Mis-Implementation in Cancer Prevention and Control

项目总结 背景：通过应用现有的知识，大部分癌症负担是可以预防的。国家-- 水平从业者处于理想的位置，可以影响与癌症控制相关的计划和政策。错失- 执行是指结束有效的方案和政策或继续执行无效的方案和政策。更大 对错误执行的关注应导致使用有效的干预措施和更有效率地支出 资源，从长远来看，这将导致积极的癌症结果。 目标：本提案旨在描述癌症控制实施失误的程度，并确定 利用积分解决美国的错误实施问题。 目标和方法：这是一项采取综合方法的三阶段研究，导致 阐明解决错误执行问题的策略。阶段1：第一个目标寻求评估以下方面的程度 在公共卫生领域的州癌症控制计划中发生了哪些错误的实施。这一初始阶段 将对代表所有州的800名从业者进行调查。所代表的计划将跨越整个 癌症控制的连续体(从预防到生存)。阶段2：使用阶段1中的数据确定 ，我们将进行八个比较案例研究，以 了解背景差异。这些案例研究将突出从错误实施中吸取的教训。 并找出假想的司机。阶段3：第三个目标寻求构建基于代理的模型来识别动态 导致错误实施的个人、组织和背景(外部)因素之间的相互作用。 将使用基于代理的建模来确定减少误判的最有效的潜在方法。 实施。我们将把第一至第三阶段的研究结果翻译和传播给从业者和实践者- 与相关利益攸关方合作，以支持减少错误执行情况。所有研究阶段都将依赖于 公共卫生从业人员咨询小组以及与主要业务伙伴的密切合作。 创新和影响：这项研究具有创新性和影响力，因为它将：1)第一个提炼 并进一步制定可靠有效的公共卫生项目错位实施措施；2)带来 组建一支强大的跨学科团队，在实践研究方面拥有丰富的专业知识；3)使用代理- 基于模型以解决癌症控制实施；以及4)使用参与性的、基于证据的、 利益相关者驱动的方法，将确定关键的杠杆点，以解决以下问题 州公共卫生计划。这项研究有望产生一种可复制的模型，它可以显著地 影响在癌症控制中的错误实施，并可应用于其他卫生领域。

PROJECT SUMMARY BACKGROUND: Through application of existing knowledge, much of the cancer burden is preventable. State- level practitioners are in ideal positions to affect programs and policies related to cancer control. Mis- implementation refers to ending effective programs and policies or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to positive cancer outcomes. GOAL: This proposal seeks to describe the extent of cancer control mis-implementation and to identify leverage points for addressing mis-implementation in the United States. AIMS AND METHODS: This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: The first aim seeks to assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control (from prevention to survivorship). Phase 2: Using data from Phase 1 to identify organizations in which mis-implementation is high or low, we will conduct eight comparative case studies to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: The 3rd aim seeks to build agent-based models to identify dynamic interactions between individual, organizational, and contextual (external) factors driving mis-implementation. Agent-based modeling will be used to determine the most effective potential approaches for reducing mis- implementation. We will translate and disseminate findings from Phases 1-3 to practitioners and practice- related stakeholders in order to support the reduction of mis-implementation. All study phases will rely on an Advisory Group of public health practitioners and close collaboration with key practice partners. INNOVATIONS AND IMPACT: This study is innovative and impactful because it will: 1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; 2) bring together a strong, transdisciplinary team with significant expertise in practice-based research; 3) use agent- based modeling to address cancer control implementation; and 4) use a participatory, evidence-based, stakeholder-driven approach that will identify key leverage points for addressing mis-implementation among state public health programs. This research is expected to result in a replicable model that can significantly impact mis-implementation in cancer control and can be applied to other health areas.