As the major health professions have embraced evidence-based practice globally, practice and policy guidelines have increasingly become based upon systematic evidence reviews. Dissemination of systematic evidence reviews has become a worldwide enterprise supported by the Cochrane and Campbell Collaborations. However, a number of challenges surround the uptake of evidencebased practices, especially when interventions are introduced into cultures very different than those from which they originated. After Bonnie Spring introduces the topic, speakers will present lessons learned when implementing globally in diverse real-world settings behavioral medicine interventions that were validated in an Anglo-European context. Ross Brownson will discuss findings derived from introducing public health physical activity campaigns in South America. Geoffrey Setswe will discuss implications for intervention of social aspects of HIV/AIDS and health across the African continent. Brian Oldenburg will share observations based on the spread of diabetes interventions between different countries, cultures, and populations. Discussant, Stephen Weiss will synopsize lessons learned about the process of engaging in evidence-based practice when the relevance of the available research is unclear. Presenters will address three issues: 1) How can an evidence-based intervention best be tailored to a local individual or community? 2) How should an investigator evaluate both the adequacy of contextualization and the success with which active intervention ingredients were preserved? 3) What does treatment fidelity mean when interventions are to be implemented in diverse cultural contexts? Introduction: Many HIV prevention interventions have been tested for efficacy or effectiveness. However, in almost three decades of the HIV/AIDS epidemic, we are still not sure which interventions work best in preventing HIV transmission in different communities and cultural settings. This presentation provides evidence of HIV prevention interventions that work and also presents lessons learned about applying them in different contexts. Methods: A systematic review of randomized controlled trials (RCTs) testing HIV prevention interventions for evidence of efficacy or effectiveness was conducted. The interventions were classified as biomedical, behavioral and structural. The evidence provided by RCTs was graded in four different levels: best (80% or more), good (60-79%), promising (30-59%) and poor or no evidence (<30%). We calculated the effect size to show the difference between treated and control conditions. Findings and Discussion: Using the grading system, male and female condoms and PMTCT were classified as best evidence HIV prevention interventions because they had achieved more 80% level of efficacy or effectiveness. ART, male circumcision, HIV Counseling and Testing for people who test positive were classified as good evidence HIV prevention interventions as they had achieved between 60 and 79% level of efficacy or effectiveness. Treatment of STI, a microbicide called PRO2000, the RV144 Thailand vaccine trial and a structural community RCT that reduced intimate partner violence were classified as promising evidence HIV prevention interventions as they had achieved between 30 and 59% level of efficacy or effectiveness. All other interventions that obtained less than 30% effectiveness were classified as poor or no evidence. We will present the effect size of these interventions. Conclusion: There is no "magic bullet" for HIV prevention, particularly as applied in different cultural settings. The lesson learned is that the acceptability of intervention strategies is not the same across most cultures and individuals. A community should choose to use a combination of interventions that best suits their context from among best, good or promising practices. (2) How to extend the reach of such programs to low and middle income countries, as the current trial evidence based in such countries is currently very limited? This presentation considers the development, implementation and evaluation of such programs in Finland and Australia, as well as the recent uptake of lifestyle-related interventions for reducing diabetes risk in other countries. The GOAL study in Finland involved the "real world" evaluation of a moderate-intensity group-based lifestyle change counselling program to prevent type 2 diabetes, adapted from the original Finnish Diabetes Prevention Study (DPS). Drawing on evidence from the Finnish DPS and the short-term results from the GOAL implementation trial, the Australian Diabetes Prevention Program (DPP), adapted from the GOAL program, achieved similar positive behavioral and clinical outcomes. Currently, more routinized programs, that are building on the evidence from these 'real world' implementation trials, are being implemented and evaluated in Finland and Australia. As key components of the Finnish GOAL program have become more refined over time, successive versions of the program in different countries are aiming to improve the 'fit' between characteristics of the interventions, the adopters, and the implementation environments. Core components of the GOAL program are now also being adapted for use in programs that are currently being evaluated in Malaysia, India and South Africa. There is an urgent need for more collaborative and coordinated approaches that compare and contrast methods for adapting and spreading effective intervention programs between settings, regions, and countries. Adults diagnosed with cancer are often faced with multiple treatment options. Many want to participate with their physicians in the process of deciding which treatment is best for them. This symposium features four projects that are testing various applications of the SCOPED process in different settings, using different delivery models and intervention components. SCOPED is a six step process for helping patients formulate and analyze issues, synthesize insight, and translate the insight into action. The steps include documenting questions and answers about the Situation, Choices, Objectives, People, Evaluation, and Decisions. Each project will present data about using the SCOPED process to inform and involve adults making cancer treatment decisions. Introduction: The 'Better Cancer Care' campaign launched by the Scottish Government promotes partnership between patients and healthcare professionals. The aim of this study in progress is to evaluate decision navigation using the SCOPED question-listing and note taking process within NHS Scotland. Methods: Newly diagnosed breast and prostate cancer patients attending the Edinburgh Cancer Centre are invited to participate. Patients are randomized to intervention or control. Decision self efficacy (DSE) is measured in both groups (scale of 0 to10) at baseline (T1) and after the consultation (T3). DSE is additionally measured in the intervention group after the decision navigation session (T2). Intervention patients also receive a service evaluation form at T2. Preliminary Analysis: Prostate: N=63 age range 56-78 years. As of November 2009, there are no differences between groups at T1 on the DSE x=8.39 in the intervention group and x=8.3 in the control group (p=.82). At T3 there is a significant difference between groups x=9.0 in the intervention group and x=8.3 in the control group (t(51) = 2.059, p=.045). 90% of the intervention group (n=24) found decision navigation 'very helpful' and 10% (n=3) 'somewhat helpful'. Breast: N=40 age range 41-81 years. 79% of the intervention group (n=15) found decision navigation 'very helpful' and 21% (n=4) 'somewhat helpful' at T2. The intervention and control group do not differ significantly on the DSE. Feedback from a subset of patients (n=9) stated that the intervention was "supportive" "helped to structure thoughts" and "reason through the decision process". Discussion: It is premature to draw conclusions from these preliminary data. Eventual differences in impact of decision navigation between breast and prostate patients may be attributable to the greater degree of choice left to prostate patients. In contrast, breast cancer patients are strongly advised to follow set treatment guidelines for adjuvant therapy. Introduction: Open to Options, a pilot project of ENACCT and CSC provides one-on-one support to hematological cancer patients in Philadelphia, PA, San Francisco/East Bay, CA, and Cincinnati, OH. Methods: Trained CSC facilitators use the SCOPED process to prompt patients to list questions for their providers. Patients complete pre and post session surveys, and follow-up evaluations at 30 and 90 days. The surveys measure distress, anxiety, question self-efficacy, satisfaction and (for a subset), patient use of the question list during a health care provider visit. Results: Three facilitators have used the SCOPED question-listing process with 42 patients. Among patients, there was a significant decrease in distress (p=0.044) and anxiety (p=0.045) and a significant increase in the patient's question self-efficacy (p< 0.001). To date, 26 have made a treatment decision, and 4 (15%) of these chose treatment through a clinical trial, which is higher than the national participation rate of 3-5%. Thirteen of 25 respondents reported discussing cancer clinical trials with their oncologist. Satisfaction among participants was high post-intervention (mean= 8.6 out of a maximum of 10) and remained high at 30 (mean=8.5) and 90 (mean=8.7) days follow-up. Fifteen of 16 patients surveyed (94%) reported bringing their question list to their provider appointment, 13 (81%) thought the question list contributed to a more productive appointment, and 13 (81%) reported their oncologist answered most of their questions. Participants reported the question list: "gave structure to the meeting like an agenda"; "clarified my thoughts"; and "was empowering." Discussion: Preliminary findings suggest use of the SCOPED process for question-listing among blood cancer patients in a community-based setting may be associated with improvements on psychosocial measures and with enhanced enrollment in clinical trials.