A CROSS-COUNTRY COMPARISON OF EVIDENCE-BASED PREVENTION OF CANCER

简介(申请人提供)：背景。癌症和其他慢性病(如心脏病、中风)是过早死亡的主要原因， 生命和经济代价。这些疾病造成的负担可以通过应用循证癌症预防(EBCP)的做法来预防。为了通过EBCP在预防癌症方面取得成功，公共卫生从业者和政策制定者需要循证信息。然而，关于背景差异可能如何影响循证干预措施在国家内部和国家之间的转移和转化，目前知之甚少。进球了。我们的主要目标是了解美国、澳大利亚、巴西和中国在EBCP中的语境异同。方法：研究方法。为了推进传播科学，我们将在四个国家使用混合(三角)方法，为更大规模的跨国研究奠定基础。这个项目包括两个部分。目的1用定性的方法来理解影响EBCP的背景因素(即个人、机构、社区、社会文化和政治/经济层面的因素)。为了实现这一目标，我们将对每个国家的关键信息提供人进行半结构化访谈，涉及六个主要领域：1)传记信息和经验；2)对循证干预措施的认识；3)对循证方案的行政支持；4)政治气候和对循证方案的支持；5)支持循证决策的关键网络和伙伴关系；以及6)促进循证方案的传播战略。将使用每个国家12至24次采访(总数=48至96次)的目标来实现内容饱和。从目标1收集的背景信息将用于开发目标2的量化工具，用于评估EBCP是可靠和有效的，可在多个国家使用。为了开发内容，我们将使用主要的同行审查数据库搜索涵盖我们领域和目标受众的现有工具。除了正式的文献搜索外，我们还将与我们的核心研究团队一起进行滚雪球抽样。利用前一阶段获得的证据，我们将开发一种调查工具，它将对每个国家的50个个体进行(重测)信度测试(总计=200)，然后使用结构方程模型进行因素分析和内部一致性测试(每个国家100个；总计=400)。传播创新。该项目的成果将广泛传播给研究人员、从业人员和政策制定者。这项研究具有创新性，在现实世界环境中工作，开发新的传播方法，并进行此类研究的第一次跨国研究。拟议中的研究结果将为更大规模的跨国研究奠定基础。这一未来项目将审查拟议研究中将确定的各种传播战略(例如讲习班、技术援助)的影响。

DESCRIPTION (provided by applicant): Background. Cancer and other chronic diseases (e.g., heart disease, stroke) account for the majority of premature death, reductions in quality of life, and economic costs. The burden due to these diseases is preventable through the application of the practice of evidence-based cancer prevention (EBCP). To achieve success on preventing cancer through EBCP, public health practitioners and policy-makers need evidence- based information. However, little is currently known about how contextual differences might affect the transfer and translation of evidence-based interventions within and across countries. Goal. Our primary goal is to understand contextual similarities and differences in EBCP in the United States, Australia, Brazil and China. Methods. To advance dissemination science, we will use mixed (triangulated) methods across four countries to set the stage for a larger, cross-national study. This project has two parts. Aim 1 uses qualitative method to understand the contextual factors influencing EBCP (i.e., factors at the individual, agency, community, sociocultural, and political/economic levels). To achieve this objective we will develop semi-structured interviews with key informants from each country covering six major domains: 1) biographical information and experience; 2) awareness of the existence of evidence-based interventions; 3) administrative support for EBCP; 4) political climate and support for EBCP; 5) key networks and partnerships to support evidence-based decision making; and 6) dissemination strategies that would further EBCP. A goal of 12 to 24 interviews per country (total = 48-96) will be used to achieve content saturation. The contextual information gathered from Aim 1 will be used to develop an Aim 2 quantitative tool for assessing EBCP that is reliable and valid and can be used across multiple countries. To develop the content, we will search for existing instruments covering our domains and target audiences using major peer-reviewed data bases. In addition to formal literature searching, we will conduct snowball sampling with our core research team. Using the evidence obtained in the previous stage, we will develop a survey instrument, which will undergo (test-retest) reliability testing in a sample of 50 individuas from each country (total = 200) followed by factor analysis using structural equation models and testing of internal consistency (n = 100 per country; total = 400). Dissemination and innovations. Results of this project will be disseminated widely to researchers, practitioners, and policy makers. This research is innovative by working in real world settings, developing new dissemination measures, and conducting the first cross-country study of its kind. Findings from the proposed study will form the foundation of a larger, cross-country study. This future project would examine the impact of various dissemination strategies (e.g., workshops, technical assistance) that will be identified in the proposed study.