The Implementation Science Center for Cancer Control Equity

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Abstract - Overall After decades of research developing and testing interventions for cancer control, we have the evidence needed to prevent more than half of all cancers. The impact of these strategies on cancer outcomes is significant for both the general population and low income and under-represented groups that bear a disproportionate share of preventable cancer burden, but evidence-based interventions have not been uniformly used across population groups. Gaps in implementation of the evidence base can be seen for nearly all known cancer prevention and early detection strategies. As a result, we incur substantial avoidable cancer morbidity and mortality and tolerate preventable inequities. The Implementation Science Center for Cancer Control Equity (ISCCCE) will create an ecosystem for robust implementation science (IS) related to cancer prevention and control in Massachusetts community health centers (CHCs) and their local communities. Our theme, improving community health by integrating health equity and implementation science for evidence-based cancer control, reflects our critical mass of expertise in cancer disparities, IS, and community-based cancer prevention and control research. Our “grand challenge” is to address the inequitable implementation and limited scale of evidence-based interventions by developing and testing implementation strategies aimed at narrowing health inequities and by advancing methods that carefully consider the low-resource, complex nature of CHCs where adaptation and cost-effective solutions are needed most. The implementation studies we conduct will address inequities within CHC clinical practice as well as prevention interventions that link to community resources and assets. Our I-Lab is comprised of 31 CHCs who are members of the Mass League of Community Health Centers and use a common EHR vendor- neutral population management system that has extensive reporting capability within and across CHCs, which will allow us to study implementation outcomes in different geographic settings across the state using common measures. Given that achieving equity in community health requires clinical, community, and policy-level interventions, our pilots will also examine how to expand the impact and sustainability of CHCs’ cancer prevention efforts through effective partnerships in community and policy settings. Our Network Unit connects us directly with other Moonshot IS initiatives and national community health leadership, and expands opportunities for collaboration and synergy, building IS capacity in our own institutions and across the nation.