It has been a little more than a year since I joined the Implementation Science (IS) team at the National Cancer Institute (NCI) as a health scientist. My focus is primarily on advancing the involvement of practitioners in IS to enhance the integration of evidence-based guidelines, programs, and policies for cancer control in public health and clinical practice.
Practitioners are the individuals leading cancer prevention and control work on the ground. Certainly, direct service providers, clinical support staff, and health system administrators are essential practitioners to involve in IS as they are the ones delivering interventions to patients. Historically, much of the cancer-focused implementation research has been conducted in clinical settings. However, because of the importance of primary prevention and a desire to advance health equity by reaching community members outside of health systems walls, it is urgent that the cancer IS field work to engage individuals responsible for adopting and implementing interventions in public health and community settings. Accordingly, re-issuances of the Dissemination and Implementation Research in Health parent announcements (22-105, 22-106, 22-109) emphasize the importance of engaging communities and practitioners and conducting IS in non-clinical contexts.
To explore the extent to which and how community partners, practitioners, and others are engaged in recently NIH-funded dissemination and implementation (D&I) research, I have been collaborating with colleagues across NIH over the past year to conduct a grants portfolio analysis. Preliminary findings are encouraging— the vast majority of NCI IS grants funded in fiscal years 2020 and 2021 have some level of engagement and engaged individuals in multiple roles. However, few grants engaged partners or participants deeply through a collaborative or partnership approach. In addition, most of the grants were set in a healthcare context and few involved non-clinical professionals from public health, education, social service, or other community-based settings. Stay tuned for a formal, more detailed reporting of this portfolio analysis later this year.
Several of the research-practice partnership networks I am engaged in have been looking at and beginning to address this opportunity. A 2021 needs assessment conducted by the Comprehensive Cancer Control National Partnership (CCCNP) demonstrated that professionals involved in comprehensive cancer control programs and coalitions are interested in building their capacity to apply IS in practice and in participating in dissemination and implementation research (learn more about CCCNP). Several cancer control practitioners/implementers are participating in the Cancer Prevention and Control Research Network Scholars program, a year-long experience that involves a learning curriculum and mentored projects to build capacity in D&I. In fiscal year 2022, NCI funded nine cancer centers to develop or expand on partnerships with cancer coalitions to advance implementation science and practice. The Implementation Science Centers in Cancer Control capacity-building workgroup is developing an online database of resources to support IS capacity building for researchers and their partners. The Consortium for Cancer Implementation Science community participation action group is hard at work on public goods related to the value of and best practices for participatory IS, working with implementation champions, and building institutional capacity to support engaged IS. And finally, the NCI team is developing teaching case studies that will be added to the Evidence Based Cancer Control Programs website and are intended to be useful in a range of public health courses.
Engaging public health and community-based organizations in cancer-focused D&I research is limited by unique contextual challenges and considerations. Have these been fully articulated and what are promising solutions or facilitators for participatory IS in these settings? Do implementation scientists have the competencies needed to successfully build and sustain these partnerships? What factors in to cancer control partners’ decisions about engaging with researchers and how can investigators assess and help enhance the research readiness of public health and community-based organizations and their capacity to deliver evidence-based interventions? How can more cancer implementation scientists incorporate engagement science in their research to study relationships and empirically assess various engagement strategies and their influence on implementation outcomes? How can we better disseminate lessons learned from successful initiatives to the field and partners in practice?
I hope that you too feel the importance and urgency of increasing engagement and participation in IS of professionals working on cancer control in community settings. I welcome your thoughts on the questions I’ve posed and invite additional questions to consider.
Aubrey Van Kirk Villalobos, DrPH, MEd, is a Health Scientist with the Implementation Science (IS) Team in the Office of the Director in the Division of Cancer Control and Population Sciences (DCCPS) at the National Cancer Institute (NCI).
Dispatches from the Implementation Science Team, is an episodic collection of short form updates, authored by members and friends of the IS team representing a sample of the work being done and topics that our staff are considering for future projects. Topics address some of the advances in implementation science, ongoing issues that affect the conduct of research studies, reflections on fellowships and meetings, as well as new directions for activity from our research and practice communities.