Support to Intervention Research & the RTIPs Database of Interventions

Recherche Interventionnelle contre le cancer : réunir chercheurs, décideurs et acteurs de terrain

Paris, France │ November 17, 2014

Cynthia A. Vinson, PhD, MPASenior Advisor for Implementation Science

Division of Cancer Control and Population SciencesNational Cancer Institute

Session Objectives

1. Describe NCI support for intervention research

2. Understand importance of utilizing evidence-based interventions and approaches in cancer planning.

3. Access tools and resources that help identify evidence-based interventions and approaches and provide guidance for adapting and implementing them in real world settings.

Behavioral Intervention Research at the National Cancer Institute

• In FY 2013, the budget of the NCI was $4.79 billion.

• The NCI funding portfolio in behavioral and social science exceeded $310 million in FY13.

– More than $155 million of the FY13 NCI-funded research in behavioral and social science was attributed to the Division of Cancer Control and Population Sciences (DCCPS).

• Through innovative behavioral and psychosocial research initiatives, DCCPS supports the development, testing, and dissemination of interventions in areas such as tobacco use, diet and physical activity, sun and viral protection, appropriate cancer screening and treatment adherence andsurvivorship.

http://fundedresearch.cancer.gov/

Selection of Current Funding Programs in Behavioral Intervention Research

• Behavioral and Social Science Research on Understanding and Reducing Health Disparities [PA-13-292 (R01), PA-13-288 (R21)]

• Examination of Survivorship Care Planning Efficacy and Impact [PA-12-274 (R21), PA-12-275 (R01)]

• Innovative Research Methods: Prevention and Management of Symptoms in Chronic Illness [PA-13-165 (R01), PA-13-166 (R15), PA-13-167 (R21)]

• Interventions for Health Promotion and Disease Prevention in Native American Populations [PAR-14-260 (R01)];

• Physical Activity and Weight Control Interventions Among Cancer Survivors: Effects on Biomarkers of Prognosis and Survival [PAR-12-228(R01), PAR-12-229 (R21)]

• Research to Characterize and Reduce Stigma to Improve Health [PA-13-246 (R21), PA-13-247 (R03), PA-13-248 (R01)]

• Understanding and Promoting Health Literacy [PAR-13-130 (R01), PAR-13-131 (R03), PAR-13-132 (R21)].

What do you think of when you hear the term

“evidence-based”?

Question

What is Evidence?

“ the available body of facts or information indicating whether a belief or propositionis true or valid”

In public health practice, a collection of

• Data or scientific evidence (guidelines)

• Input from community members

• Input from other stakeholders

• Professional experience

Brownson RC, Baker EA, Leet TL, Gillespie KN, Evidence-Based Public Health. New York: Oxford University Press; 2003

What Is Evidence?

• Surveillance Data

• Systematic Reviews of Multiple Intervention Studies

• An Intervention Research Study

• Program Evaluation

• Word of Mouth

• Personal Experience

Practice Based Research Based

Different Types of Public Health Approaches

Policies

ProgramsEnvironment

Strategies

Strategy

• Broad intervention that changes individual, systems within organizations, or the community

• Infrastructure strategies: changes to the organization or system– patient reminders for screening with electronic

medical records

• Environmental strategies: alter the physicalor social environment– walking trails

• A specific intervention and its components

• Smart Moves: a manual-driven, family-based weight management program that offers periodic exercise and nutrition education or cognitive behavioral skill training to obese children and adolescents (aged 8-18 years) and their caregivers.

• Specific components: – Exercise education– Nutrition education– Cognitive behavioral skill

training to obese children and adolescents

– peer support– Parents participate in

separate cognitive behavioral skill sessions

Program

• A system of laws, regulatory measures, courses of action, and funding priorities concerning a given topic

– Policy: regulation set by government or local authorities (e.g., laws, ordinances)

– policy: organizational rule or regulation (e.g., worksite)

Policy

What do you think of when you hear the term

“evidence-based”?

Question

The Simple Answer

An evidence-based program has been:

• Implemented

• Evaluated

• Found to be effective

“...the development, implementation, and evaluation of effective cancer education and screening programs and policies through systematic uses of data and research information, and appropriate use of theory-based program planning models.”

Adapted from Brownson et al., J Public Health Management Practice 1999,5:86-97

What is Evidence-Based Cancer Control?

What are the advantages to using evidence-based programs?

Question

Advantages of “EBPs”

• Demonstrated to work in the study populations

• Cost-effective

• Shortens development time

• Can reduce research time

• Can help focus the evaluation

What are some perceived barriers to using evidence-based programs?

Question

Perceived disadvantages to adopting Evidence-Based Programs

Perceived barriers Possible solutions

Ownership/creativity limits • Customize/Brand• Do less formative

research

Cost • Pick a program that fits your budget

Too scientific • Use the evaluation of evidence-based intervention (EBI)

My community is unique, anEBI will not be appropriate for this audience

• Adapt, Adapt, Adapt!

www.cancercontrolplanet.cancer.gov

http://rtips.cancer.gov/rtips/index.do

http://rtips.cancer.gov/rtips/index.do

Research Tested Intervention Programs (RTIPs)

• Intervention outcome finding(s) must be published in a peer-reviewed

journal.

• The study must have produced one or more positive behavioral and/or

psychosocial outcomes (p ≤ .05) among individuals, communities, or

populations.

• Evidence of these outcomes has been demonstrated in at least one study

using an experimental or quasi-experimental design. • The intervention must have messages, materials, and/or other components

that include English and can be disseminated in a U.S. community or clinical

setting. (Interventions conducted in other countries are welcome.)

• The intervention has been conducted within the past 10 years.

How You Can Get Involved:1. Submit your intervention for RTIPs consideration:

http://rtips.cancer.gov/rtips/register/index.do

2. Contact the RTIPs team for questions,

comments, additional information:

http://rtips.cancer.gov/rtips/contact.do

Key Take Aways: Evidence-based Cancer Control

• Evidence-based interventions have been proven to work

• There are resources available online for you to locate evidence-based interventions that meet your goals

• You can save time and money in implementing previously developed evidence-based interventions