Resources and Tools for Implementation Sciences
DCCPS recognizes that advances in our understanding of implementation processes will have maximum benefit if communicated in a way that supports and informs the important work of cancer control researchers and practitioners, providing them with the tools and resources necessary to help them better understand, plan for, and conduct rigorous D&I studies. Below, we highlight some tools and resources for use in implementation science, which are also of use in population science more broadly.
State Cancer Profiles
State Cancer Profiles, an invaluable tool accessible on cancer.gov, is a collaboration of NCI and the Centers for Disease Control and Prevention (CDC). State Cancer Profiles supplies health planners, policymakers, and cancer information providers with data, maps, and interactive graphs to help guide and prioritize cancer control activities at the state and local levels. The site illuminates the cancer burden in a standardized manner to motivate action, integrate surveillance into cancer control planning, characterize areas and demographic groups, and expose health disparities.
Evidence-Based Cancer Control Programs
Another important tool, also accessible on cancer.gov, is Evidence-Based Cancer Control Programs (EBCCP), formerly Research-Tested Intervention Programs (RTIPs). The EBCCP website is a searchable database of evidence-based cancer control interventions and program materials, designed to provide program planners and public health practitioners easy and immediate access to research-tested materials. The online directory offers a review of programs available for use in a community or clinical setting.
Dissemination and Implementation Models in Health Research and Practice
The Dissemination and Implementation Models in Health Research and Practice webtool was developed and is maintained as a collaborative effort with D&I science colleagues around the country. The interactive tool is designed to help researchers and practitioners develop a logic model or diagram for their research or practice question, select the D&I model(s) that best fit(s) their research question or practice problem, combine multiple D&I models, adapt the D&I model(s) to the study or practice context, use the D&I model(s) throughout the research or practice process, and find existing measures to assess the key constructs of the D&I model(s) selected.
In addition to the implementation science tools mentioned above, DCCPS supports numerous data sets and analysis tools that inform implementation of evidence-based practices, interventions, and policies:
Healthy Eating Index
The Healthy Eating Index (HEI) is a measure of dietary quality that assesses conformance to the Dietary Guidelines for Americans (DGA). Scientists at NCI collaborate with colleagues at the US Department of Agriculture to update the index to correspond to the DGA updates that occur every 5 years. The 2020 Dietary Guidelines Advisory Committee applied the HEI using National Health and Nutrition Examination Survey (NHANES) data to assess the current American diet; using this information, the committee made recommendations to the federal government about updates needed to the DGAs. Furthering the reach of the HEI, NCI researchers have recently created an HEI report that provides research participants with feedback about their HEI score and advice on how to improve their diet based on responses to the Diet History Questionnaire, a frequency questionnaire developed by NCI DCCPS researchers. The HEI report has been pilot tested in a cancer survivorship clinic, and additional user testing is planned.
Classification of Laws Associated with School Students (CLASS)
CLASS is a scoring system that monitors, classifies, and evaluates the strength of school physical education and nutritional policies, state by state and over time. These data help researchers, policymakers, and the educational community examine the relationship of state laws with student behavioral and school environment outcomes to inform public policy. CLASS data are available for 2003–2018 and are updated annually. Interactive maps and tables allow users to visualize and compare data by grade level and state. State profile visualizations provide an in-depth view of a selected state’s policies by grade level and changes over time. CLASS is distinct from other school policy scoring systems because it captures policies codified into law by school level, rather than informal policies that have not been made into law. It also uses valid and reliable empirical scoring systems based on independent coding by attorneys and policy analysts according to prevailing national standards for nutrition and physical education. CLASS data have been used in high-impact publications, are a recommended data source for school policy surveillance in two Institute of Medicine reports, and CLASS is listed in the Catalogue of Surveillance Systems by the National Collaborative of Childhood Obesity Research.
Automated Self-Administered 24-Hour Dietary Assessment Tool
The Automated Self-Administered 24-Hour (ASA24) Dietary Assessment Tool is a free, web-based application to collect dietary intake data. The ASA24 system consists of a respondent website used to collect dietary intake data and a researcher website used to manage study logistics and obtain nutrient and food group data files. Although it was designed by NCI DCCPS researchers for use among the general population, ASA24 was recently implemented and evaluated among low-income women and found to provide high-quality dietary intake data, even when self-administered. Future implementation work will further examine how the tool can be applied among other subpopulations to provide additional insights for diverse communities.
WHO 2020 Global Recommendations on Physical Activity for Health
DCCPS is also playing a role in the World Health Organization’s (WHO’s) Guideline Development Group (GDG), which is in the process of updating the WHO 2010 Global Recommendations on Physical Activity for Health , to support the implementation of the Global Action Plan on Physical Activity 2018–2030. The GDG met in Geneva, Switzerland, in July 2019 and February 2020 to provide an evidence-based synthesis that is the basis for the 2020 WHO Guidelines on Physical Activity and Sedentary Behavior, approved by the WHO Guideline Review Committee, with an anticipated release by the end of 2020.
The updated guidelines package a complex body of research on physical activity and sedentary behavior across various health outcomes, study designs, and populations into a relatively straightforward, smaller set of public health recommendations to improve population health. The guidelines include recommendations for children and adolescents, adults, older adults, and, for the first time, specific recommendations on physical activity in subpopulations such as pregnant women and those living with chronic conditions or disability.
Also new to this update is a discussion of the relationship of sedentary behavior to health outcomes. Provision of these guidelines by WHO will facilitate adoption and implementation by WHO member countries that do not have the resources to develop their own national guidelines. WHO does recommend customizing messaging around the guidelines to specific national and cultural settings.