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Implementation and spread of interventions into the multilevel context of routine practice and policy: implications for the cancer care continuum.
- Source :
-
Journal of the National Cancer Institute. Monographs [J Natl Cancer Inst Monogr] 2012 May; Vol. 2012 (44), pp. 86-99. - Publication Year :
- 2012
-
Abstract
- The promise of widespread implementation of efficacious interventions across the cancer continuum into routine practice and policy has yet to be realized. Multilevel influences, such as communities and families surrounding patients or health-care policies and organizations surrounding provider teams, may determine whether effective interventions are successfully implemented. Greater recognition of the importance of these influences in advancing (or hindering) the impact of single-level interventions has motivated the design and testing of multilevel interventions designed to address them. However, implementing research evidence from single- or multilevel interventions into sustainable routine practice and policy presents substantive challenges. Furthermore, relatively few multilevel interventions have been conducted along the cancer care continuum, and fewer still have been implemented, disseminated, or sustained in practice. The purpose of this chapter is, therefore, to illustrate and examine the concepts underlying the implementation and spread of multilevel interventions into routine practice and policy. We accomplish this goal by using a series of cancer and noncancer examples that have been successfully implemented and, in some cases, spread widely. Key concepts across these examples include the importance of phased implementation, recognizing the need for pilot testing, explicit engagement of key stakeholders within and between each intervention level; visible and consistent leadership and organizational support, including financial and human resources; better understanding of the policy context, fiscal climate, and incentives underlying implementation; explication of handoffs from researchers to accountable individuals within and across levels; ample integration of multilevel theories guiding implementation and evaluation; and strategies for long-term monitoring and sustainability.
- Subjects :
- Colorectal Neoplasms economics
Colorectal Neoplasms prevention & control
Cost-Benefit Analysis
Early Detection of Cancer economics
Health Education
Humans
Information Dissemination
Interdisciplinary Communication
Patient Care Team standards
Patient Care Team trends
Quality Assurance, Health Care trends
Reimbursement, Incentive
United States
Continuity of Patient Care standards
Continuity of Patient Care trends
Delivery of Health Care, Integrated economics
Delivery of Health Care, Integrated standards
Delivery of Health Care, Integrated trends
Health Policy
Neoplasms diagnosis
Neoplasms economics
Neoplasms prevention & control
Neoplasms therapy
Practice Patterns, Physicians' economics
Practice Patterns, Physicians' organization & administration
Practice Patterns, Physicians' standards
Practice Patterns, Physicians' trends
Quality of Health Care standards
Quality of Health Care trends
Subjects
Details
- Language :
- English
- ISSN :
- 1745-6614
- Volume :
- 2012
- Issue :
- 44
- Database :
- MEDLINE
- Journal :
- Journal of the National Cancer Institute. Monographs
- Publication Type :
- Academic Journal
- Accession number :
- 22623601
- Full Text :
- https://doi.org/10.1093/jncimonographs/lgs004