Improving cancer prevention and control through academic-local public health department partnerships

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PROJECT SUMMARY Background: The 2,800 local public health departments (LHDs) in the United States have been increasingly responsible for implementing evidence-based programs and policies (EBPPs) to prevent and control cancer in their local communities, which has immense potential to impact population-level cancer burden. Our team has developed effective strategies to support LHDs and their staff to implement EBPPs, including guided facilitation and training, but the reach and sustainability of these strategies is currently limited. A promising strategy is for LHDs to engage in an academic-public health department (AHD) partnership, in which LHD practitioners and academics collaborate to improve public health practice and education through joint research projects and education opportunities for students. However, research on how AHD partnerships should be structured to improve implementation of cancer-related EBPPs is sparse. Goal: This proposal seeks to understand how to leverage AHD partnerships to facilitate implementation of EBPPs to prevent and control cancer. Methods: Aim 1: We will survey an existing, nationwide network of AHD partnerships to identify 4 high- and 4 low-performing partnerships based on their implementation of cancer-related EBPPs. We will use qualitative interviews and document reviews to refine our existing set of strategies, which can improve the use of EBPPs (e.g., facilitation needed, defining a tailored AHD partnership “package”), based on the structures, processes, and contextual influences among successful partnerships. Aim 2: Building on Aim 1, we will test the effectiveness of these refined strategies designed to improve the adoption of EBPPs for cancer prevention and control by strengthening AHD partnerships. We will conduct a group-randomized study (total N=28 AHD partnerships) to evaluate the effect of strategies to improve the adoption of cancer control and prevention EBPPs by supporting AHD partnerships. A mixed-methods approach will be used to evaluate changes in AHD partnerships and understand how contextual factors may have impacted the AHD partnership’s ability to support EBPP implementation. We will translate and disseminate findings from Phases 1 and 2 to LHD practitioners and academic partners to support cancer prevention and control in LHDs. Innovations and impact: The proposed study is innovative and impactful because it will be first study to focus on local-level collaborations that leverage expertise of LHDs and academics to improve public health practice. Also, its application of bridging factors, a component of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework receiving a greater focus recently, will contribute to the application of emerging components of theoretical frameworks in dissemination and implementation research. Last, this study examines new models for how public practice and academic public health can work together to meet common goals sustainably, i.e., without ongoing support from outside researchers.