Promoting state health department evidence-based cancer and chronic disease prevention: a multi-phase dissemination study with a cluster randomized trial component

Peg Allen, Sonia Sequeira, Rebekah R Jacob, Adriano Akira Ferreira Hino, Katherine A Stamatakis, Jenine K Harris, Lindsay Elliott, Jon F Kerner, Ellen Jones, Maureen Dobbins, Elizabeth A Baker, Ross C Brownson, Peg Allen, Sonia Sequeira, Rebekah R Jacob, Adriano Akira Ferreira Hino, Katherine A Stamatakis, Jenine K Harris, Lindsay Elliott, Jon F Kerner, Ellen Jones, Maureen Dobbins, Elizabeth A Baker, Ross C Brownson

Abstract

Background: Cancer and other chronic diseases reduce quality and length of life and productivity, and represent a significant financial burden to society. 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 emerging priorities and crises, and limited skill among the public health workforce. The purpose of this study is to learn how best to promote the adoption of evidence based public health practice related to chronic disease prevention.

Methods/design: This paper describes the methods for a multi-phase dissemination study with a cluster randomized trial component that will evaluate the dissemination of public health knowledge about evidence-based prevention of cancer and other chronic diseases. Phase one involves development of measures of practitioner views on and organizational supports for evidence-based public health and data collection using a national online survey involving state health department chronic disease practitioners. In phase two, a cluster randomized trial design will be conducted to 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 will be randomly selected and assigned to intervention or control. State health department staff and the university-based study team will jointly identify, refine, and select dissemination strategies within intervention units. Intervention (dissemination) strategies may include multi-day in-person training workshops, electronic information exchange modalities, and remote technical assistance. Evaluation methods include pre-post surveys, structured qualitative phone interviews, and abstraction of state-level chronic disease prevention program plans and progress reports.

Trial registration: clinicaltrials.gov: NCT01978054.

Figures

Figure 1
Figure 1
Conceptual framework for dissemination of evidence based public health. Framework adapted from: Kramer DM, Cole DC. Sci Commun. 2003; 25(1):56-82 [36]. Kramer DM, Cole DC, Leithwood K. B Sci Technol Soc. 2004; 24(4):316-330 [37]. Kramer DM, Wells RP, Carlan N, Aversa T, Bigelow PP, Dixon SM, McMillan K. JOSE. 2013; 19(1):41-62 [38].
Figure 2
Figure 2
State health department selection process for phase two.

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