The implementation road: engaging community partnerships in evidence-based cancer control interventions.
Southern rural and underserved counties have high proportions of individuals with increased mortality for cervical and breast cancers. To improve the integration of behavioral research into practice, the dissemination and implementation of efficacious interventions to encourage the use of screening have increased in recent years. This study addressed gaps in the dissemination and implementation of evidence-based interventions with a pilot called Team Up. Qualitative interviews with 24 key individuals in six state-level partnerships explored partnership characteristics that influenced selection and use of evidence-based interventions among low-income, rarely or never screened women. Guided by diffusion of innovations theory and the Lasker and Weiss partnership functioning model, interviews about the intervention centered on (a) knowledge surrounding evidence base; (b) identification, selection, and adoption; (c) planning and adaptation; (d) implementation; and (e) partnership reflections and impact. Using grounded theory and content analysis, data revealed that lack of communication and high partner turnover hindered adoption and adaptation, whereas failure of partnership leaders to engage local stakeholders and lack of sufficient funds hampered implementation. Delivery of evidence-based interventions was more effective when partnerships included local partners in early decision making and when coaches were introduced to facilitate strategic thinking about translating evidence-based interventions into practice. A challenge for public health partnerships was the translation of interventions into successful programs, such that underserved communities benefited from early detection intervention research.
National Cancer Institute, Bethesda, MD, USA breslaue@mail.nih.gov.
Erica S
ES
Breslau
The Leukemia & Lymphoma Society, White Plains, NY, USA.
Elisa S
ES
Weiss
Mayor's Office to Combat Domestic Violence, The City of New York, New York, NY, USA.
Abigail
A
Williams
National Cancer Institute, Bethesda, MD, USA MedStar Washington Hospital Center, Washington, DC, USA.
Allison
A
Burness
National Cancer Institute, Bethesda, MD, USA University of Utah, Salt Lake City, UT, USA.
Deanna
D
Kepka
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D003142:Communication; D003657:Decision Making; D055088:Early Detection of Cancer / Q000379:methods; D019317:Evidence-Based Medicine; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D033181:Information Dissemination; D007373:Interinstitutional Relations; D009111:Local Government; D011203:Poverty; D015980:Public Health Practice
cancer prevention and control; health disparities; health education; health promotion; partnerships/coalitions; program planning and evaluation; women’s health