National Cancer Institute, Rockville, Maryland.
Cancer Epidemiol Biomarkers Prev. 2021 Feb;30(2):260-267. doi: 10.1158/1055-9965.EPI-20-0795. Epub 2020 Dec 2.
To ensure investment in cancer research reaches populations who can benefit, the NCI has funded implementation science grants since the Dissemination and Implementation Research in Health (DIRH) funding opportunities launched in 2006. We analyzed NCI-funded DIRH grants to provide a snapshot of implementation science conducted across the cancer care continuum and highlight areas ripe for exploration.
NCI-funded DIRH grants between fiscal years 2006 and 2019 were identified using the iSearch database. Two coders classified each grant by topic, populations studied, intervention and setting characteristics, strategies tested, study designs and methods used, and outcomes measured.
Seventy-one grants were awarded addressing cancer prevention ( = 33), screening ( = 33), diagnosis ( = 4), treatment ( = 9), and/or survivorship ( = 11). Colorectal ( = 20), breast ( = 15), and cervical ( = 11) were the most studied cancers. Most grants focused on delivery of guidelines ( = 36) or behavioral change interventions ( = 18) in health care settings ( = 47), studying implementation processes ( = 37) and/or testing implementation strategies ( = 43) using experimental ( = 35) and quasi-experimental ( = 6) designs. Few studied sustainability ( = 7), scale-up ( = 2), deimplementation ( = 4), measure development ( = 6), or policy-level implementation ( = 6).
Current funding suggests researchers are studying implementation of cancer control interventions across the care continuum. However, research gaps remain in strategies for sustainability, scale-up, and deimplementation. More emphasis is needed on cancer treatment and survivorship. Additional focus on policy implementation and measure development is warranted.
Understanding the breadth of NCI-funded implementation science can inform future efforts to build the knowledge base on how to improve dissemination and implementation of evidence in cancer control.
为确保癌症研究的投资惠及受益人群，美国国立卫生研究院（NCI）自 2006 年开展传播和实施健康研究（DIRH）资助机会以来，一直资助实施科学研究。我们分析了 NCI 资助的 DIRH 项目，以了解整个癌症护理过程中实施科学的概况，并强调探索的成熟领域。
使用 iSearch 数据库确定了 2006 财年至 2019 财年 NCI 资助的 DIRH 项目。两位编码员根据主题、研究人群、干预和设置特征、测试策略、研究设计和方法以及测量的结果对每个项目进行分类。
共授予 71 项资助，涉及癌症预防（ = 33）、筛查（ = 33）、诊断（ = 4）、治疗（ = 9）和/或生存（ = 11）。结直肠癌（ = 20）、乳腺癌（ = 15）和宫颈癌（ = 11）是研究最多的癌症。大多数项目侧重于在医疗保健环境中提供指南（ = 36）或行为改变干预措施（ = 18），研究实施过程（ = 37）并/或使用实验（ = 35）和准实验（ = 6）设计测试实施策略（ = 43）。很少有研究可持续性（ = 7）、扩大规模（ = 2）、去实施（ = 4）、措施开发（ = 6）或政策层面实施（ = 6）。
目前的资金表明，研究人员正在研究整个护理过程中癌症控制干预措施的实施情况。然而，在可持续性、扩大规模和去实施的策略方面仍存在研究空白。需要更加重视癌症治疗和生存问题。有必要进一步关注政策的实施和措施的开发。
了解 NCI 资助的实施科学的广度可以为未来努力提供信息，以建立关于如何改善癌症控制中证据传播和实施的知识库。
