findings showing the effectiveness of the minimal intervention to promote smoke-free homes in low-income households, and extends those findings by demonstrating they can be achieved when 2-1-1 information and referral specialists deliver the intervention. Findings offer support for this intervention as a generalizable and scalable model for reducing secondhand smoke exposure in homes.
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Affiliation(s)
- Rebecca S. Williams
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, United States of America
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, United States of America
- * E-mail:
| | - Jana H. Stollings
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, United States of America
| | - Łucja Bundy
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Matthew W. Kreuter
- Health Communication Research Laboratory, Washington University, St. Louis, Missouri, United States of America
| | - Patricia Dolan Mullen
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, Texas, United States of America
| | - Mel Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, California, United States of America
| | - Marti Morris
- United Way of North Carolina, NC 2-1-1, Cary, North Carolina, United States of America
| | - Michelle C. Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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Roussi P, Miller SM. Monitoring style of coping with cancer related threats: a review of the literature. J Behav Med 2014; 37:931-54. [PMID: 24488543 DOI: 10.1007/s10865-014-9553-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 01/16/2014] [Indexed: 12/11/2022]
Abstract
Building on the Cognitive-Social Health Information-Processing model, this paper provides a theoretically guided review of monitoring (i.e., attend to and amplify) cancer-related threats. Specifically, the goals of the review are to examine whether individuals high on monitoring are characterized by specific cognitive, affective, and behavioral responses to cancer-related health threats than individuals low on monitoring and the implications of these cognitive-affective responses for patient-centered outcomes, including patient-physician communication, decision-making and the development of interventions to promote adherence and adjustment. A total of 74 reports were found, based on 63 studies, 13 of which were intervention studies. The results suggest that although individuals high on monitoring are more knowledgeable about health threats, they are less satisfied with the information provided. Further, they tend to be characterized by greater perceived risk, more negative beliefs, and greater value of health-related information and experience more negative affective outcomes. Finally, individuals high on monitoring tend to be more demanding of the health providers in terms of desire for more information and emotional support, are more assertive during decision-making discussions, and subsequently experience more decisional regret. Psychoeducational interventions improve outcomes when the level and type of information provided is consistent with the individual's monitoring style and the demands of the specific health threat. Implications for patient-centered outcomes, in terms of tailoring of interventions, patient-provider communication, and decision-making, are discussed.
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Affiliation(s)
- Pagona Roussi
- Department of Psychology, Aristotle University of Thessaloniki, Thessaloníki, Greece,
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Yeh VM, Schnur JB, Montgomery GH. Disseminating hypnosis to health care settings: Applying the RE-AIM framework. ACTA ACUST UNITED AC 2014; 1:213-228. [PMID: 25267941 DOI: 10.1037/cns0000012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hypnosis is a brief intervention ready for wider dissemination in medical contexts. Overall, hypnosis remains underused despite evidence supporting its beneficial clinical impact. This review will evaluate the evidence supporting hypnosis for dissemination using guidelines formulated by Glasgow and colleagues (1999). Five dissemination dimensions will be considered: Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM). REACH In medical settings, hypnosis is capable of helping a diverse range of individuals with a wide variety of problems. EFFICACY There is evidence supporting the use of hypnosis for chronic pain, acute pain and emotional distress arising from medical procedures and conditions, cancer treatment-related side-effects and irritable bowel syndrome. ADOPTION Although hypnosis is currently not a part of mainstream clinical practices, evidence suggests that patients and healthcare providers are open to trying hypnosis, and may become more so when educated about what hypnosis can do. IMPLEMENTATION Hypnosis is a brief intervention capable of being administered effectively by healthcare providers. MAINTENANCE Given the low resource needs of hypnosis, opportunities for reimbursement, and the ability of the intervention to potentially help medical settings reduce costs, the intervention has the qualities necessary to be integrated into routine care in a self-sustaining way in medical settings. In sum, hypnosis is a promising candidate for further dissemination.
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Affiliation(s)
- Vivian M Yeh
- Integrative Behavioral Medicine Program, Department of Oncology Sciences, Icahn School of Medicine at Mount Sinai
| | - Julie B Schnur
- Integrative Behavioral Medicine Program, Department of Oncology Sciences, Icahn School of Medicine at Mount Sinai
| | - Guy H Montgomery
- Integrative Behavioral Medicine Program, Department of Oncology Sciences, Icahn School of Medicine at Mount Sinai
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O'Brian S, Iverach L, Jones M, Onslow M, Packman A, Menzies R. Effectiveness of the Lidcombe Program for early stuttering in Australian community clinics. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2013; 15:593-603. [PMID: 23691980 DOI: 10.3109/17549507.2013.783112] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study explored the effectiveness of the Lidcombe Program for early stuttering in community clinics. Participants were 31 speech-language pathologists (SLPs) using the Lidcombe Program in clinics across Australia, and 57 of their young stuttering clients. Percentage of syllables stuttered (%SS) was collected 9 months after beginning treatment along with information about variables likely to influence outcomes. The mean %SS for the 57 children 9 months after starting treatment was 1.7. The most significant predictor of outcome was Lidcombe Program Trainers Consortium (LPTC) training. The children of trained SLPs (n = 19), compared to the children of untrained SLPs, took 76% more sessions to complete stage 1, but achieved 54% lower %SS scores, 9 months after starting treatment. Results suggest that outcomes for the Lidcombe Program in the general community may be comparable to those obtained in clinical trials when SLPs receive formal training and support.
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Affiliation(s)
- Sue O'Brian
- Australian Stuttering Research Centre, The University of Sydney, Sydney , Australia
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Cabell A, Casteel C, Chronister T, Nocera M, Vladutiu CJ, Peek-Asa C. Factors influencing law enforcement decisions to adopt an evidence-based robbery prevention program. HEALTH EDUCATION RESEARCH 2013; 28:1105-1115. [PMID: 24057272 DOI: 10.1093/her/cyt093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Homicide is the leading cause of workplace death among small retail and service businesses in the United States. Evidence-based programs have been shown to reduce robbery and robbery-related crimes in small retail businesses; however, reaching small businesses with programs has been difficult. As small businesses typically have no corporate backing or trade affiliation, police departments have been identified as potential vehicles for program dissemination. A national sample of 300 law enforcement agencies was surveyed to identify facilitators and barriers to adoption and sustainability of an evidence-based program. The questionnaire was developed using behavioral theory concepts and administered via telephone. Preliminary findings suggest the primary facilitators to program adoption included organizational capacity factors such as staff buy-in, dedicated personnel and financial support. Competing responsibilities was the primary barrier identified by agencies. Agency size and program complexity were identified as potential predictors of program adoption. Identifying agency and program-specific characteristics that influence program adoption by law enforcement agencies will be valuable for marketing programs to agencies that have the infrastructure to support and sustain program dissemination. Understanding these factors will optimize the reach of evidence-based strategies to small businesses.
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Affiliation(s)
- A Cabell
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599 Department of Epidemiology, Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, USA, Oxnard Police Department (retired), Oxnard, CA 93030, USA and Department of Occupational and Environmental Health, Injury Prevention Research Center, University of Iowa, Iowa City, IA 52242, USA
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Tessaro I, Campbell MK, Golden S, Gellin M, McCabe M, Syrjala K, Ganz PA, Jacobs L, Baker S, Miller KD, Rosenstein DL. Process of diffusing cancer survivorship care into oncology practice. Transl Behav Med 2013; 3:142-8. [PMID: 24073165 DOI: 10.1007/s13142-012-0145-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
The LIVESTRONG Centers of Excellence were funded to increase the effectiveness of survivorship care in oncology practice. This study describes the ongoing process of adopting and implementing survivorship care using the framework of the diffusion of innovation theory of change. Primary data collection included telephone interviews with 39 members from the eight centers and site visits. Organizational characteristics, overall progress, and challenges for implementation were collected from proposals and annual reports. Creating an awareness of cancer survivorship care was a major accomplishment (relative advantage). Adoption depended on the fit within the cancer center (compatibility), and changed over time based on trial and error (trialability). Implementing survivorship care within the existing culture of oncology and breaking down resistance to change was a lengthy process (complexity). Survivorship care became sustainable as it became reimbursed, and more new patients were seen (observability). Innovators and early adopters were crucial to success. Diffusion of innovation theory can provide a strategy to evaluate adoption and implementation of cancer survivorship programs into clinical practice.
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Abstract
Answer questions and earn CME/CNE Hypnosis has been used to provide psychological and physical comfort to individuals diagnosed with cancer for nearly 200 years. The goals of this review are: 1) to describe hypnosis and its components and to dispel misconceptions; 2) to provide an overview of hypnosis as a cancer prevention and control technique (covering its use in weight management, smoking cessation, as an adjunct to diagnostic and treatment procedures, survivorship, and metastatic disease); and 3) to discuss future research directions. Overall, the literature supports the benefits of hypnosis for improving quality of life during the course of cancer and its treatment. However, a great deal more work needs to be done to explore the use of hypnosis in survivorship, to understand the mediators and moderators of hypnosis interventions, and to develop effective dissemination strategies.
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Affiliation(s)
- Guy H Montgomery
- Integrative Behavioral Medicine Program, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
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Sly JR, Jandorf L, Dhulkifl R, Hall D, Edwards T, Goodman AJ, Maysonet E, Azeez S. Challenges to replicating evidence-based research in real-world settings: training African-American peers as patient navigators for colon cancer screening. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:680-6. [PMID: 22791543 PMCID: PMC3725586 DOI: 10.1007/s13187-012-0395-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Many cancer-prevention interventions have demonstrated effectiveness in diverse populations, but these evidenced-based findings slowly disseminate into practice. The current study describes the process of disseminating and replicating research (i.e., peer patient navigation for colonoscopy screening) in real-world settings. Two large metropolitan hospitals collaborated to replicate a peer patient navigation model within their existing navigation systems. Six African-American peer volunteers were recruited and trained to navigate patients through colonoscopy scheduling and completion. Major challenges included: (1) operating within multiple institutional settings; (2) operating within nonacademic/research infrastructures; (3) integrating into an established navigation system; (4) obtaining support of hospital staff without overburdening; and (5) competing priorities and time commitments. Bridging the gap between evidence-based research and practice is critical to eliminating many cancer health disparities; therefore, it is crucial that researchers and practitioners continue to work to achieve both diffusion and fusion of evidence-based findings. Recommendations for addressing these challenges are discussed.
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Affiliation(s)
- Jamilia R Sly
- Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Allicock M, Campbell MK, Valle CG, Carr C, Resnicow K, Gizlice Z. Evaluating the dissemination of Body & Soul, an evidence-based fruit and vegetable intake intervention: challenges for dissemination and implementation research. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2012; 44:530-8. [PMID: 22406012 PMCID: PMC3374882 DOI: 10.1016/j.jneb.2011.09.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/27/2011] [Accepted: 09/04/2011] [Indexed: 05/21/2023]
Abstract
OBJECTIVE To evaluate whether the evidence-based Body & Soul program, when disseminated and implemented without researcher or agency involvement and support, would achieve results similar to those of earlier efficacy and effectiveness trials. DESIGN Prospective group randomized trial. SETTING Churches with predominantly African American membership. PARTICIPANTS A total of 1,033 members from the 15 churches completed baseline surveys. Of these participants, 562 (54.4%) completed the follow-up survey 6 months later. INTERVENTION Church-based nutrition program for African Americans that included pastoral involvement, educational activities, church environmental changes, and peer counseling. MAIN OUTCOME MEASURE Daily fruit and vegetable (FV) intake was assessed at pre- and posttest. ANALYSIS Mixed-effects linear models. RESULTS At posttest, there was no statistically significant difference in daily servings of FVs between the early intervention group participants compared to control group participants (4.7 vs 4.4, P = .38). Process evaluation suggested that added resources such as technical assistance could improve program implementation. CONCLUSIONS AND IMPLICATIONS The disseminated program may not produce improvements in FV intake equal to those in the earlier efficacy and effectiveness trials, primarily because of a lack of program implementation. Program dissemination may not achieve public health impact unless support systems are strengthened for adequate implementation at the church level.
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Affiliation(s)
- Marlyn Allicock
- Gillings School of Global Public Health, Department of Nutrition, University of North Carolina at Chapel Hill, NC 27599, USA.
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Quintiliani L, Stoddard A, Lederman R, Harden E, Wallace L, Sorensen G. Dissemination of a tobacco cessation program for unionized workers. FAMILY & COMMUNITY HEALTH 2012; 35:246-255. [PMID: 22617415 PMCID: PMC3695705 DOI: 10.1097/fch.0b013e318250bd89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Many multilevel, contextually relevant, evidenced-based health promotion programs are not disseminated widely. The purpose of this study is to describe the adaptation of a published effective tobacco-use cessation intervention, which was implemented and evaluated in a broader population of unionized workers partnering with a health and welfare fund health benefits carrier. 68 tobacco users enrolled. Implementation and effectiveness outcomes indicated that most participants (69%) completed all counseling calls and at 16 weeks' follow-up, 30.9% reported not using tobacco. The intervention had relatively high levels of implementation, effectiveness, and acceptability, but low reach, highlighting issues arising during dissemination.
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Affiliation(s)
| | - Anne Stoddard
- Center Statistical Analysis & Research, New England Research Institutes, Watertown MA
| | - Ruth Lederman
- Center for Community-based Research, Dana-Farber Cancer Institute, Boston MA
| | - Elizabeth Harden
- Center for Community-based Research, Dana-Farber Cancer Institute, Boston MA
| | - Lorraine Wallace
- Center for Community-based Research, Dana-Farber Cancer Institute, Boston MA
| | - Glorian Sorensen
- Center for Community-based Research, Dana-Farber Cancer Institute, Boston MA; Professor Department of Health and Social Behavior, Harvard School of Public Health, Harvard University, Boston MA
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Calo WA, Fernández ME, Rivera M, Díaz EC, Correa-Fernández V, Pattatucci A, Wetter DW. Assessing awareness and use of evidence-based programs for cancer control in Puerto Rico. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:486-493. [PMID: 22528632 PMCID: PMC3422596 DOI: 10.1007/s13187-012-0348-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Community Cancer Control Outreach Program (CCCOP) is a community-academic partnership aimed at developing and implementing a cancer control outreach, research, and training program in Puerto Rico. The CCCOP surveyed 56 partners to assess their awareness, training needs, and use of resources related to evidence-based programs (EBPs). Despite relatively high levels (70 %) of confidence in adopting EBPs, there were low levels of awareness (37 %) and use (25 %) of existing EBPs resources. Respondents' who had used EBPs resources were more likely to have positive beliefs about EBPs than nonusers (p<0.05). Training needs were high among respondents and no significant differences were found between those who had and had not used existing EBPs resources. These findings can guide the development of training tools and technical assistance to increase the use of EBPs for Latino audiences.
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Affiliation(s)
- William A Calo
- Division of Management, Policy, and Community Health, The University of Texas School of Public Health, Houston, TX 77030, USA.
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Harrop JP, Nelson DE, Kuratani DG, Mullen PD, Paskett ED. Translating cancer prevention and control research into the community setting: workforce implications. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:S157-S164. [PMID: 22362356 DOI: 10.1007/s13187-012-0329-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A gap exists between cancer prevention research and its translation into community practice. Two strategies to reduce this gap are community-based participatory research (CBPR) and dissemination research. CBPR offers an avenue to engage academic and community partners, thereby providing mechanisms for joint learning and application of knowledge. Dissemination research examines the movement of evidence-based public health and clinical innovations to practice settings. While applying these approaches may reduce the gap between research and practice, the cancer prevention workforce may be inadequate in size, insufficiently trained, lack resources and incentives, or face structural barriers to effectively participate in CBPR and disseminate evidence-based research findings into practice. Information on translating cancer prevention information to communities and workforce implications was obtained from a panel of experts and through a review of the literature on CBPR and dissemination research. The expert panel and literature review identified major barriers to successfully conducting CBPR and dissemination research in community settings. Barriers included inadequate policies; insufficient networking and communication infrastructures; unsupportive research cultures, climates, and mindsets; inadequate researcher and practitioner education; and limited CBPR and dissemination research with adequate study designs. No specific estimates of the cancer prevention workforce were found; however, indirect evidence for a shortfall were identified. We recommend expanding CBPR training for academic and community partners; increasing funding for dissemination research and practice; supporting proven partnerships; and providing strategic coordination for government agencies, research institutions, nongovernmental organizations, and the private sector to foster better dissemination of information and integration of community-based cancer prevention and control programs and practices. Specific challenges and needs that must be addressed to improve the translation of cancer prevention research into community settings were identified.
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Affiliation(s)
- J Phil Harrop
- College of Public Health, Division of Health Services Management and Policy, Comprehensive Cancer Center, The Ohio State University, 1590 North High Street, Suite 525, Columbus, OH 43201, USA
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Promoting life skills and preventing tobacco use among low-income Mumbai youth: effects of Salaam Bombay Foundation intervention. PLoS One 2012; 7:e34982. [PMID: 22523567 PMCID: PMC3327682 DOI: 10.1371/journal.pone.0034982] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 03/08/2012] [Indexed: 11/19/2022] Open
Abstract
Background In response to India's growing tobacco epidemic, strategies are needed to decrease tobacco use among Indian youth, particularly among those who are economically disadvantaged. The objective of this study was to assess the effectiveness of a school-based life-skills tobacco control program for youth of low socio-economic status in Mumbai and the surrounding state of Maharashtra. We hypothesized that compared to youth in control schools, youth exposed to the program would have greater knowledge of effects of tobacco use; be more likely to take action to prevent others from using tobacco; demonstrate more positive life skills and attitudes; and be less likely to report tobacco use. Methods/Findings Using a quasi-experimental design, we assessed program effectiveness by comparing 8th and 9th grade students in intervention schools to 8th grade students in comparable schools that did not receive the program. Across all schools, 1851 students completed a survey that assessed core program components in early 2010. The program consisted of activities focused on building awareness about the hazards of tobacco, developing life skills, and advocacy development. The primary outcome measure was self-reported tobacco use in the last 30 days. Findings indicate that 4.1% of 8th grade intervention students (OR = 0.51) and 3.6% of 9th grade intervention students (OR = 0.33) reported using tobacco at least once in the last 30 days, compared to 8.7% of students in the control schools. Intervention group students were also significantly more knowledgeable about tobacco and related legislation, reported more efforts to prevent tobacco use among others, and reported stronger life skills and self-efficacy than students in control schools. Limitations to the study include schools not being randomly assigned to condition and tobacco use being measured by self-report. Conclusions This program represents an effective model of school-based tobacco use prevention that low-income schools in India and other low- and middle-income countries can replicate.
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Gallo KP, Barlow DH. Factors involved in clinician adoption and nonadoption of evidence‐based interventions in mental health. ACTA ACUST UNITED AC 2012. [DOI: 10.1111/j.1468-2850.2012.01276.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pollack LA, Hawkins NA, Peaker BL, Buchanan N, Risendal BC. Dissemination and translation: a frontier for cancer survivorship research. Cancer Epidemiol Biomarkers Prev 2012; 20:2093-8. [PMID: 21980017 DOI: 10.1158/1055-9965.epi-11-0652] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
As the field of survivorship research grows, the need for translation is imperative to expand new knowledge into arenas that directly impact survivors. This commentary seeks to encourage research focused on dissemination and translation of survivorship interventions and programs, including practice-based research. We overview diffusion, dissemination and translation in the context of cancer survivorship and present the RE-AIM and Knowledge to Action frameworks as approaches that can be used to expand research into communities. Many academic, governmental, and community-based organizations focus on cancer survivor. Future survivorship research should contribute to harmonizing these assets to identify effective interventions, maximize their reach and adoption, and integrate promising practices into routine care.
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Affiliation(s)
- Lori A Pollack
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Emmons KM, Weiner B, Fernandez ME, Tu SP. Systems antecedents for dissemination and implementation: a review and analysis of measures. HEALTH EDUCATION & BEHAVIOR 2012; 39:87-105. [PMID: 21724933 PMCID: PMC3272116 DOI: 10.1177/1090198111409748] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is a growing emphasis on the role of organizations as settings for dissemination and implementation. Only recently has the field begun to consider features of organizations that affect dissemination and implementation of evidence-based interventions. This manuscript identifies and evaluates available measures for five key organizational-level constructs: (a) leadership, (b) vision, (c) managerial relations, (d) climate, and (e) absorptive capacity. Overall the picture was the same across the five constructs--no measure was used in more than one study, many studies did not report the psychometric properties of the measures, some assessments were based on a single response per unit, and the level of the instrument and analysis did not always match. One must seriously consider the development and evaluation of a robust set of measures that will serve as the basis of building the field, allow for comparisons across organizational types and intervention topics, and allow a robust area of dissemination and implementation research to develop.
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Affiliation(s)
- Karen M Emmons
- Dana-Farber Cancer Institute/Harvard School of Public Health, Boston, MA, USA.
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Shiovitz S, Gay A, Morris A, Graff JJ, Katz SJ, Hawley ST. Dissemination of Quality-of-Care Research Findings to Breast Oncology Surgeons. J Oncol Pract 2011; 7:257-62. [PMID: 22043192 DOI: 10.1200/jop.2010.000195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2011] [Indexed: 11/20/2022] Open
Abstract
PURPOSE In this era of rapidly evolving clinical knowledge, clinicians need to be aware of current research and how it might affect their practice. The Internet is a widely available, under-assessed tool for providing this information. In this two-phase pilot study, a novel Web site (www.cansortsurgeons.org) was developed to specifically disseminate relevant clinical information to community breast oncology surgeons. METHODS The first phase targeted a sample of community surgeons identified from Surveillance, Epidemiology, and End Results catchment areas in Los Angeles, CA and Detroit, MI. The second phase broadened availability by linking the site through the American College of Surgeons (ACoS) Commission on Cancer (CoC) homepage. An eight-question, Web-based survey was used to obtain feedback regarding the Web site's utility and potential application to clinical practice. Journal continuing medical education credit was also offered through ACoS. RESULTS For phase 1, of the 315 community surgeons invited to view the site, 114 (36%) participated in the study and 98 (86%) responded to the survey. Overall, there was a strongly supportive response, with 79 (81%) recommending the site to other clinicians. For phase 2, of the 516 site hits, 411 came from the ACoS site. Only 10 individuals completed the survey during this phase, but all positively endorsed the utility of the site. CONCLUSION The implication for clinical practice is that the Internet is a useful tool for providing relevant clinical research to providers. In the future, this could be tailored to an individual's needs, aiding synthesis and, hopefully, improving the quality of clinical care.
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Affiliation(s)
- Stacey Shiovitz
- Department of Internal Medicine, Division of General Medicine; Department of Surgery, University of Michigan, Ann Arbor; Ann Arbor Veteran's Health Care System, Ann Arbor, MI; Cancer Institute of New Jersey and Robert Wood Johnson Medical School, New Brunswick, NJ
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Vanderpool RC, Gainor SJ, Conn ME, Spencer C, Allen AR, Kennedy S. Adapting and implementing evidence-based cancer education interventions in rural Appalachia: real world experiences and challenges. Rural Remote Health 2011; 11:1807. [PMID: 21988459 PMCID: PMC4089209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION There is recognition among public health scholars and community practitioners that translating cancer prevention and control research into practice is challenging. This circumstance is particularly germane to medically underserved communities, such as rural Appalachia, where few evidence-based interventions originate and cancer incidence and mortality are elevated. METHODS A case study approach was selected to examine the collective experience of 13 West Virginia community organizations awarded mini-grants requiring the use of an evidence-based cancer control intervention. Methods included a systematic review of grant applications and final programmatic reports, a faxed survey, and qualitative, in-depth interviews with key stakeholders. RESULTS Appalachian grantees reported notable challenges with selecting, adapting, and implementing evidence-based cancer education interventions. Evidence-based programming was viewed as a barrier. Grantees made a range of adaptations to meet constituent needs, thereby jeopardizing intervention fidelity. However, programs were perceived as successful due to community participation and engagement, some element of behavioral change, dissemination of the health message, and establishment of collaborative partnerships. CONCLUSIONS A descriptive examination provides insights into the challenges of translating research to practice. This Appalachian cancer education grant program also highlights areas of compromise that are important for researchers and practitioners to understand.
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Affiliation(s)
- Robin C Vanderpool
- Department of Health Behavior, University of Kentucky College of Public Health, Lexington, Kentucky, USA.
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Puschel K, Thompson B. Mammogram screening in Chile: using mixed methods to implement health policy planning at the primary care level. Breast 2011; 20 Suppl 2:S40-5. [PMID: 21334897 DOI: 10.1016/j.breast.2011.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Breast cancer has the highest incidence of all cancers among women in Chile. In 2005, a national health program progressively introduced free mammography screening for women aged 50 and older; however, three years later the rates of compliance with mammographic screening was only 12% in Santiago, the capital city of Chile. This implementation article combines the findings of two previous studies that applied qualitative and quantitative methods to improve mammography screening in an area of Santiago. Socio-cultural and accessibility factors were identified as barriers and facilitators during the qualitative phase of the study and then applied to the design of a quantitative randomized clinical trial. After six months of intervention, 6% of women in the standard care group, 51.8% in the low intensity intervention group, and 70.1% in the high intensity intervention group had undergone a screening mammogram. This review discusses how the utilization of mixed methods research can contribute to the improvement of the implementation of health policies in local communities.
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Affiliation(s)
- Klaus Puschel
- Department of Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Cherniack M, Henning R, Merchant JA, Punnett L, Sorensen GR, Wagner G. Statement on national worklife priorities. Am J Ind Med 2011; 54:10-20. [PMID: 20949545 PMCID: PMC5860803 DOI: 10.1002/ajim.20900] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The National Institute for Occupational Safety and Health (NIOSH) WorkLife Initiative (WLI) [http://www.cdc.gov/niosh/worklife] seeks to promote workplace programs, policies, and practices that result in healthier, more productive employees through a focus simultaneously on disease prevention, health promotion, and accommodations to age, family, and life stage. The Initiative incorporates the Institute's foundational commitment to workplaces free of recognized hazards into broader consideration of the factors that affect worker health and wellbeing. Workplace hazards, such as physical demands, chemical exposures, and work organization, often interact with non-work factors such as family demands and health behaviors to increase health and safety risks. New workplace interventions being tested by the first three NIOSH WLI Centers of WorkLife Excellence are exploring innovative models for employee health programs to reduce the human, social, and economic costs of compromised health and quality of life. Many parties in industry, labor, and government share the goals of improving employee health while controlling health care costs. NIOSH convened a workshop in 2008 with representatives of the three Centers of Excellence to develop a comprehensive, long-range strategy for advancing the WorkLife Initiative. The recommendations below fall into three areas: practice, research, and policy. Responding to these recommendations would permit the WorkLife Center system to establish a new infrastructure for workplace prevention programs by compiling and disseminating the innovative practices being developed and tested at the Centers, and elsewhere. The WLI would also extend the customary scope of NIOSH by engaging with multiple NIH Institutes that are already generating research-to-practice programs involving the working-age population, in areas such as chronic disease prevention and management. Research to Practice (r2p) is a concept focused on the translation of research findings, technologies, and information into evidence-based prevention practices and products that are adopted in the workplace or other "real-world" settings. NIOSH's goal is to overcome the translational issues that now prevent state-of-the-art occupational health, health promotion, and chronic disease research findings from benefiting working age populations immediately, regardless of workplace size, work sector, or region of the country.
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Affiliation(s)
- Martin Cherniack
- Center to Promote Health in the New England Workplace (CPH-NEW)
- Ergonomics Technology Center, University of Connecticut Health Center, Farmington, Connecticut
| | - Rob Henning
- Center to Promote Health in the New England Workplace (CPH-NEW)
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - James A. Merchant
- Department of Occupational and Environmental Health and Healthier Workforce Center for Excellence, University of Iowa, Iowa City, Iowa
| | - Laura Punnett
- Center to Promote Health in the New England Workplace (CPH-NEW)
- Department of Work Environment and Center for Women and Work, University of Massachusetts, Lowell, Lowell, Massachusetts
| | - Glorian R. Sorensen
- Center for Work, Health and Wellbeing, Harvard School of Public Health, and Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Gregory Wagner
- Harvard School of Public Health, Boston, Massachusetts
- National Institute for Occupational Safety and Health, Washington, District of Columbia
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Rohrbach LA, Gunning M, Grana R, Gunning G, Sussman S. Dissemination of Project Towards No Drug Abuse (TND): findings from a survey of program adopters. Subst Use Misuse 2010; 45:2551-66. [PMID: 20394506 PMCID: PMC2906613 DOI: 10.3109/10826081003725278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examines adoption and implementation decisions among organizations that purchased Project Towards No Drug Abuse from 2001 to 2004. Telephone interviews were conducted with 120 organizations nationwide. The most common reason for adopting the program was its evidence base. In schools, classroom teachers were more likely to deliver the program than other types of implementers, and in nonschool organizations, prevention specialists, and counselors were more common (p < .05). Most organizations (73%) reported that they delivered all of the program sessions. The limitations of the study, as well as the implications of the findings for future research and wide-scale prevention program dissemination, are discussed.
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Affiliation(s)
- Louise Ann Rohrbach
- University of Southern California, Preventive Medicine, IPR, Alhambra, California, USA.
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Rohrbach LA, Gunning M, Sun P, Sussman S. The Project Towards No Drug Abuse (TND) dissemination trial: implementation fidelity and immediate outcomes. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2010; 11:77-88. [PMID: 19757052 DOI: 10.1007/s11121-009-0151-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
One of the important research issues in the emerging area of research on dissemination of prevention programs relates to the type and extent of training needed by program providers to prepare them to implement effective programs with fidelity. The present paper describes the immediate outcomes of a dissemination and implementation trial of Project Toward No Drug Abuse, an evidence-based prevention program for high school students. A total of 65 high schools in 14 school districts across the USA were recruited and randomly assigned to one of three experimental conditions: comprehensive implementation support for teachers, regular workshop training only, or standard care control. The comprehensive intervention was comprised of on-site coaching, web-based support, and technical assistance, in addition to the regular workshop. Students (n = 2,983) completed self-report surveys before and immediately after program implementation. Fidelity of implementation was assessed with a classroom observation procedure that focused on program process. Results indicated that relative to the controls, both intervention conditions produced effects on hypothesized program mediators, including greater gains in program-related knowledge; greater reductions in cigarette, marijuana and hard drug use intentions; and more positive changes in drug-related beliefs. There were stronger effects on implementation fidelity in the comprehensive, relative to the regular, training condition. However, seven of the ten immediate student outcome measures showed no significant differences between the two training conditions. The implications of these findings for dissemination research and practice are discussed.
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Affiliation(s)
- Louise Ann Rohrbach
- Department of Preventive Medicine, Institute for Health Promotion and Disease Prevention Research, University of Southern California, Alhambra, CA 91803, USA.
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Dissemination and implementation research on community-based cancer prevention: a systematic review. Am J Prev Med 2010; 38:443-56. [PMID: 20307814 DOI: 10.1016/j.amepre.2009.12.035] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Revised: 09/30/2009] [Accepted: 12/07/2009] [Indexed: 11/20/2022]
Abstract
CONTEXT An extensive array of effective interventions for the prevention of cancer exists, suggesting that evidence is ready for widespread use. However, few of these approaches have been extensively utilized in real-world settings. Further, little is known on how to best disseminate and implement evidence-based interventions for the primary prevention of cancer in community settings. EVIDENCE ACQUISITION A systematic review of the dissemination and implementation literature was conducted between 2006 and 2008 in the topic areas of smoking, healthy diet, physical activity, and sun protection. English-language peer-reviewed articles published between 1980 and 2008 that met the inclusion criteria were classified by suitability of study design (i.e., greatest, moderate, least); quality of execution (i.e., good, fair, limited); and effectiveness (i.e., substantial, some, or little/no evidence of effectiveness) and were abstracted for dissemination- and implementation-related content. EVIDENCE SYNTHESIS Twenty-five unique dissemination and implementation studies were identified. The majority of included studies were conducted in the U.S., in schools, and with children as the ultimate target population, had the least suitability of study design, had fair or limited execution, and used a theoretic framework, active dissemination and implementation approaches, and multimodal strategies. There was considerable heterogeneity across studies in reported mediators, moderators, and outcomes. CONCLUSIONS Key implications from this review include the need for uniform language, studies targeting various populations and settings, valid and reliable measures, triangulation of and more practice-based evidence, standardized reporting criteria, and active and multimodal strategies.
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Bowen DJ, Powers D. Effects of a Mail and Telephone Intervention on Breast Health Behaviors. HEALTH EDUCATION & BEHAVIOR 2010; 37:479-89. [DOI: 10.1177/1090198109348463] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study evaluated a mail and telephone intervention to improve breast health behaviors while maintaining quality of life. Women recruited from the general public were randomized to a stepped-intensity intervention consisting of mailings, telephone calls, and counseling (if requested or appropriate given a woman’s genetic risk for breast cancer) or to a delayed treatment control group. Outcomes (mammography screening and quality of life) were measured at baseline in a telephone survey and again at a 12-month follow-up period. Women in the intervention group significantly increased screening mammography uptake by 12% and quality of life by 5.3 scale points compared to control participants. Changes in knowledge of breast cancer, genetic testing, and cancer worry all significantly predicted intervention changes. This successful intervention can help women make better breast health choices without causing increased worry.
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Affiliation(s)
| | - Diane Powers
- Fred Hutchinson Cancer Research Center, Seattle, Washington
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