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Multilevel Interventions in Health Care: Building the Foundation for Future Research

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Understanding and Influencing Multilevel Factors Across the Cancer Continuum
Journal of the National Cancer Institute (JNCI) Special Issue

Access articles online or order a free, printed copy of the May 2012 cross-disciplinary publication that aims to expand the scientific base of multilevel intervention research and improve health care and cancer outcomes for individuals. Visit https://pubs.cancer.gov and search for publication number T433 to obtain a copy. Written by transdisciplinary teams, the thirteen papers and five commentaries in the publication complete the work of the March 2011 NCI conference, Multilevel Interventions in Health Care: Building the Foundation for Future Research.

Toward Improving the Quality of Cancer Care: Addressing the Interfaces of Primary and Oncology Related Subspecialty Care
2010 JNCI Supplement on multilevel intervention planning

Multilevel Interventions in Health Care: Building the Foundation for Future Research

BEHAVIORAL FACTORS ON A MULTILEVEL FRAMEWORK

The Multilevel Interventions in Health Care: Building the Foundation for Future Research Goals conference, held March 4-5, 2011, in Las Vegas, Nevada, featured paper presentations, keynote addresses, and a poster session highlighting current multilevel research and future research needs. The goal of the conference was to expand the scientific base of multilevel interventions in cancer care as well as other health conditions. The conference was attended by researchers interested in multilevel interventions and evaluation.

In hopes of expanding the audience and stimulating even more discussion of these issues, we have posted videos, paper summaries, and slides from the presentations and keynote addresses. Abstracts from the accepted poster presentations are also available on the site.

We encourage interested researchers to explore the site and to look for the full papers in a special supplement to the Journal of the National Cancer Institute, which will be published in the next year.

The Multilevel Interventions in Health Care conference format

  • Centered around 11 foundational papers that grew out of a discussion on multilevel theory, models, and methods from several disciplines, exploring interactions across levels, including mediators and moderators of the effects and exploring the efficacy of multilevel interventions in health care issues. The papers will be published as a journal supplement in the Journal of the National Cancer Institute.
  • Included small group discussions and moderated Question and Answer sessions after each set of papers, allowing audience participation and identification of issues that are missing from each paper.
  • Identified priorities for research and explored research designs and measurement approaches that address the challenges of developing multilevel interventions that affect individuals' health and health behavior.
  • Included poster presentations that address salient issues relevant to building the foundation of successful multilevel interventions.

Definition of Multilevel Interventions

For the purposes of this conference, a multilevel intervention was defined as one that addresses the health outcomes for patients, as well as at least two additional levels of contextual influence. Such interventions target at least three levels in a multilevel model of improving health status. While there is a long history of interventions targeted at patients and providers in specific contexts, such as the patient's network of social support, or the type of organization (HMO, PPO, MCO) within which care was provided, discussions at the conference encouraged consideration of a wider set of factors affecting the health behaviors and outcomes of patients seeking care.