Implementation Science

Fostering the Rapid Integration of Research, Practice, and Policy

Implementation science (IS) bridges the gap between research and practice to ultimately improve individual and population health outcomes through the integration of effective health interventions in clinical and community settings. Implementation science activities at NCI were initiated from a recognition that biomedical research findings and health interventions were not being taken up within health systems and communities, limiting the benefit for population health. Significant strides have been made in recent years to move beyond identifying barriers, toward the adoption of interventions, and increasingly focused on intervention adaptation, sustainment, implementation strategies, and de-implementation of ineffective practices.

Implementation science has long been supported across the entire NIH. At NCI, implementation science is largely led by DCCPS and the IS team, working to advance the field through a variety of activities, including funded studies and training programs. Notably, NCI, along with many other participating institutes and centers across NIH, issued the trans-NIH PAs with special receipt, referral and/or review (PAR) Dissemination and Implementation Research in Health (R01/R03/R21). Investigators are encouraged to submit research applications that utilize innovative approaches to identifying, understanding, and developing strategies for overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based interventions, tools, policies, and guidelines. Conversely, there is a benefit to understanding circumstances that create a need to stop, or reduce, or de-implement the use of interventions that are ineffective, unproven, low-value, or harmful. The goals of these PARs are to (1) encourage transdisciplinary teams of scientists and practice stakeholders to work together to develop and test conceptual models of dissemination and implementation (D&I) that are potentially applicable across diverse community and practice settings and (2) design studies that will accurately assess the outcomes of D&I efforts. In further support of advancing the science, the IS team co-chairs the Annual Conference on the Science of Dissemination and Implementation, organizes monthly webinars and blogs on new areas of research, and published an edited volume on cancer IS.

As a discipline, implementation science is characterized by a variety of research designs and methodological approaches, partnerships with key stakeholder groups (e.g., patients, providers, organizations, systems, and/or communities), and the development and testing of ways to effectively and efficiently integrate evidence-based practices, interventions, and policies into routine health settings. To build capacity in the field and support the study of these methods, the Training Institute for Dissemination and Implementation Research in Cancer (TIDIRC) was developed to provide participants a thorough grounding in conducting D&I research — with a specific focus on cancer — across the cancer control continuum. In its fourth year, TIDIRC has welcomed faculty and guest lecturers that include leading experts in D&I theories, models, and frameworks; intervention fidelity and adaptation; stakeholder engagement and partnership for D&I; research methods and study designs for D&I; and measures and outcomes for D&I. The 2018 and 2019 institutes utilized a combination of online coursework and in-person training, and the 2020 and 2021 institutes have been conducted virtually. Since 2018, a total of 185 trainees have matriculated through the course. While attendees must be accepted to participate in TIDIRC, all training materials are publicly available online, and in 2021, the entire curriculum was refreshed and expanded with a focus on study designs, qualitative research approaches, and emerging topics in implementation science, including equity, policy, and costs.

NCI’s implementation science approach involves strategic partnerships and multilevel perspectives, along with strong stakeholder engagement. Along with CDC and HRSA, the IS team is a member of the CCCNP, a collaborative group of 19 diverse national organizations working together to build and strengthen comprehensive cancer control efforts across the nation. Through coordination and collaboration, the CCCNP assists comprehensive cancer control coalitions to develop and sustain implementation of comprehensive cancer control plans at the state, tribe, territory, US Pacific Island Jurisdiction, and local levels. NCI staff enhance this research-practice partnership through active participation as subject matter experts and by serving in past and current leadership roles.

To better collaborate with and incorporate feedback from stakeholders, the Consortium for Cancer Implementation Science, launched in 2019 (formerly the Implementation Science Consortium in Cancer), seeks to (1) create “public goods” for IS, (2) foster collaborations across the implementation science and cancer control field, (3) improve networking and dissemination of implementation science information and resources to the field at-large, (4) target and work with underrepresented topics and areas, and (5) maintain ongoing engagement with underrepresented communities. Significantly, this consortium has brought together a total of 658 cancer control and implementation researchers, practitioners, and funders representing more than 111 institutions around the world and most recently focused on short-term and long-term cancer control priorities, challenges, and opportunities during the COVID-19 pandemic, synergies and gaps in the implementation science space across NCI and other federally funded initiatives, as well as discussions on infrastructure for cross-collaboration.

NCI has been and continues to be an important leader in and funder of implementation science. Current and future efforts should build upon this important foundation and infrastructure to improve the impact of cancer control and population science on the health and healthcare of the population, and foster rapid integration of research, practice, and policy.