Disseminating Public Health Evidence to Support State Health Department Prevention of Cancer and Other Chronic Diseases

Study Overview
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Brief Summary
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The purpose of this study is to identify and evaluate dissemination strategies to promote the uptake of evidence-based cancer and other chronic disease prevention among state-level public health practitioners. Dissemination strategies such as multi-day in-person training workshops and electronic information exchange modalities are hypothesized to associate with improved access and use of public health evidence and organizational supports for program and policy decision making based on evidence-based public health.

Detailed Description
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Evidence-based public health approaches to prevent cancer and other chronic diseases have been identified in recent decades and have the potential for high impact. Yet barriers to implement prevention approaches persist as a result of multiple factors including lack of organizational support, limited resources, competing priorities, and limited skill among the public health workforce. The purpose of this study was to learn how best to promote the adoption of evidence based public health practice related to chronic disease prevention. This cluster randomized trial aimed to evaluate the dissemination of public health knowledge about evidence-based prevention of cancer and other chronic diseases and test receptivity and usefulness of dissemination strategies directed toward state health department chronic disease practitioners to enhance capacity and organizational support for evidence-based chronic disease prevention. Twelve state health department chronic disease units were randomly selected and assigned to intervention or control. State health department staff and the university-based study team jointly identified, refined, and selected dissemination strategies. Intervention strategies included multi-day in-person training workshops, remote telephone follow-up and technical assistance, supplemental brief remote trainings, and health department work unit procedural changes to support and strengthen evidence-based decision making. Evaluation methods included pre-post surveys and structured qualitative phone interviews.

Official Title
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Disseminating Evidence-Based Interventions to Control Cancer

Conditions
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Information Dissemination, Evidence-Based Public Health

Intervention / Treatment
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* Other: Dissemination of public health knowledge


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: State Health Department chronic disease units (cluster) in the United States and corresponding public health workforce (individuals within cluster) Exclusion Criteria: State health department has received extensive technical assistance and training comparable to our intervention (dissemination activities) Origin state has no logical matching pair matched state based on state population size Origin state has the lowest excess burden of cancer and other chronic risk and disease Origin state health department has lowest or highest capacity for EBDM as determined from previous research

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dissemination<br>Dissemination of public health knowledge: Participating states will help develop and choose 3-5 dissemination strategies they prefer for their state health department chronic disease units to receive. Dissemination strategies may include multi-day in-person training workshops, electronic information exchange modalities, and information on ways to enhance organizational climates favorable to evidence-based chronic disease prevention. | Other: Dissemination of public health knowledge<br>* State health department chronic disease units will be involved with developing and choosing dissemination activities to spread public health knowledge and information on population-based public health strategies that have been shown to reduce risk factors for cancer and other chronic diseases. Example of activities include: multi-day in-person training workshops and electronic information exchange modalities.<br>|
| No Intervention: Comparison<br>Comparison state health department chronic disease units will be provided links to preexisting sources of public health evidence-based information such as the Community Guide, Cancer Control P.L.A.N.E.T. (Plan, Link, Act, Network, with Evidence-based Tools), and NCI Research to Reality. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Organizational supports for evidence-based decision making (EBDM) | Self-report Likert scale items in 4 factors: access to evidence and skilled staff, program evaluation, supervisory expectations and incentives for EBDM, and participatory decision-making | 18-24 months post baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| EBDM competencies | Self-report Likert scale items measure perceived importance and availability of specific public health practitioner skill sets for EBDM | 18-24 months post baseline | 
| Use of research evidence for job tasks | Self-report frequency items for 6 job tasks, summary variable creating by calculating the mean frequency across the tasks | 18-24 months post baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Information Dissemination, Information Sharing, Innovation Diffusion, Public Health Practice, Evidence-Based Public Health, Chronic Disease Prevention, Cancer Prevention and Control