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

描述（由申请人提供）：背景。癌症和其他慢性疾病（例如，心脏病、中风）占过早死亡的大多数， 生命和经济成本。这些疾病造成的负担是可以通过应用循证癌症预防（EBCP）来预防的。为了通过EBCP成功预防癌症，公共卫生从业人员和政策制定者需要基于证据的信息。然而，目前很少有人知道如何上下文差异可能会影响转移和翻译的循证干预措施在国内和国家之间。 目标.我们的主要目标是了解美国、澳大利亚、巴西和中国EBCP的相似性和差异。 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。这个项目有两个部分。目的1采用定性方法了解影响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，我们将对来自每个国家的关键信息提供者进行半结构化访谈，涵盖六个主要领域：1）传记信息和经验; 2）对循证干预措施存在的认识; 3）对EBCP的行政支持; 4）对EBCP的政治气候和支持; 5）支持循证决策的关键网络和伙伴关系;（6）促进EBCP的传播策略。每个国家的目标是12至24次访谈（总数= 48-96），以实现内容饱和。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，该工具可靠有效，可在多个国家使用。为了开发内容，我们将使用主要的同行评审数据库搜索涵盖我们的领域和目标受众的现有文书。除了正式的文献检索外，我们还将与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，我们将开发一个调查工具，该工具将在每个国家的50个个体（总共= 200）的样本中进行（重测）可靠性测试，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n = 100;总共= 400）。传播和创新。这一项目的成果将广泛传播给研究人员、从业人员和决策者。这项研究是创新的工作在真实的世界设置，开发新的传播措施，并进行了第一次跨国研究。拟议研究的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各种传播战略的影响（例如，讲习班、技术援助）。

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.