OPTICC Center Research Studies
OPTICC studies were identified through a competitive process during the OPTICC Center grant development process. Investigators submitting applications for funding were encouraged to focus on implementation challenges related to cancer control initiatives.
Implementation study #1
Increasing colorectal cancer screening through optimized implementation of an evidence-based intervention
Practice facilitation is an effective strategy for improving preventive service delivery and chronic disease management in primary care settings. However, practice facilitation can be conducted in myriad ways, resulting in varying degrees of effectiveness. Researchers partnered with I-Lab members WPRN and BCCHP to optimize the impact of practice facilitation on colorectal cancer screening in FQHCs.
Implementation STUDY #2
A patient centered approach to tailoring human papilloma virus self-sampling for cervical cancer screening (PATH)
In a recently completed pragmatic trial, home-based testing increased cervical cancer screening by 50% in a hard-to-reach population. However, qualitative inquiry with women who did not complete the screening illuminated the opportunity to optimize implementation by distributing patient-centered outreach materials with HPV self-sampling kits. Researchers partnered with I-Lab member KPWA to develop patient outreach materials.
pilot study #1
Assessing acceptability, feasibility, & demand of a ride-share transportation program for patients with abnormal FIT
Transportation is a frequently cited determinant to colonoscopy completion and a likely contributor to lack of FIT follow-up. Ride-share platforms are potentially scalable and cost-effective strategies as rides are scheduled by the health care team, costs are billed to the organization and utilization does not require individual smartphone ownership. Researchers partnered with Harborview Medical Center (UW Medicine) to assess the acceptability, feasibility, and demand for such a ride-share transportation program for patients with abnormal FIT results.
pilot study #2
A staged approach to implementing hereditary cancer risk assessment guidelines for large-scale testing
Clinical guidelines recommend routine ascertainment of individuals at increased hereditary breast and ovarian cancer risk to facilitate timely access to counseling, testing, and risk-management. Yet only about 20% of eligible women have ever discussed genetic testing with a health professional. Researchers partnered with I-Lab member KPWA, leveraging an existing implementation effort to match and identify promising strategies to implement hereditary breast cancer risk assessment guidelines using a stakeholder-driven approach.
pilot study #3
Designing a chatbot intervention to ameliorate disparities in breast cancer screening
Few effective scalable strategies have been shown to improve breast cancer screening outcomes for Black women. Conversational technologies such as chatbots offer a promising approach that can be tailored to individual needs and are of low-resource burden to primary care practices. Using Stage II and Stage III methods, this study explored how a chatbot could address perceived barriers to breast cancer screening among Black women and how chatbot features could be optimized to improve breast cancer screening outcomes.
MEASUREMENT STUDY
Improving identification of determinants of evidence-based practice implementation
Assessing implementation determinants (i.e., barriers and facilitators) before and during implementation is widely regarded critical for successfully integrating evidence-based interventions in cancer control into routine practice. Yet, available measures of implementation determinants lack desirable psychometric and pragmatic qualities, limiting their use and usefulness in both research and practice. This study compiled a bank of items used to measure intervention characteristics in previous studies, assessed the content validity of the items in the item bank, and assessed the reliability, concurrent validity, and predictive validity of measures constructed from items demonstrating good content validity.
Using OPTICC Methods to Close the Research to Practice Gap
Measurement development spans the stages of optimization. Researchers and implementers need robust, useful measures of determinants (Stage I), mechanisms (Stage II), and outcomes (Stage III). Project leads are supported by Research Program Core faculty in their methods application specific to their project work, and offered consultation from a national expert to further build their general implementation science capacity.
Researchers and implementers can begin work in any of OPTICC’s evidence-based intervention implementation stages and move forward or backward depending on their optimization goals.
A linear progression (Stage I→II→III) can be appropriate if researchers or implementers need to clarify critical determinants to select and then test strategies to alter them.
Stages of Optimization
Stage I
Identify & Prioritize Determinants
Stage II
Match
Strategies
Stage III
Optimize
Strategies
Others may have an effective multicomponent strategy that could be optimized by moving backward to mapping strategy components (Stage II) and then forward to optimization testing of strategy components before large-scale evaluation or use in clinical or community settings (Stage III).
OPTICC’s initial studies include those that approach the stages left to right (Implementation Study 2), right to left (Implementation Study 1), those that stay within a single stage (Pilot Study 2) and those that span two stages (Pilot Study 1).
There will be open calls for OPTICC studies, which will engage additional I-Lab partners and researchers.