School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR 97239. Email:
Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Bend, Oregon.
Prev Chronic Dis. 2020 Dec 10;17:E156. doi: 10.5888/pcd17.200231.
Physical activity can help mitigate the long-term symptoms and side effects of cancer and its treatment, but most cancer survivors are not active enough to achieve these benefits. An evidence-based strategy to promote physical activity among adults is a community group-based walking program. However, many evidence-based programs do not achieve intended population health outcomes because of the challenges of real-world implementation. We used the Interactive Systems Framework for Dissemination and Implementation to conceptualize implementation of a capacity-building intervention to support delivery of a community group-based walking program. We adapted an evidence-based guide for community group-based walking programs for cancer survivors and their support network. We provided a capacity-building intervention (technical assistance and small-grant funding) and evaluated this implementation intervention. We assessed effectiveness of the intervention by measuring adoption, acceptability, appropriateness, feasibility, fidelity, implementation costs, and penetration through monthly progress reports, site visit observations, interviews, and a final report. Eight organizations received a small grant and technical assistance and implemented Step It Up! Survivors (SIUS). SIUS helped cancer survivors increase their physical activity, establish social connections, and be part of a supportive environment. Despite receiving monthly technical assistance, some grantees experienced challenges in recruiting participants, developing community partnerships, and adhering to the prescribed implementation plan. Implementation facilitators included community partners and specific components (eg, incentives for participants, webinars). Organizations needed different amounts and types of assistance with adaptation and implementation. Overall fidelity to SIUS ranged from 64% to 88%. Some integrated SIUS within existing organizational programming for sustainability. The provision of funding and technical assistance was a successful implementation intervention. Our results suggest a need to better tailor technical assistance while organizations are in the process of adapting, implementing, and sustaining an evidence-based program in their local communities.
身体活动有助于减轻癌症及其治疗的长期症状和副作用，但大多数癌症幸存者的身体活动量不足，无法从中受益。促进成年人身体活动的循证策略是社区团体步行项目。然而，由于现实实施的挑战，许多循证项目并未实现预期的人群健康结果。我们使用互动系统框架来传播和实施，将概念化的能力建设干预措施付诸实施，以支持社区团体步行项目的交付。我们为癌症幸存者及其支持网络改编了基于社区团体的步行项目的循证指南。我们提供了能力建设干预措施（技术援助和小额赠款资金），并对该实施干预措施进行了评估。我们通过每月进度报告、现场访问观察、访谈和最终报告来衡量采用、可接受性、适当性、可行性、保真度、实施成本和渗透度，从而评估干预措施的有效性。八个组织获得了小额赠款和技术援助，并实施了 Step It Up！Survivors (SIUS)。SIUS 帮助癌症幸存者增加了身体活动量、建立了社会联系并融入了支持性环境。尽管每月都收到技术援助，但一些受赠者在招募参与者、发展社区伙伴关系和遵守规定的实施计划方面遇到了挑战。实施促进者包括社区伙伴和特定组件（例如，参与者的激励措施、网络研讨会）。组织在适应和实施以及可持续性方面需要不同数量和类型的援助。SIUS 的整体保真度范围从 64%到 88%。一些组织将 SIUS 纳入现有的组织计划中以实现可持续性。提供资金和技术援助是一项成功的实施干预措施。我们的结果表明，需要更好地调整技术援助，而组织正在将循证计划适应、实施和维持在其当地社区的过程中。
