Dissemination and Implementation Research at the National Cancer Institute: A Review of Funded Studies (2006-2019) and Opportunities to Advance the Field.

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

IMPACT

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.