Implementation strategies preferred by primary care clinicians to facilitate cancer prevention and control activities

Abstract

Key clinical and community members need to be involved in the identification of feasible and impactful implementation strategies for translation of evidence-based interventions into practice. While a wide range of implementation strategies has been developed, there is little research on their applicability for cancer prevention and control (CPC) efforts in primary care. We conducted a survey of primary care physicians to identify implementation strategies they perceive as most feasible and impactful. The survey included both primary prevention behavior change counseling and cancer screening issues. Analyses contrasted ratings of feasibility and impact of nine implementation strategies, and among clinicians in different settings with a focus on comparisons between clinicians in rural vs. non-rural settings. We recruited a convenience sample of 326 respondents from a wide range of practice types from four practice-based research networks in 49 states and including 177 clinicians in rural settings. Ratings of impact were somewhat higher than those for feasibility. Few of the nine implementation strategies were high on both impact and feasibility. Only ‘adapting to my practice’ was rated higher than a 4 (“moderate”) on both impact and feasibility. There were relatively few differences between rural and non-rural clinicians or associated with other clinician or setting characteristics. There is considerable variability in perceived impact and feasibility of implementation strategies for CPC activities among family medicine clinicians. It is important to assess both feasibility and impact of implementation strategies as well as their generalizability across settings. Our results suggest that optimal strategies to implement evidence-based CPC activities will likely need to be adapted for primary care settings. Future research is needed to replicate these findings and identify practical, implementation partner informed implementation strategies.

Implementation science for cancer control: One center’s experience addressing context, adaptation, equity, and sustainment

“…The survey also focused on types of implementation strategies clinicians found most helpful. Ratings revealed that only one implementation strategy (adapt to my practice) was rated highly on both feasibility and estimated impact [ 66 ]. There were no differences associated with CPC topic, rural vs. urban setting, or clinician characteristics.…”

Demographic Analysis of Cancer Research Priorities and Treatment Correlations

“…The rates of smoking are higher in rural areas and people in rural and remote areas might experience more problems in accessing and following advice that is relevant to prevention [10,11]. Success largely depends on assessing whether needs differ among types of healthcare practice, and identifying the specific areas in preventive services where clinicians require the most improvement and assistance [12]. In the past decade, close to 100 new cancer medications have gained approval in Europe, but their availability is limited, with Central and Eastern European (CEE) countries notably trailing Northern and Western Europe.…”

Aligning Cancer Research Priorities in Europe with Recommendations for Conquering Cancer: A Comprehensive Analysis

“…While primary care prevention is widely recommended, delivering a variety of relevant services is often unfeasible for most clinicians, especially in low-resource and rural healthcare settings. The gap between research and practical implementation in cancer prevention and control, as in other preventive healthcare areas, is well-documented [15]. A study reports an average of 17 years for only 14% of research evidence to be put into practice.…”