Building the Science of

Dissemination Research

Glorian Sorensen, PhD, MPH

Harvard School of Public Health Dana-Farber Cancer

InstituteCathy Melvin, PhD, MPH

University of North Carolina

October 7, 2008 – UCLA meeting

Dissemination Research within

the CPCRN Agenda•CPCRN Mission: To accelerate

the adoption of evidence-based cancer prevention and control in communities

•Objectives include: To conduct research and practice activities that span the translation continuum from discovery to the dissemination and adoption of effective interventions.

Barriers to Translation

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Intervention Characteristics

• High cost• Intensive time demands High level of staff

expertise required• Difficult to learn or understand• Not packaged or manualized

• Not developed considering user needs• Not designed to be selfsustaining• Highly specific to particular setting

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Research Design

Not representative sample of:

patientssettingsclinicians

Failure to evaluate: cost reach setting adoption

Failure to evaluate: implementationmaintenance sustainability

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Situation of Intended Target Settings

Competing demandsProgram imposed from

outside Financial/organizational

instability Limited resources/ time Limited organizational

support Prevailing practices work

against innovation Perverse incentives or

regulations

Glasgow & Emmons, 2007

Role of the CPCRN in Building the Science of Dissemination Research

•Articulating the parameters of the science

•Building a portfolio of research•Refining the science and

building capacity•Leading the field in conducting

dissemination research

Articulating the Parameters of the Science

•CPCRN Dissemination Research Forum–October 31, 2007

•TACTIC (Tailored Assistance for Choosing Tested Cancer Control Tools in Communities)

•Dissemination Research publication (Bowen et al., Cancer Cause Control, in press)

•Conference Sessions

Conference Sessions

•NCI Dissemination Forum, January ’09– Represented on planning committee

(Emmons)– Two sessions submitted:

•“TACTIC: Increasing use of evidence-based tools in communities” – UT, UW, WU, UNC, Emory

•“Pool Cool Dissemination” Emory, WU•Society of Behavioral Medicine,

March ’09– “Methods in dissemination research”

(Emory, Harvard/BU, U-W, UNC)

Building a portfolio of research:

Grant Submissions • TACTIC • CDC Translational Research RFA:

includes:– **WU- Understanding and Enhancing

Dissemination among US Chronic Disease Practitioners

– **UT – “Dissemination of a Smoking Quitline to the Underserved”

– UCLA – Dissemination of a brief Tobacco Intervention through Filipino American CBOs

– Emory – Pool Cool for Life Guards

Building a portfolio of research:

Grant Submissions • NCI Dissemination Research RFA – including:

– **U-W: Cancer Control Dissemination to Asian Americans

– UCLA: Strategies for Community Dissemination of and Evidence –Based CRC Screening Intervention

– Emory: Disseminating Nutrition Interventions through Faith-based Partnerships

– UT: Dissemination of a Lay Health Worker-Delivered Program to Increase Cancer Screening

– Harvard/BU: Comprehensive Worksite Cancer Prevention

– UNC Increasing CRC Screening Rates

Refining the Science

- Building Capacity•Grant reviews by the

Dissemination Working Group (Emory, UCLA, Harvard/BU, UW, UT)

•Learning from Dissemination Research Cores–UNC Lineberger Cancer Center

–UNC CTSA–W-U CECCR

Conducting Dissemination

Research – Multiple Site Exemplars• Increasing CRC Screening in Health

Plan members (Emory, UNC)• Disseminating a lay health worker-

delivered program to increase cancer screening (UCLA, UT)

• Dissemination of interactive Breast Cancer Kiosks for low-income Latinas (UT, UW)

• Improving the health of native employees (Harvard/BU, U-W)

• Fuel Up/Lift Off 10 minutes to a healthier workplace (WU, UCLA)

Next Steps

•Dissemination Research Resource Center

•Other strategies to increase dialogue and build research in this emerging priority area in multiple venues