Cancer Moonshot-Supported Research Initiatives with Implementation Science Components
Below, we describe a few examples of DCCPS-led funding announcements and initiatives that feature implementation science as a key component.
Improving Management of Symptoms Across Cancer Treatments (IMPACT)
Historically, there have been major barriers to effective symptom control among cancer patients, and a lack of systematic efforts to translate research into practice. The Cancer MoonshotSM Blue Ribbon Panel emphasized the need to gather and monitor patient-reported symptoms and to provide decision support and care using evidence-based symptom management guidelines. Two RFAs encouraged the development of scalable, transferrable, and sustainable models for monitoring and addressing symptoms in routine practice. The RFAs supported three research centers and a coordinating center to form a research consortium, with the overall goal to develop evidence that will guide efforts to improve symptom control for cancer patients during treatment and survivorship, to build a foundation for effective cancer symptom management in standard clinical care. The research centers are deploying integrated electronic systems to monitor and manage cancer symptoms in diverse practice settings and testing them in pragmatic trials to understand the effects on patient health, treatment delivery, health care utilization, and implementation outcomes. The coordinating center provides scientific expertise and logistical support to unite the consortium. Together, the centers are poised to test the state-of-the science symptom management interventions, using implementation science approaches. Multiple working groups support shared components, including development of common data elements, integration of clinical informatics, understanding and addressing health inequities, and implementation science approaches to evaluating and improving the interventions over time.
Accelerating Colorectal Cancer Screening and follow-up through Implementation Science (ACCSIS)
ACCSIS is working to promote colorectal cancer screening, follow-up, and referral-to-care among populations for whom screening rates are far below national standards. In underserved populations, among whom common challenges keep screening rates low, many also share common strengths that could support innovative approaches to increasing implementation. The goals of the ACCSIS program are to provide a robust evidence base for 1) multilevel interventions that increase rates of colorectal cancer screening, follow-up, and referral-to-care; and 2) how these interventions can be scaled up to reduce the burden of colorectal cancer on the US population. Currently, five research projects and one coordinating center have been awarded. All five research projects and the coordinating center participate in trans-ACCSIS working groups focusing on common data collection, common multilevel intervention components, and data sharing. Data will be shared with the broader research community to allow for others to build on the ACCSIS evidence. Preparing for sustainability is integral, as all projects are collaborating with local experts to ensure local acceptability, feasibility, and effectiveness.
Approaches to Identify and Care for Individuals with Inherited Cancer Syndromes
Despite the availability of genetic testing and counseling, a substantial number of those at risk for inherited cancer syndromes are not identified and thus may not benefit from available prevention and early-detection approaches. The purpose of these funding opportunity announcements is to increase case ascertainment and appropriate follow-up care, optimizing the delivery of evidence-based health care for individuals at high risk of cancer due to an inherited genetic susceptibility. Twelve grants have been funded across FY 2018 through FY 2020.
Communication and Decision Making for Individuals with Inherited Cancer Syndromes
One of the most challenging tasks confronting an individual with an inherited cancer syndrome is understanding his or her risk of disease and applying this understanding to decisions involving disease risk management and disclosure of genetic test results to family members. The purpose of this funding opportunity announcement is to develop, test, and evaluate interventions and implementation approaches, or adapt existing approaches, to improve patient/provider/family risk communication and decision making for individuals and families with an inherited susceptibility to cancer. Grants supported from this initiative include one grant funded in FY 2019 and five more funded in FY 2020.
Implementation Science Centers For Cancer Control (ISC3)
The Implementation Science Centers in Cancer Control (ISC3) Program supports the rapid development, testing, and refinement of innovative approaches to implement a range of evidence-based cancer control interventions. Centers all feature “implementation laboratories” involving clinical and community sites that will engage in implementation research across the cancer control continuum to advance methods in studying implementation and develop and validate reliable measures of key implementation science constructs. These centers collectively provide leadership for an implementation science consortium across this and other Cancer Moonshot initiatives.