My Journey into Implementation Science

Seven months ago, I joined the Implementation Science (IS) Team at the National Cancer Institute (NCI). I was drawn to the field through my work implementing telehealth services at the Veterans Affairs (VA) Healthcare system. As a research coordinator in the health outcomes area and later as an implementation specialist at the VA Veterans Integrated Services Networks 7 Clinical Resource Hub, I worked closely with clinical staff. I observed firsthand the need to bridge the gap between research and practice and build strong collaborative partnerships to improve patients’ health outcomes. 

I saw research involving patients with health issues including head and neck cancer as well as eye care and dermatology issues. We worked to bring care to the clinical settings but encountered many challenges. Implementing the Technology-based Eye Care Services (TECS) program required purchasing equipment, tagging, and shipping to the local clinics, networking to the computer system, and busy staff with months of process time. When qualified technicians left, it took months to replace them in rural areas, due to the lack of available and qualified candidates. Equipment breakages could lead to long delays resulting in patients being moved to other locations or to community care. Different settings from rural eye care clinics to large hospitals, with different resources available, procedures, staffing, and policies presented complex situations. As we worked to overcome these challenges, it was difficult but also rewarding. The VA TECS program expanded greatly during my time and is now critical to providing quality care to patients in rural areas. These experiences gave me a grounding in the complex challenges we seek to address through implementation science.

This summer I participated in an internal training course, which used materials from the Training Institute for Dissemination and Implementation Research in Cancer (TIDIRC) led by Dr. Gila Neta. The training was an opportunity to learn the basics of implementation research, enabling me to better support team initiatives. Since joining the IS Team, I have worked on three key initiatives: Implementation Science Centers in Cancer Control (ISC³), Consortium for Cancer Implementation Science (CCIS), and Evidence-Based Cancer Control Program (EBCCP). 

The ISC³ initiative includes seven Implementation Science Centers: Harvard’s Implementation Science Center for Cancer Control Equity, Penn’s Implementation Science Center in Cancer Control, Wake Forest/UMass’ Implementation and Informatics – Developing Adaptable Processes and Technologies for Cancer Control, WashU’s Implementation Science Center for Cancer Control, Colorado’s Implementation Science Center in Cancer Control, University of Washington’s Optimizing Implementation in Cancer Control, and Oregon Health and Science University’s Building Research in Implementation and Dissemination to Close Gaps and Achieve Equity in Cancer Control Center. I met many wonderful principal investigators and early-stage investigators at our grantee meeting in Boston. It was great watching them collaborate to move the field forward. I have also immersed myself in learning the logistics involved in operating a large P50 funding initiative. 

The Consortium (CCIS) brings together researchers, practitioners, and funders focusing on developing a new approach to address key challenges and identify and develop new areas of investigation toward advancing the implementation science agenda in cancer control. The CCIS participants are working hard on developing public goods, including popular webinars and podcasts. The CCIS team is busy getting ready for the highly anticipated 2023 annual hybrid meeting. This year, the meeting will include discussions on the latest advancements and trends in implementation science, with sessions focused on a) the evolving landscape of the field; b) how to adapt and transfer evidence-based policies and programs effectively; and c) exploring strategies for developing and nurturing partnerships that promote health equity and foster collaboration across the cancer research and healthcare community. Unlike in previous years, the action groups are meeting prior to the annual meeting to work on their priorities for the upcoming year. I look forward to hosting my first hybrid CCIS annual meeting. 

The third key initiative, EBCCP, provides evidence-based interventions and materials on a variety of cancer-related health topics (e.g., breast cancer screening, cervical cancer screening, colorectal cancer screening, diet and nutrition, HPV vaccination, informed decision making, obesity, physical activity, public health genomics, sun safety, survivorship/supportive care, and tobacco control) that are implementation-ready. EBCCP is designed to provide program planners and public health practitioners immediate access to program materials that have gone through a rigorous process. The EBCCP website also features case studies from real-world implementers, providing more information about program adaptation and implementation for their settings. To me, the value of evidence-based interventions is best demonstrated in implementing and disseminating those programs in the areas and to the people in need. Our team cares deeply about disseminating the programs and would love to hear more ideas for how we can do even more. 

Working on these key initiatives has impressed me with colleagues’ commitment and passion for the work we do. I hope to find new ways to engage with practitioners and community partners from the field and incorporate their voices in how we strive to foster a stronger partnership. It has been an incredible journey so far, and I am looking forward to continuing to contribute to this important work and taking a small part in ending cancer as we know it today.