Mis-Implementation in Cancer Prevention and Control

项目摘要 背景：通过应用现有知识，大部分癌症负担是可以预防的。说明─ 一级的从业人员处于影响与癌症控制有关的计划和政策的理想位置。错了 执行是指结束有效的方案和政策或继续无效的方案和政策。更大 对执行不当的关注应导致使用有效的干预措施和更有效的支出， 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错误实施的程度，并确定 利用点来解决美国的错误实施。 目的和方法：这是一项三阶段研究，采用综合方法， 阐明解决执行不当问题的策略。第一阶段：第一个目标是评估 在公共卫生的州癌症控制计划中，这个初始阶段 将对代表所有国家的800名从业人员进行调查。所代表的方案将跨越整个 癌症控制的连续性（从预防到生存）。第2阶段：使用第1阶段的数据来确定 组织，其中错误执行是高或低，我们将进行八个比较案例研究， 理解上下文差异。这些个案研究将突出说明在执行不当方面吸取的经验教训 并确定假设的驱动程序。第三阶段：第三个目标是建立基于代理的模型，以识别动态 个人，组织和环境（外部）因素之间的相互作用导致错误执行。 基于代理的建模将被用来确定最有效的潜在方法，以减少错误， 实施.我们将把第1-3阶段的研究结果翻译和传播给从业人员和实践- 相关利益攸关方，以支持减少执行不当。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实践伙伴的密切合作。 创新和影响：这项研究是创新和有影响力的，因为它将：1）是第一个完善 并进一步制定可靠和有效的措施，以防止公共卫生方案的错误实施; 2） 在实践基础研究方面具有重要专业知识的强大的跨学科团队; 3）使用代理- 基于建模，以解决癌症控制的实施;和4）使用一个参与性的，基于证据的， * 采用由负责人驱动的办法，确定关键的杠杆点， 国家公共卫生项目。这项研究有望产生一种可复制的模型， 影响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.