scholarly journals The role of dissemination and implementation science in global breast cancer control programs: Frameworks, methods, and examples

Cancer ◽  
2020 ◽  
Vol 126 (S10) ◽  
pp. 2394-2404 ◽  
Author(s):  
Anne F. Rositch ◽  
Karla Unger‐Saldaña ◽  
Rebecca J. DeBoer ◽  
Anne Ng’ang’a ◽  
Bryan J. Weiner
2019 ◽  
Vol 4 (3) ◽  
pp. 188-194 ◽  
Author(s):  
Rowena J. Dolor ◽  
Enola Proctor ◽  
Kathleen R. Stevens ◽  
Leslie R. Boone ◽  
Paul Meissner ◽  
...  

AbstractIntroduction:Dissemination and implementation (D&I) science is not a formal element of the Clinical Translational Science Award (CTSA) Program, and D&I science activities across the CTSA Consortium are largely unknown.Methods:The CTSA Dissemination, Implementation, and Knowledge Translation Working Group surveyed CTSA leaders to explore D&I science-related activities, barriers, and needed supports, then conducted univariate and qualitative analyses of the data.Results:Out of 67 CTSA leaders, 55.2% responded. CTSAs reported directly funding D&I programs (54.1%), training (51.4%), and projects (59.5%). Indirect support (e.g., promoted by CTSA without direct funding) for D&I activities was higher – programs (70.3%), training (64.9%), and projects (54.1%). Top barriers included funding (39.4%), limited D&I science faculty (30.3%), and lack of D&I science understanding (27.3%). Respondents (63.4%) noted the importance of D&I training and recommended coordination of D&I activities across CTSAs hubs (33.3%).Conclusion:These findings should guide CTSA leadership in efforts to raise awareness and advance the role of D&I science in improving population health.


2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Mishka K. Cira ◽  
Allison Dvaladze ◽  
Robel Tesfay ◽  
Jo Anne Zujewski ◽  
Kalina Duncan

PURPOSE The objective of the Project ECHO (Extension for Community Healthcare Outcomes) for Knowledge Summaries for Comprehensive Breast Cancer Control (KSBC) was to strengthen the capacity to plan and implement evidence-based, resource-appropriate breast cancer control programs using virtual case-based learning within a global network of experts and peers. METHODS The KSBC ECHO was a collaboration between the US National Cancer Institute Center for Global Health, Women’s Empowerment Cancer Advocacy Network, and Breast Health Global Initiative in alignment with the Breast Cancer Initiative 2.5 campaign to reduce disparities in breast cancer outcomes. Using the ECHO model, we developed a 6-month Web-based program to support the development of locally relevant, resource-appropriate cancer control programs through mentorship and use of KSBCs. The course was advertised via existing networks, conferences, and social media. Breast cancer control project teams from around the world applied and were accepted to participate in the KSBC ECHO. Fourteen biweekly ECHO sessions were held via Zoom and included case presentations, didactic presentations, and discussion. Projects spanned the care continuum and sessions addressed preplanning, assessing need/barriers, setting objectives/priorities, and implementing/evaluating. Baseline and end point surveys were used to evaluate the ECHO program. Participants identified a mentor, completed worksheets, and presented on the project status. RESULTS Fifteen project teams from 11 countries—64 participants: advocates, clinicians, policymakers, and researchers—were enrolled. Twenty-eight participants (57%) completed the baseline and end point surveys. Analysis of the data using a paired t-test indicates that the knowledge increase was statistically significant: The average knowledge gain was 0.76 ± 0.89 (95% CI, 0.44 to 1.08; P < .0001). Additional feedback on the Web-based collaborative learning model will be presented. CONCLUSION The ECHO model encouraged interaction between policymakers, clinicians, advocates, and technical experts while using evidence-based tools to develop locally relevant, resource-appropriate implementation strategies and policy recommendations.


2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 46s-46s
Author(s):  
Ethan Thayumanavan ◽  
Catherine Duggan ◽  
Barri M. Blauvelt

Purpose Women with breast cancer in low- and middle-income countries (LMICs) have worse health outcomes than their counterparts in high-income countries (HICs). Improved outcomes in HICs are attributable to more rigorous breast cancer control policies, implementation of evidence-based guidelines, and greater national investment in health care. In resource-limited settings, identifying the most effective resource-appropriate policies can be a challenge. The proposed study will provide a framework to identify unmet breast cancer policy and infrastructure needs in LMICs and will aid in the prioritization of key elements of successful breast cancer control programs. Building on previous work, we will develop a framework for policy analysis and conduct a breast cancer policy needs assessment through a comparative analysis of attitudes and preferences for breast cancer control elements in 30 countries. Methods The proposed observational survey-based study will measure and compare attitudes and preferences for breast cancer control across 24 LMICs and six reference HICs from across the six WHO regions, stratifying countries by health care spending and mortality-to-incidence ratios. This study will be a cross-sectional survey of medical, policy, and advocacy experts in breast cancer from each of the selected countries. Research will be conducted in three phases. First, we will conduct key informant interviews of international breast cancer experts. Then we will develop and pilot a survey tool. Finally, we will conduct the full survey in countries. The study will use analysis of variance, conjoint analysis, and best-worst scaling to analyze survey results. Results This study will assess current breast cancer control needs, prioritize elements of a comprehensive breast cancer control plan, and determine attitudes about the potential of emerging technologies to improve breast cancer control. Conclusion This study will facilitate the improvement of health outcomes for women with breast cancer by assessing the specific unmet breast cancer policy and infrastructure needs in LMICs and prioritizing elements to improve breast cancer control programs. The study thus provides a resource-appropriate framework to improve breast cancer control policy, reform, and implementation. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Barri M. Blauvelt Stock or Other Ownership: AstraZeneca, Biogen, Celgene, Ecolab, Elite Pharmaceuticals Consulting or Advisory Role: Boehringer Ingelheim, Novartis


Author(s):  
Ana A. Baumann ◽  
Leopoldo J. Cabassa ◽  
Shannon Wiltsey Stirman

This chapter focuses on adaptations in the context of dissemination and implementation research and practice. Consistent with the existing literature, the authors recommend that adaptations be proactively and iteratively determined, strongly informed by a variety of stakeholders, and that efforts be made to carefully describe and document the nature of the adaptations and evaluate their impact on desired service, health, and implementation outcomes. While this chapter focuses on adaptations to interventions and the context of practice, the authors also note that adaptations may need to be made to implementation strategies. Following the call by Proctor and colleagues for further precision in defining and operationalizing implementation strategies, and based on evidence that scholars are not necessarily reporting what and how they are adapting the interventions, scholars are urged to define and evaluate the adaptations they are making not only to the interventions and context of practice but also to the implementation strategies.


Author(s):  
James W. Dearing

The main concepts of the diffusion of innovations represent a hybrid change research and practice paradigm that blends ideas that can now be found in life cycle, evolutionary, and teleological theories of social change. This chapter discusses why the paradigm developed in the ways that it did, including the shortcomings of this approach, especially for studying the role of organizations in change processes. The chapter also examines the rapid rise of dissemination and implementation science as conducted by health services and public health researchers and how those new literatures are related to diffusion. This paradigmatic evolution from descriptive and explanatory studies to intervention research utilizing diffusion concepts is a theme of this chapter, with emphases on organizational implementation of innovations, inter-organizational diffusion, external validity of innovations and how a recognition of the agency of adopters can reshape diffusion study.


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