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Hudson MF, Oostdyk AM, Simmons VM, Martin JC. Considering context in area-level socioeconomic status, cancer treatment initiation, and survival. JNCI Cancer Spectr 2023; 7:pkad078. [PMID: 37850333 PMCID: PMC10582689 DOI: 10.1093/jncics/pkad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023] Open
Affiliation(s)
- Matthew F Hudson
- Department of Medicine, Prisma Health Cancer Institute, Greenville, SC, USA
| | - Alicia M Oostdyk
- Department of Medicine, Prisma Health Cancer Institute, Greenville, SC, USA
| | - Virginia M Simmons
- Department of Medicine, Prisma Health Cancer Institute, Greenville, SC, USA
| | - Julie C Martin
- Department of Medicine, Prisma Health Cancer Institute, Greenville, SC, USA
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Adsul P, Chambers D, Brandt HM, Fernandez ME, Ramanadhan S, Torres E, Leeman J, Baquero B, Fleischer L, Escoffery C, Emmons K, Soler M, Oh A, Korn AR, Wheeler S, Shelton RC. Grounding implementation science in health equity for cancer prevention and control. Implement Sci Commun 2022; 3:56. [PMID: 35659151 PMCID: PMC9164317 DOI: 10.1186/s43058-022-00311-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The past decade of research has seen theoretical and methodological advances in both implementation science and health equity research, opening a window of opportunity for facilitating and accelerating cross-disciplinary exchanges across these fields that have largely operated in siloes. In 2019 and 2020, the National Cancer Institute's Consortium for Cancer Implementation Science convened an action group focused on 'health equity and context' to identify opportunities to advance implementation science. In this paper, we present a narrative review and synthesis of the relevant literature at the intersection of health equity and implementation science, highlight identified opportunities (i.e., public goods) by the action group for advancing implementation science in cancer prevention and control, and integrate the two by providing key recommendations for future directions. DISCUSSION In the review and synthesis of the literature, we highlight recent advances in implementation science, relevant to promoting health equity (e.g., theories/models/frameworks, adaptations, implementation strategies, study designs, implementation determinants, and outcomes). We acknowledge the contributions from the broader field of health equity research and discuss opportunities for integration and synergy with implementation science, which include (1) articulating an explicit focus on health equity for conducting and reviewing implementation science; (2) promoting an explicit focus on health equity in the theories, models, and frameworks guiding implementation science; and (3) identifying methods for understanding and documenting influences on the context of implementation that incorporate a focus on equity. To advance the science of implementation with a focus on health equity, we reflect on the essential groundwork needed to promote bi-directional learning between the fields of implementation science and health equity research and recommend (1) building capacity among researchers and research institutions for health equity-focused and community-engaged implementation science; (2) incorporating health equity considerations across all key implementation focus areas (e.g., adaptations, implementation strategies, study design, determinants, and outcomes); and (3) continuing a focus on transdisciplinary opportunities in health equity research and implementation science. We believe that these recommendations can help advance implementation science by incorporating an explicit focus on health equity in the context of cancer prevention and control and beyond.
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Affiliation(s)
- Prajakta Adsul
- Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM USA
| | - David Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD USA
| | - Heather M. Brandt
- HPV Cancer Prevention Program, St. Jude Children’s Research Hospital, Memphis, TN USA
| | - Maria E. Fernandez
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, USA
| | | | - Essie Torres
- East Carolina University, 2309 Carol Belk Bldg, Greenville, NC 27858 USA
| | | | - Barbara Baquero
- University of Washington, 3980 15th Ave. NE, Seattle, WA 98195 USA
| | | | - Cam Escoffery
- Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322 USA
| | - Karen Emmons
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Montserrat Soler
- Ob/Gyn and Women’s Health Institute, Cleveland Clinic, Cleveland, OH USA
| | - April Oh
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Ariella R. Korn
- Cancer Prevention Fellowship Program, Implementation Science, Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, USA
| | - Stephanie Wheeler
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7411, Chapel Hill, NC 27599 USA
| | - Rachel C. Shelton
- Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, 722 W 168th Street, New York, NY 10032 USA
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Norton WE, Loudon K, Chambers DA, Zwarenstein M. Designing provider-focused implementation trials with purpose and intent: introducing the PRECIS-2-PS tool. Implement Sci 2021; 16:7. [PMID: 33413489 PMCID: PMC7791810 DOI: 10.1186/s13012-020-01075-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/10/2020] [Indexed: 12/18/2022] Open
Abstract
Background First articulated by Schwartz and Lellouch (1967), randomized controlled trials (RCTs) can be conceptualized along a continuum from more explanatory to more pragmatic. The purpose and intent of the former is to test interventions under ideal contexts, and the purpose and intent of the latter is to test interventions in real-world contexts. The PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) is a validated tool that helps researchers make decisions about the elements of the trial to match the overall purpose and intent of the trial along the continuum. The PRECIS-2 tool has guided the design of hundreds of RCTs. However, a few aspects of the tool would benefit from greater clarity, including its application to provider-focused implementation trials rather than patient-focused intervention trials. Main text We describe the newly developed PRECIS-2-Provider Strategies (PRECIS-2-PS) tool, an extension of the PRECIS-2 tool, which has been adapted for trials testing provider-focused strategies. We elaborate on nine domains that can make a provider-focused trial more explanatory or more pragmatic, including eligibility, recruitment, setting, implementation resources, flexibility of provider strategies, flexibility of intervention, data collection, primary outcome, and primary analysis. We detail the complementary roles that researchers and stakeholders play in the trial design phase, with implications for generalizability of trial results to the contexts in which they are intended to be applied. Conclusions The PRECIS-2-PS tool is designed to help research and practice teams plan for provider-focused trials that reflect the overall intent and purpose of the trial. The tool has potential to help advance the science of provider-focused strategies across a range of trials, with the ultimate goal of facilitating the adoption, integration, and sustainability of provider-focused strategies outside the context of trials. Supplementary Information The online version contains supplementary material available at 10.1186/s13012-020-01075-y.
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Affiliation(s)
- Wynne E Norton
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, #3E424, Bethesda, MD, 20850, USA.
| | | | - David A Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, #3E424, Bethesda, MD, 20850, USA
| | - Merrick Zwarenstein
- Centre for Studies in Family Medicine, Department of Family Medicine, Western University, London, Ontario, Canada
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