Cancer is the second leading cause of death overall in the United States. While university-based research is yielding an abundance of new discoveries related to cancer treatment, research findings often take 10 to 20 years before they are incorporated into clinical or public health practice.
The science of dissemination and implementation (D&I) has emerged to address the gap between research and practice.
A team of researchers at Washington University in St. Louis has been an international leader in developing the science of D&I research. A recent mentored training program is helping to expand that knowledge base well beyond the university.
“The Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) program was the first of its kind in cancer prevention and control, and we have some impressive findings showing its impact in a variety of ways, including an increase in skills, grants, publications, networking and even some practice changes,” said Ross Brownson, the Steven H. and Susan U. Lipstein Distinguished Professor and director of the Prevention Research Center at Washington University.
Brownson directed the training program, which was funded by the National Cancer Institute from 2014-2020.
As an example of a real-world impact, one fellow helped to secure funding through their state health agency responsible for overseeing the Medicaid health program to provide technical assistance and support to 15 coordinated care organizations (CCOs), including education on evidence-based interventions and best practices for their uptake. Early results show increases in cancer screening rates across these CCOs, Brownson said.
Making international connections
Postdoctoral and early-career cancer researchers with full-time appointments in a research setting and interests in D&I research were enrolled. Between 2014 and 2017, 58 fellows representing the United States, Australia and Canada were trained.
The fellows participated in two summer institutes (five-day trainings) in St. Louis each June. Trainings primarily focused on competencies for D&I research and in-person mentoring and interactive sessions to work on and receive feedback related to research proposals and or other projects in progress.
“MT-DIRC was absolutely pivotal in my career. The mentored approach to training in dissemination and implementation in cancer was critical in helping me to situate my expertise in the context of the intersection of these fields, identifying my unique contribution,” said program fellow Sarah Birken, associate professor in the Division of Implementation Science at Wake Forest School of Medicine.
“Participating in MT-DIRC also gave me a network of scholars with expertise that complements mine, offering us long-sustained collaborations.”
“The MT-DIRC program has been pivotal in my career development,” said Nicole Rankin, assistant professor in implementation science in the School of Public Health at the University of Sydney in Australia.
“It has enabled me to develop expertise in implementation science that would otherwise not have been possible because of that deep immersion through the summer institutes and having dedicated time to devote to the program from my workplace,” said Rankin, who also directs the implementation science program at Sydney Health Partners.
“The mentoring aspect was a vital ingredient of success as I had someone to check in with each month and my mentor was so generous with her time,” Rankin said. “It was also incredibly helpful to have my co-mentees to bounce ideas off and learn from their experiences.
“The broader network of mentors and mentees has also been career changing, as I’ve made international connections I would otherwise not have had,” she added. “More than anything else, the MT-DIRC program gave me the confidence to pursue a career in implementation science and it helped me to form a vision of what might be possible in the Australian setting. A colleague recently said to me that in this decade, implementation science will transform healthcare services. And I think she is right!”
Thirteen D&I research faculty members from various institutions served as mentors to program participants. Five Washington University faculty members from the Brown School, the School of Medicine and the Siteman Cancer Center were involved.