Toward optimal implementation of cancer prevention and control programs in public health: a study protocol on mis-implementation

Padek, Margaret; Allen, Peg; Erwin, Paul C.; Franco, Melissa; Hammond, Ross A.; Heuberger, Benjamin; Kasman, Matt; Luke, Doug A.; Mazzucca, Stephanie; Moreland-Russell, Sarah; Brownson, Ross C. · 2018 · DOAJ

DOI: 10.1186/s13012-018-0742-9

archive: archived pipeline: cataloged verified

Get this paper ↗ (DOI — opens at the source; we link to it, we don't host it)

Summary

This document is a study protocol outlining a three-phase research design aimed at understanding and reducing "mis-implementation" in state-level cancer prevention and control programs. Mis-implementation is defined as the premature discontinuation of effective, evidence-based interventions or the continued funding of ineffective ones. The study is motivated by the significant preventable burden of cancer in the USA and the substantial resources ($1.1 billion annually) allocated to state cancer control, despite limited evidence that these programs are effectively sustained or discontinued based on scientific merit. The methodology employs a comprehensive, multi-stage approach. Phase 1 involves refining and pilot-testing survey measures to assess the scope of mis-implementation, followed by a large-scale survey of 800 public health practitioners across all US states. This phase utilizes cognitive testing, expert review, and reliability testing to ensure valid measurement of constructs such as organizational support, individual skills, and barriers to evidence-based decision-making. Phase 2 consists of eight comparative case studies (four in states with high mis-implementation and four with low) involving key informant interviews to explore contextual drivers and organizational dynamics. Phase 3 utilizes agent-based modeling (ABM) to simulate the complex, non-linear interactions between individual practitioners, organizational structures, and external factors. The ABM will incorporate data from Phases 1 and 2 to model decision-making processes regarding program continuation or discontinuation. The protocol does not report empirical findings, as it describes a study yet to be conducted. However, it outlines the expected outputs: the development of reliable measures for mis-implementation, identification of contextual factors driving poor implementation decisions, and the creation of computational simulation models. These models are intended to serve as "policy laboratories" to identify leverage points for improving implementation fidelity. The significance of this work lies in its innovative application of agent-based modeling to public health implementation science, a field traditionally reliant on linear statistical methods. By addressing mis-implementation, the study aims to improve the efficiency of public health resource expenditure and enhance cancer outcomes. The authors anticipate that the resulting models and insights will provide replicable tools for identifying system dynamics that hinder evidence-based practice, potentially extending beyond cancer control to other public health domains.

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed.

Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• child passenger safety