Research Program

宾夕法尼亚大学癌症控制实施科学中心(ISC3)解决的重大挑战是应用 来自行为经济学的见解，以迅速加快我们部署循证实践的步伐 为癌症患者提供服务，从而提高癌症护理质量和预后。我们的研究计划，由 Beidas博士(实施科学专家)和Buttenheim博士(行为经济学专家)将监督 在执行实验室内制定和测试执行战略。我们的实施 策略设计和测试方法包括以患者和临床医生为目标，并以行为为依据 经济学“推动”个人为实施循证护理做出最佳决定。宾夕法尼亚大学 ISC3建立在三个原则之上。首先，实施科学没有从行为中利用丰富的文献-- 社会经济学，它阐明了决策和行为背后的许多启发式 到次优的健康结果。行为经济学的方法还没有得到系统的应用 与实施科学一起改善癌症护理；这些方法旨在加快EVI- 基于Dence的实践。第二，实施科学没有应用快速失败和快速学习的方法， 我们将通过应用快速循环办法将其纳入其中。第三，识别机械的研究- 改进采用循证做法的执行战略尚处于初级阶段。这个 研究计划包括具有实施科学、行为经济学、可以- CER护理提供研究、医疗保健创新、测量和混合方法。在头两年，我们 提出三个标志性试点项目(SPP)和两个方法项目，同时支持SPP和ad- 万斯教授实施科学，着眼于快速学习。SPP 1(Jenssen/Leone)检测患者- 以及临床医生指导的实施策略，以增加患者对戒烟计划的转介 接受癌症治疗。SPP 2(Bekelman/Patel)测试患者和临床医生指导的实施策略- GES将在晚期乳腺癌、肺癌和前列腺癌患者中增加高价值骨改良剂的使用 癌症。通用的方法和措施将这些项目联系起来，以提供汇集的数据来实现我们的目标 测试多层次执行战略，以阐明机制和目标。SPP 3(贝克尔曼/伦德尔)， 最具探索性和最高回报的SPP将测试以患者为导向的实施战略，该战略利用 人工智能和机器学习，促进口服化疗依从性和症状管理。 项目1将开发一个用于应用快速循环方法的工具包(Asch/Buttenheim)； 项目2将使用定性的比较分析来描述多层次的背景变化和机制 (巴格/伦德尔)研究计划所取得的科学进步将对公众健康产生重大影响 影响，与NCI的优先事项一致，通过迅速提高对循证实践的接受来改善癌症 数以百万计的美国癌症患者的护理质量和结果。 PHS 398/2590(06/09版)页面续格式页面

The grand challenge addressed by the Penn Implementation Science Center in Cancer Control (ISC3) is to apply insights from behavioral economics to rapidly accelerate the pace at which we deploy evidence-based practices for patients with cancer, thereby improving cancer care quality and outcomes. Our Research Program, led by Drs. Beidas (implementation science expert) and Buttenheim (behavioral economics expert), will oversee the development and testing of implementation strategies within the Implementation Laboratory. Our implementation strategy design and testing approach includes the patient and clinician as targets, and is informed by behavioral economics to ‘nudge’ individuals to make optimal decisions for implementing evidence-based care. The Penn ISC3 is built on three principles. First, implementation science has not leveraged the rich literature from behav- ioral economics, which has elucidated many of the heuristics that underlie decisions and behaviors contributing to suboptimal health outcomes. Approaches from behavioral economics have not been applied systematically alongside implementation science to improve cancer care; these approaches aim to accelerate uptake of evi- dence-based practices. Second, implementation science has not applied methods to fail fast and learn quickly, which we will incorporate through the application of rapid cycle approaches. Third, research to identify mecha- nisms of the implementation strategies to improve uptake of evidence-based practices is in its infancy. The Research Program includes investigators with expertise in implementation science, behavioral economics, can- cer care delivery research, healthcare innovation, measurement, and mixed methods. In the first two years, we propose three Signature Pilot Projects (SPPs) and two Methods Projects that both support the SPPs and ad- vance the science of implementation with an eye towards rapid learning. SPP 1 (Jenssen/Leone) tests patient- and clinician-directed implementation strategies to increase referral to tobacco cessation programs in patients receiving cancer treatment. SPP 2 (Bekelman/Patel) tests patient- and clinician-directed implementation strate- gies to increase use of higher-value bone modifying agents in patients with advanced breast, lung, and prostate cancer. Common methods and measures link these projects to provide pooled data to accomplish our objectives of testing multilevel implementation strategies to elucidate mechanisms and targets. SPP 3 (Bekelman/Rendle), the most exploratory and high-reward SPP, will test a patient-directed implementation strategy that leverages artificial intelligence and machine learning to promote oral chemotherapy adherence and symptom management. Methods Project 1 will develop a toolkit for the application of rapid cycle approaches (Asch/Buttenheim); Methods Project 2 will use qualitative comparative analysis to characterize multilevel contextual variation and mechanisms (Barg/Rendle). The scientific advances to come out of the Research Program will have a significant public health impact, consistent with NCI priorities, by rapidly improving uptake of evidence-based practices to improve cancer care quality and outcomes for millions of Americans with cancer. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page