Center of Excellence in Cancer Communication Research

Translation to Practice Core

Introduction and Significance

Under CECCR I, EPIC disseminated research results through policy briefs issued through the Leonard Davis Institute, through publication in medical, public health and communication journals, through presentations at national and international scholarly meetings and through website and newsletter distributions. Under CECCR II we will continue to use those mechanisms, but, recognizing the additional emphasis on affecting clinical care, EPIC will conduct workshops with practitioners to shape recommendations and add a major new mechanism for direct collaboration on implementing findings through the Abramson Cancer Center.

Translating research results to clinical application is a goal for both major projects. PCIE focuses on patient clinician communication and its effects, with immediate implications for clinical practice. Smoking Cues in Anti-tobacco PSAs, focusing on smoking cessation advertising and the possible risks associated with current use of stimulants of tobacco craving, is intended to produce specific advice to anti-smoking communication programs. In both cases, important results won’t be enough; deliberate efforts to turn results into practice are required.

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Specific Aims

Aim One: Working closely with the Cancer Outcomes and Delivery section at the Abramson Cancer Center assures that results of CECCR II research are reviewed and, when appropriate, implemented in hospital and physician practice protocols, and to hold feedback workshops with practitioners to shape recommendations.
Aim Two: Develop and share policy briefs describing policy relevant research undertaken in CECCR II through the Leonard Davis Institute of Health Economics policy brief development and distribution network.
Aim Three: Publish articles in refereed (referred?) journals and present results at national and international meetings relevant to medicine (and oncology), to public health and to communication specifically.
Aim Four: Making use of electronic mailing lists, use of the CECCR website and newsletter to reach individuals with continuing interests in cancer communication, and keep them informed of Penn CECCR II activities and the results of current research.

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Research Design

Working with the Decision Making Committees in the Abramson Cancer Center: Both of the CECCR II projects will make discoveries that have the potential to greatly improve the practice of cancer prevention, screening and treatment. However, this potential can be difficult to realize as the translation from research to clinical practice requires active dissemination activities far beyond publication in peer reviewed journals. The importance of these activities is often overlooked in research proposals, perpetuating the large gap between research and practice. In this application, we propose a novel approach to "real-time dissemination" to maximize the impact of the research discoveries on individuals at risk for cancer and on individuals undergoing cancer treatment and follow up.

Our approach takes advantage of the close relationship between the Penn CECCR and the Abramson Cancer Center (ACC), a large NCI Comprehensive Cancer Center with active clinical programs in cancer prevention, screening, treatment and survivorship. The Abramson Cancer Center is also situated within a large integrated health system that includes 60 primary care practices and cares for over 80,000 patients age 50 or over. Both the ACC and the primary care practices undertake a continuous process of improving the quality and effectiveness of care delivery. In this process, decisions are made about how best to improve outcomes for patients, including how to increase use of effective preventive care services (such as colon cancer screening) and how to ensure the optimal use of cancer therapeutics and adjunct interventions. This process occurs through the Cancer Service Line Steering Committee, led by Dr. Douglas Fraker, for the ACC, and through the Primary Care Services Committee, led by Dr. Susan Day, for the primary care practices. The proposed CECCR dissemination strategy will link the ongoing research and research findings directly to these activities so that the research findings can have a direct impact on the policy decisions made for the clinical care at the University of Pennsylvania Health System (UPHS).

Workshops with Practitioners: We recognize that shaping clinical care and policy recommendations should not be a one-way process. We need not only tell practitioners about our results and recommendations that seem logically derived from them; we need also to provide them an opportunity to reflect on and advise us about the relevance of the results to practice, and indicate whether recommendations that we think are appropriate also fit with what they believe can be implemented. We will set up ad hoc half-day seminars (four during the period of CECCR II) with appropriate practitioners in the Penn system and with others to present results and tentative recommendations and gain feedback from them to reshape those recommendations.

Disseminating Results to Policy Makers: The Leonard Davis Institute for Health Economics (LDI) publishes a widely respected series of policy Issue Briefs which are circulated to a broad audience of 4,000 policy makers, and industry leaders worldwide. Each brief reports the results of a single study and lays out the policy implications of the study. The LDI has agreed to publish four Issue Briefs based on work published by Center investigators. Each Brief is a four-page, two-color document, with margin cutouts and bulleted points to telegraph its message to busy policymakers and health professionals. Issue Briefs reach an audience that does not usually read professional journals or attend scientific meetings—namely, federal, state and local elected leaders, insurance and hospital executives, and industry and consumer representatives. In addition to hard copy mailings, Issue Briefs are part of a monthly e-mail newsletter sent to more than 1,000 hospital chief executive officers, chief nursing executives, and pharmacist-executives. They are also posted on the LDI web site in .pdf format for easy downloading. We would expect, for example, that the PSA Cues study (Project Two) will lead to a policy brief about the risk of including smoking cues in anti-smoking ads.

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