Colorado's Partnership to Implement Evidence-Based Interventions to Reduce the Cancer Burden

摘要 科罗拉多大学癌症中心(UCCC)和科罗拉多州癌症联盟(CCC)将合作 发展区域网络以实施癌症控制干预措施，以减少科罗拉多州的癌症差异。 UCCC的集水区是科罗拉多州，是该州唯一一家由NCI指定的癌症中心 通过基础到转化、临床到人口科学研究的癌症发现和创新。 CCC是一个全州范围的组织，旨在通过参与、促进、 扩大和加强全州范围的网络，致力于改善科罗拉多州的癌症生活。 作为该州的领导人，UCCC和CCC将带来来自科罗拉多州5个地区的关键利益相关者(Front Range， 东部、西部、中部山区和圣路易斯山谷/南部地区)合作，并有意义地 降低对未得到充分服务的人群造成不成比例影响的发病率、死亡率和晚期癌症。 受癌症差异影响的科罗拉多州人将从更多的获得和接受癌症控制中受益匪浅 循证干预(EBI)贯穿整个癌症过程，但特别是为了减少可改变的风险因素 (例如，吸烟、人乳头瘤病毒感染、低癌症筛查)。加强社区网络 来自初级保健和公共卫生的利益相关者对更广泛地实施证据- 基于干预措施，并增加科罗拉多州的癌症控制研究。因此，我们将召集并支持5 RCN建立合作和加强癌症控制工作所需的基础设施。我们已经决定 癌症差异县实施癌症控制活动和开展研究的需求和能力。AS 下一步，UCCC和CCC将召集关键利益相关者的5个RCN开始规划和实施 在差异县开展癌症控制EBIs，并开展研究以研究EBIs的实施情况。每个人 网络将有一名区域规划师、个人或组织，负责监督实施和 对倡议进行短期(1年)和长期(5年)评估。规划者还将协调区域 在科罗拉多州癌症联盟癌症工作组中的代表，以扩大转诊资源和 将该州较小的地区与更广泛的联盟努力联系起来，以减少该州的癌症负担。 为达致第二个目标，总队将与UCCC调查人员合作，进行一项试验计划，以研究 实施与区域癌症优先事项相关的EBIs，并影响癌症控制目标，如 提高HPV疫苗接种率、肺癌筛查和结肠镜检查等目标。这些项目 拟议将使用一系列概念框架来研究EBIS的实施情况，包括 REACH、有效性、采用和实施、维护(RE-AIM)框架，实用可靠 实施和可持续发展模型(PRISM)和综合研究框架(CFIR)，其中 帮助设计和评估EBIS的实施，以改善目标癌症控制结果。

Abstract The University of Colorado Cancer Center (UCCC) and the Colorado Cancer Coalition (CCC) will collaborate to develop regional networks to implement cancer control interventions to reduce cancer disparities in Colorado. UCCC’s catchment area is the State of Colorado and is the only NCI-designated cancer center in the state driving cancer discovery and innovation through its basic to translational to clinical to population science investigations. The CCC is a statewide organization seeking to eliminate the cancer burden in Colorado by engaging, facilitating, expanding, and strengthening the statewide network dedicated to improving Colorado lives touched by cancer. As leaders in the state, the UCCC and CCC will bring key stakeholders from 5 regions in Colorado (Front Range, Eastern, Western, Central Mountain, and the San Luis Valley/Southern regions) to partner and meaningfully reduce the incidence, mortality, and late-stage cancers that disproportionately affect underserved populations. Coloradans affected by cancer disparities would benefit greatly from increased access and uptake cancer control evidence-based interventions (EBIs) across the cancer continuum, but specially to reduce modifiable risk factors (e.g., smoking, human papillomavirus infection, low cancer screenings). Strengthening networks of community stakeholders from primary care and public health holds great promise for the wider implementation of evidence- based interventions and to increase cancer control research in Colorado. Thus, we will convene and support 5 RCNs to build collaboration and the infrastructure needed to bolster cancer control efforts. We have determined cancer disparity counties’ needs and capacity to implement cancer control activities and to conduct research. As the next step, UCCC and CCC will convene the 5 RCNs of key stakeholders to begin planning and implementing cancer control EBIs in disparity counties and to conduct research to study the implementation of EBIs. Each network will have a Regional Planner, an individual or organization, who will oversee the implementation and the short (1-year) and long-term (5-years) evaluation of the initiatives. The planner will also coordinate regional representation in the Colorado Cancer Coalition’s Cancer Task Forces to expand the referral resources and connect smaller regions of the state to the broader coalition efforts towards decreasing the state’s cancer burden. For the second aim, the RCNs will collaborate with UCCC investigators to conduct a pilot project to study the implementation of EBIs relevant to the regional cancer priorities and to affect cancer control targets such as improving HPV vaccine rates, lung cancer screenings, and colonoscopies, among other targets. The projects proposed will use a combination of conceptual frameworks to study the implementation of EBIs, including the Reach, Effectiveness, Adoption, and Implementation, Maintenance (RE-AIM) framework, the Practical Robust Implementation and Sustainability Model (PRISM), and the Consolidated Framework for Research (CFIR), which aid in designing and evaluating the implementation of EBIs to improve the cancer control outcomes targeted.