Through application of existing knowledge, much of the cancer burden is preventable. State- level practitioners are in ideal positions to affect programs and policies related to cancer control. Mis- implementation refers to ending effective programs and policies or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to positive cancer outcomes. GOAL: This proposal seeks to describe the extent of cancer control mis-implementation and to identify leverage points for addressing mis-implementation in the United States.
AIMS AND METHODS: This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1:
The first aim seeks to assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control (from prevention to survivorship). Phase 2: Using data from Phase 1 to identify organizations in which mis-implementation is high or low, we will conduct eight comparative case studies to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: The 3rd aim seeks to build agent-based models to identify dynamic interactions between individual, organizational, and contextual (external) factors driving mis-implementation. Agent-based modeling will be used to determine the most effective potential approaches for reducing mis- implementation. We will translate and disseminate findings from Phases 1-3 to practitioners and practice- related stakeholders in order to support the reduction of mis-implementation. All study phases will rely on an Advisory Group of public health practitioners and close collaboration with key practice partners. INNOVATIONS AND IMPACT: This study is innovative and impactful because it will: 1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; 2) bring together a strong, transdisciplinary team with significant expertise in practice-based research; 3) use agent- based modeling to address cancer control implementation; and 4) use a participatory, evidence-based, stakeholder-driven approach that will identify key leverage points for addressing mis-implementation among state public health programs. This research is expected to result in a replicable model that can significantly impact mis-implementation in cancer control and can be applied to other health areas.
This project is relevant to public health because it addresses population health strategies related to premature cancer morbidity and mortality. Sparse knowledge exists regarding effective approaches for reducing mis- implementation among real world practice audiences. Upon completion, our study will provide practice-relevant strategies for more efficient use of resources that can be adapted to other settings and risk factors.
| Padek, Margaret; Allen, Peg; Erwin, Paul C et al. (2018) Toward optimal implementation of cancer prevention and control programs in public health: a study protocol on mis-implementation. Implement Sci 13:49 |
