Over the next several years, we see continued opportunities to grow implementation science within the cancer control community. Many of the initiatives are still in their early stages and are charting a course toward increasing capacity to do innovative, relevant research. The efforts begun under the Cancer Moonshot, including the ISC3, ACCSIS, IMPACT, C3I, and hereditary cancers, will continue to make progress on their specific aims, while the expanding Implementation Science Consortium will work to share research findings; identify common research questions; and engage the research, practice, and policy communities to identify additional “public goods” for the field.
Several of the themes mentioned previously, including expanded concentration on policy-relevant implementation science and increasing the global footprint of research, will continue to progress, and the trans-NIH activities (including funding opportunities, training programs, conferences and workshops, and publications) will extend the knowledge base in areas common to cancer control, including enhanced understanding of the effectiveness of implementation strategies, mechanisms of action that predict adoption and implementation of evidence-based practice, and closing gaps in measurement and research methods.
In addition, we are excited to see heightened focus on areas of implementation science underrepresented in our portfolio. First, the continuation of disparities in access and quality of care, resulting in inequities at all stages of the cancer continuum, demands ever greater attention to the interface between health equity and implementation science. Future studies must attend to important social determinants of health that establish the context upon which effective interventions are implemented and the degree to which the evidence base meets the needs of the population. Increased efforts are also needed as we look at the longer-term decisions to be made about the use of existing interventions. We need more studies that examine and enhance the sustainability of evidence-based practices, increase our understanding of how interventions are adapted and optimized within services systems, and build a knowledge base to inform de-implementation of ineffective or low-value care.
Finally, future implementation science should examine how evidence-based cancer control is scaled up across practices, networks, systems, and communities, in order to achieve population-level improvements in adoption, implementation, and sustainment. Investigators are encouraged to move beyond studies of individual interventions to consider how broad models of care delivery can meet the needs of patients and families across the cancer continuum. In all of these activities, DCCPS will work to build field capacity, integrate implementation science into the larger cancer control and population science portfolio, and enhance collaborations among our researchers, practitioners, and policymakers.