PIECES – Towards Large-Scale Adaption and Tailored Implementation of Evidence-Based Primary Cancer Prevention Programmes in Europe and Beyond

全球癌症负担日益沉重，迫切需要有效实施针对可改变风险因素的初级癌症预防(PCP)方案。然而，在受控环境下被证明有效的循证方案在现实世界中实施时往往失败，原因是适应和执行战略不能有效地解决具体情况的障碍，导致方案失败和公共卫生不公平。PICES项目将开发、评估和传播针对癌症的方法学实施框架--PCP综合实施工具包(PCP-IT)。PCP信息技术将为(1)确定、选择和调整PCP方案，以及(2)制定针对当地障碍和限制而定制的循证实施战略，提供循证的系统流程。PCP-IT将包括一个关于PCP方案及其变革理论的综合资料库，以及系统调整方案以适应当地需求和文化限制的材料。该项目涉及来自10个不同社会文化背景的国家的16个联盟成员和实施地点，可接触到多达7770万居民。PICES提供了一个理想的自然主义实验室，以改进和研究针对主要风险因素的广泛初级PCP方案的扩大和实施：烟草、酒精、低体力活动、HPV感染、阳光照射和饮食。将进行多地点案例比较研究，以评估和优化执行结果。将使用各种社会学理论进行深入的现实主义评估，以解释实现结果的过程。该联盟将聘请一个由知名专家组成的高级别外部咨询委员会，促进与利益攸关方的持续接触，并与欧盟和相关科学学会结盟，以确保储存库和PCP-IT未来的连续性。这项行动是癌症使命“预防和及早发现”项目群的一部分。

The high and growing global burden of cancer urges the need for effective implementation of primary cancer prevention (PCP) programmes targeting modifiable risk factors. However, evidence-based programmes with proven effectiveness under controlled environments often fail when implemented in the real world due to ineffective adaptation and implementation strategies addressing context-specific barriers, leading to programme failures and public health inequities. The PIECES project will develop, assess, and disseminate a cancer-specific methodological implementation framework, the integrated PCP Implementation Toolkit (PCP-IT). PCP IT will provide an evidence-informed systematic process for (1) identification, selection, and tailoring of PCP programmes, and (2) developing evidence-informed implementation strategies tailored to local barriers and constraints. The PCP-IT will include a comprehensive repository of PCP programmes, their Theories of Change, and materials for systematically adapting the programmes to local needs and cultural constraints. The project involves 16 consortium members and implementation sites from 10 countries of diverse socio-cultural backgrounds and access to up to 77.7 million inhabitants. PIECES provides an ideal naturalistic laboratory to improve and study the up-scaling and implementation of a wide range of primary PCP programmes targeting major risk factors: tobacco, alcohol, low physical activity, HPV infection, sun exposure, and diet. A multi-site case comparison study will be conducted to assess and optimise implementation outcomes. An in-depth realist evaluation using various sociological theories will be conducted to explain the processes by which the outcomes are achieved. The consortium will employ a high-level external Advisory Board with renowned experts, facilitate continuous engagement with stakeholders, and align with the EU and relevant scientific societies to ensure the future continuity of both the repository and PCP-IT. This action is part of the Cancer Mission cluster of projects on ‘Prevention and early detection’.