Comprehensive Cancer Control National Partnership
By Prajakta Adsul, MBBS, MPH, PhD
As defined by the CDC, Comprehensive Cancer Control (CCC) is an approach that brings together key partners and organizations to develop a plan to reduce the numbers of community members that develop and are diagnosed with cancer. To achieve this, goals for comprehensive cancer control typically include evidence based interventions that lead to a reduction in cancer incidence, early detection of some cancers, reduced cancer-related morbidity and mortality, and improvements in the quality of life of cancer survivors. 
The Comprehensive Cancer Control National Partnership (CCCNP) was formed in 1998 as a collaborative group of national organizations working in the field of cancer control to build and strengthen CCC efforts across the nation. This year CCCNP celebrates their 20th Anniversary, representing an influential group of nineteen leading cancer organizations , including NCI, that utilize their combined strengths and resources to change the trajectory of the cancer burden in the US. Each partner within the CCCNP commits time and resources, skills, and knowledge to the state and local coalitions so that they can work together to address cancer in their communities. Lead by a Chair (Dr. Cynthia Vinson from NCI) and a Vice Chair (Frank Bright from NACCHO), the organization primarily works through groups focused on the strategic goals which include: increasing HPV vaccinations, colorectal cancer screening, improving healthy behaviors for survivors, and sustaining coalitions.
The CCCNP activities are geared towards providing support to the Comprehensive Cancer Control (CCC) coalitions in the U.S. states, tribes, territories, and U.S. Pacific Island Jurisdictions. These coalitions often have partners from academic and medical institutions, businesses, industries, community-based organizations, government agencies, non-profit organizations, political leaders, professional associations, and public health programs. Each coalition creates a CCC plan to guide its activities which is typically updated every five years. These plans include activities that encourage people to make healthy choices, educate people about cancer screening tests, increase access to quality cancer care, reduce health disparities, and improve the quality of life for cancer survivors. All 50 states, the District of Columbia, 7 tribes and tribal organizations, and 7 territories and U.S. Pacific Island jurisdictions have produced plans.
This year I was asked to co-chair the HPV workgroup of the CCCNP with Dr. Achal Bhatt from CDC. The goal of this workgroup is to improve the uptake of HPV vaccination rates among 11 to 12-year old boys and girls across the US. In support of this priority, the CCCNP provides technical assistance (TA) to selected state teams. States were offered the opportunity to come together to learn about evidence-based strategies and participate in facilitated discussions to develop collaborative one-year action plans with a focus on HPV vaccinations. In order to maximize the implementation of these action plans, decision-makers from key stakeholder organizations within the state such as the Comprehensive Cancer Control Program Director, the American Cancer Society Health Systems Manager, the State Immunization Program Representative and a HPV Champion were invited to be a part of the state team.
After successfully providing technical assistance to 11 state teams in 2016, this year the CCCNP offered TA to another 22 state teams in two different workshops (July and August 2018). Each team member committed to completing pre-workshop activities, full participation in all days of the workshop and completion of a state team action plan, and post workshop activities including submission of brief progress reports and evaluations. Over two days of in-person meetings with the state teams, the CCCNP provided experts that shared evidence-based strategies and tools to support statewide collaborative efforts to increase HPV vaccination rates. State teams also worked together in facilitated sessions to identify priority activities and draft one-year action plans designed to increase HPV vaccination rates, primarily through policy, system and environmental (PSE) change approaches.
For both the July and August workshops, I presented an introduction to implementation science and helped facilitate discussions with individual state teams as they developed their action plans. I was accompanied by many experts in the field including, past and current members of the Cancer Prevention and Control Research Network - Dr. Cam Escoffery, Dr. Robin Vanderpool, Dr. Heather Brandt, and Dr. Maria Fernandez. I was struck by the enthusiasm in which key stakeholders addressed their local needs and I believe that much of it came from interactions with other state teams dealing with similar issues. Listening to the experts and other state teams helped them identify and plan to adopt innovative strategies that required fewer resources and were applicable in their local settings. It was apparent that collaborations between state and local partners are critical to the success of increasing HPV vaccination rates across the U.S. These TA workshop activities also provide the unique opportunity to study the impact of technical assistance as an implementation strategy. With limited research in this area, there is a need to study the impact of TA on the uptake of evidence-based interventions for improving the HPV vaccination rates in the country. Our team is currently working to evaluate the impact of these TA efforts on subsequent cancer control practice implementation.
The value added by partnerships and collaborative work is important to consider and each partner organization, with its unique capabilities, can make a significant contribution to the effort. The CCCNP and their work provide a unique and invaluable context for synergizing research and practice partnerships that allow to integrate all relevant stakeholders to address needs of the communities in which they operate. Understanding how such partnerships can enhance the implementation of evidence-based interventions is critical to progress in the field of comprehensive cancer control.
Dr. Prajakta Adsul is a former Cancer Prevention Fellow with the Implementation Science team in the Office of the Director in the Division of Cancer Control and Population Sciences at the National Cancer Institute.