Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
JNCI Cancer Spectr. 2023 Aug 31;7(5). doi: 10.1093/jncics/pkad070.
Cancer prevention and control research has produced a variety of effective interventions over the years, though most are single disease focused. To meet the Cancer Moonshot goal to reduce the cancer death rate by 50% by 2047, it may be necessary to overcome the limitations of siloed interventions that do not meet people's multiple needs and limitations in system capacity to deliver the increasing number of interventions in parallel. In this article, we propose integrating multiple evidence-based interventions as a potential solution. We define 2 types of integrated interventions, blended and bundled, and provide examples to illustrate each. We then offer a schematic and outline considerations for how to assemble blended or bundled interventions including looking at the intervention need or opportunity along the cancer continuum as well as co-occurring behaviors or motivations. We also discuss delivery workflow integration considerations including social-ecological level(s), context or setting, implementer, and intended beneficiary. Finally, in assembling integrated interventions, we encourage consideration of practice-based expertise and community and/or patient input. After assembly, we share thoughts related to implementation and evaluation of blended or bundled interventions. To conclude the article, we present multiple research opportunities in this space. With swift progress on these research directions, cancer prevention and control interventionists and implementation scientists can contribute to achieving the promise of the reignited Cancer Moonshot.
多年来,癌症预防和控制研究已经产生了各种有效的干预措施,尽管大多数都是针对单一疾病的。为了实现 2047 年将癌症死亡率降低 50%的癌症登月计划目标,可能有必要克服孤立干预措施的局限性,这些措施无法满足人们的多种需求,也无法克服系统提供越来越多干预措施的能力方面的限制。在本文中,我们提出将多种基于证据的干预措施整合在一起作为一种潜在的解决方案。我们定义了 2 种类型的综合干预措施,即混合干预和捆绑干预,并提供了示例来说明每种干预措施。然后,我们提供了一个示意图,并概述了如何组装混合或捆绑干预措施的注意事项,包括沿着癌症连续体考虑干预需求或机会,以及同时出现的行为或动机。我们还讨论了包括社会生态层面、背景或环境、实施者和预期受益人的交付工作流程整合注意事项。最后,在组装综合干预措施时,我们鼓励考虑基于实践的专业知识以及社区和/或患者的投入。组装完成后,我们分享了有关混合或捆绑干预措施实施和评估的想法。在文章的最后,我们提出了该领域的多个研究机会。通过在这些研究方向上的快速进展,癌症预防和控制干预专家和实施科学家可以为实现重新点燃的癌症登月计划的承诺做出贡献。