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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Background. Existing cancer control knowledge is not systematically disseminated and applied-state-level policy makers are in positions to affect programs and services related to cancer control. Environmental and policy interventions show great promise for reducing the cancer burden. Goal. Our primary goal is to increase the dissemination of evidence-based interventions to control cancer, primarily focusing on the uptake of effective environmental and policy approaches among state-level policy makers. Methods and evaluation. To advance dissemination science, our approach evaluates data ("usual care") and narrative approaches. Data-based approaches are used by health experts typically trained to summarize scientific information using empirical statistics and facts. Narrative dissemination turns scientific data into compelling stones showing how evidence-based interventions can affect the daily lives of people. These narrative forms of communication are emerging as important tools for cancer prevention and control. This project will occur in two parts. Phase 1 research involves an individually-randomized experiment in which delivery methods (data versus narrative) are compared among three key groups of policy makers: legislators, legislative staffers, and executive branch administrative leaders. Phase 2 builds on Phase 1, using a group-randomized effectiveness experiment to actively disseminate evidence-based cancer control interventions in 10 states (along with 10 control states). In Phase 2, we extend our work to practitioners, who are important conduits to legislative branch leaders and senior administrators in the executive branch. Dissemination activities in Phase 2 include tool development (e.g., policy briefs), skill enhancement (e.g., dissemination workshops), and application (e.g., enhanced awareness of evidence-based interventions). Evaluation of Phase 2 interventions will rely on three sources of data: 1) measures of dissemination based on self-reported surveys from practitioners; 2) review and abstraction of state-level cancer control records; and 3) a content analysis of relevant state-level legislation (both introduced and enacted bills). We also will conduct process evaluation. Dissemination and innovations. Concurrent with Phase 2, we will begin efforts to design for dissemination. The intent of these activities is to ensure that findings from our grant are useful, relevant, and ready for widespread dissemination when funding ends. We will assemble and work with an advisory group, capture project costs, conduct qualitative case studies, and sponsor a dissemination conference. Policy-relevant dissemination of evidence-based practice is highly innovative yet is an area that remains largely uncharted. Our project advances the field by better understanding the role of narrative communication in shaping policy. Relevance. This project is relevant to public health because it addresses behaviors that lead to significant premature cancer morbidity and mortality. Sparse knowledge exists regarding effective approaches for dissemination of research-tested interventions among "real world" policy audiences. Upon completion, our study will provide policy-relevant dissemination strategies that can be adapted to other settings and risk factors.