Stephanie B. Wheeler, PhD, MPH The Cancer Prevention and Control Research Network: Accelerating the Adoption of Evidence-Based Cancer Prevention and Control in Communities A national network of academic, public health, and community partners working together to reduce the burden of cancer, especially among those disproportionately affected. Stephanie B. Wheeler, PhD, MPH University of North Carolina at Chapel Hill This presentation was supported by Cooperative Agreement Number U48 DP005006 from the Centers for Disease Control and Prevention. The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Presentation Overview CPCRN Overview Overview of the impact of CPCRN, April 2018

CPCRN Vision Reduce the burden of cancer in U.S. populations and eliminate cancer disparities

CPCRN Mission Accelerate the adoption and implementation of evidence-based cancer prevention and control strategies in communities, enhance large-scale efforts to reach underserved populations and reduce their burden of cancer, deepen our understanding of the predictable processes that achieve those goals, and develop the dissemination and implementation workforce in cancer prevention and control.

The CPCRN Organization Largest of seven Thematic Research Networks in the Prevention Research Centers (PRCs) Program Only Thematic Network focused on dissemination and implementation of cancer interventions Eight Network Centers at research institutions Collaboration with two Federal Agencies CDC – Division of Cancer Prevention and Control NCI – Division of Cancer Control and Population Sciences

Network Geographic Map University of Washington South Carolina North Carolina Pennsylvania Case Western Reserve University University of Kentucky of Iowa Oregon Health & Science University

Principal Investigators Erika Trapl, Ph.D. Jackie Shannon, Ph.D. Kerri Winters-Stone, Ph.D. Natoshia Askelson, Ph.D. Karen Glanz, Ph.D. Robin Vanderpool, Dr.P.H. Jennifer Leeman, Dr.P.H. Stephanie Wheeler, Ph.D. (CC) Daniela Friedman, Ph.D. Peggy Hannon, Ph.D. Principal Investigators

Principal Investigator Research Focus of Centers Member Name Principal Investigator Research Focus Case Western Reserve University Sue Flocke, PhD Tobacco cessation; lung cancer screening; systems change; dissemination & implementation science Oregon Health and Science University Jackie Shannon, PhD Kerri Winters Stone, PhD Cancer prevention and survivorship; nutrition and physical activity; tribal and rural populations University of Iowa Natoshia Askelson, PhD Cancer prevention and screening, health disparities, community based dissemination research University of Kentucky Robin Vanderpool, DrPH Cancer screening; Appalachian practice-based research; dissemination and implementation science University of North Carolina at Chapel Hill Jennifer Leeman, DrPH Healthy behaviors, colorectal, breast, and cervical cancer screening and survivorship; simulation modeling; big data; dissemination and implementation science; health disparities University of Pennsylvania Karen Glanz, PhD Cancer screening; health disparities; community-based dissemination and implementation research University of South Carolina Daniela Friedman, PhD Cancer screening; disease mapping; decision making and communication; CBPR; physical activity; diet University of Washington Peggy Hannon, PhD Cancer screening; HPV vaccination; tobacco cessation; workplace health; health disparities Coordinating Center – University of North Carolina at Chapel Hill Stephanie Wheeler, PhD

CPCRN Cross-Center Workgroups (and their Chairs) Cancer Screening Navigation (Barrington) FQHC Colorectal Cancer Screening (Rohweder, Friedman) Modeling EBI Impact (Wheeler) Organizational Theory Framework for Implementation (Birken) Rural Cancer (Eberth, Vanderpool) Tobacco and Lung Cancer Screening (Flocke, Zeliadt)

CPCRN Strengths Advancing science for dissemination and implementation research Strong community partnerships Focus on underserved populations Broad geographic outreach Research focus that complements NCI & CDC priorities Infrastructure funding provides impetus to focus beyond discovery and be opportunistic

Impact of the Cancer Prevention and Control Research Network April 2018 A report on the activities, productivity, and impact of CPCRN over the past year, across the current funding cycle, and across all years dating back to 2004. Funding Cycle 4, Year 3, with Summary 2004-2017

Background of CPCRN In operation since 2002, with large expansion in 2004 Funded by the Centers for Disease Control and Prevention (CDC) and National Cancer Institute (NCI) Since 2002, 16 university member centers Current Network Centers at 8 universities Current Centers Past Centers Case Western University Emory University Oregon Health & Science Harvard University University of Iowa Morehouse School of Medicine University of Kentucky Texas A&M University University of North Carolina UCLA University of Pennsylvania University of Colorado University of South Carolina University of Texas University of Washington – Seattle Washington University – St. Louis

CPCRN Research Dissemination: By the Numbers Publications Presentations Trainings Past year All 105 112 13 Multicenter 11 34 5 Current Funding Cycle (since 2009) 307 225 * 36 57 Since 2004 2,007 1,812 176 197 * Trainings were newly tracked in 2018

CPCRN Grant Funding: By the Numbers Submitted Apps Funded Apps Total $ Applied For Funded Past year All 38 20 $93,747,691 $68,790,784 Multicenter 4 3 $3,536,059 $599,792 Current Funding Cycle (since 2009) 127 69 $226,744,848 $103,923,171 10 6 $10,516,372 $945,103 Since 2004 1,270 586 $1,466,271,913 $589,930,343 189 113 $175,421,278 $90,463,610 * Some grants were reported without funding amounts, so these numbers should be considered an underestimate of actual grant application and funding amounts

Plans, Reports, and Policies CPCRN Centers were instrumental to the creation of a dozen reports, plans, or policies with state and national programs in the past year, listed below (partner organizations in parentheses). Plans: Revision of Iowa Cancer Plan 2018-2022 (Iowa Cancer Consortium) South Carolina Cancer Plan (South Carolina Cancer Alliance) Washington CRCCP Evaluation Plan, Version 2.0 (Washington Colorectal Cancer Control Program) Washington Department of Health Breast and Cervical Cancer Screening Program Evaluation Plan (Washington Breast, Cervical, and Colon Health Program)

Plans, Reports, and Policies 2017 Cancer in Iowa (Iowa Cancer Registry) Washington CRCCP Year 1 Process Evaluation Findings and Lessons Learned: A Summary Report (Washington Colorectal Cancer Control Program) Community Health Worker Interviews - Summary Report (Washington Cancer Survivorship Network) Patient Preferences for Survivorship Care Plans - Summary Report (Washington Cancer Survivorship Network) Stakeholder Research Priorities for Smoking Cessation Interventions within Lung Cancer Screening Programs (American Thoracic Society) Prostate Cancer Recommendations for Improving the Health of Pennsylvania Men (Pennsylvania Department of Health)

Plans, Reports, and Policies Kentucky Adolescent Vaccination for Pharmacists Policy Change (Kentucky Pharmacy Association) Case Western Reserve University Tobacco-Free Campus Policy (CWRU Smoke-Free Campus)

Catalyzing Action and Effecting Change UW developed a tool used by Washington CRCCP FQHCs to track, monitor, and summarize CRC screening FIT kit distribution efforts. UPenn worked with stakeholders and FQHC partners to identify barriers, challenges, and needs regarding CRC screening, and used process mapping to inform development of a project to address critical gaps in the uptake of evidence-based strategies to increase screening. UK established a partnership with Juniper Health to learn more about their Proactive Office Encounter (POE) implementation process. UK was also sought out by Appalachian Regional Healthcare for Technical assistance in implementing POE at their clinics. Case Western led an effort with local FQHCs to create a registry for abnormal Pap smears and colposcopies so that the FQHC team can better follow-up with patients in a timely manner.

Catalyzing Action and Effecting Change CWRU worked with health clinic partner MetroHealth to implement changes to their Electronic Medical Records (EMR) system to incorporate Case Western’s eReferral intervention to conduct patient tobacco use assessments, assistance, and referrals to the state Quitline. UW’s Dr. Zeliadt’s SIP-funded research findings findings were presented at the National Lung Cancer Roundtable, and influenced the American College of Radiology Registry to begin routinely calculating and reporting quit rates based on Dr. Zeliadt’s recommendations, which also informed the American Thoracic Society’s Official Research Agenda Policy Statement on integrating smoking cessation into lung cancer screening. UNC’s Dr. Wheeler used the Modeling Evidence-Based Intervention Impact Workgroup’s findings to motivate and implement a CRC screening outreach quality improvement initiative with county and state organizations.

Dissemination Communications Some of CPCRN’s work this past year was disseminated broadly over social or traditional media to reach a wide audience. University of Iowa P.I. Dr. Askelson was featured in an article in national magazine The Atlantic about how reduced health care access for women’s health, including cancer prevention and detection services, will impact the state's population. University of Iowa CPCRN research was also featured in a British National Health Service article about the link between energy-dense foods and obesity-related cancer. Oregon Health and Science University’s Dr. Winters-Stone conducted a study to determine whether providing a free exercise DVD in addition to an oncologist’s recommendation for exercise led to better outcomes then the doctor’s recommendation alone – dissemination efforts about this study reached >14,000 people’s social media feeds.

Requests for Scientific Expertise CPCRN researchers are frequently sought out by outside organizations for their scientific expertise in cancer control. UW’s Drs. Hannon and Coronado were sought by CDC to serve as members of CDC's Breast and Cervical Cancer Early Detection and Control Advisory Committee. UW’s Dr. Taylor was sought out to serve as a reviewer by the CDC and NCI’s primary groups seeking to promote Evidence-Based Approaches to cancer control, the CDC’s Guide to Community Preventive Services and NCI’s Research-Tested Intervention Programs. USC’s Dr. Friedman sought by South Carolina Hospital Association for assistance in developing a tool to gauge health literacy in patients in all hospital systems in South Carolina and by the South Carolina Cancer Alliance for assistance in developing a prostate cancer educational resource. UI’s Dr. Askelson and Ms. Seegmiller were sought by American Cancer Society and Iowa Managed Care Organizations to develop an evaluation of a statewide HPV vaccination project.

Requests for Scientific Expertise UK’s Dr. Vanderpool was sought by state teams at the 80% by 2018 forum to provide technical assistance on increasing CRC screening rates through enhanced partnerships between Comprehensive Cancer Control Coalitions and FQHCs. UNC’s Dr. Leeman was sought to serve on the NCI Qualitative Research in Implementation Science Workgroup, and presented the group’s guidance at the Seattle Implementation Research Conference. UNC’s Dr. Rohweder was sought by the National Colorectal Cancer Roundtable to share data from the FQHC workgroup’s survey and qualitative interviews. OHSU and UW’s Drs. Davis and Coronado were sought by the Oregon Health Authority’s Transformation Center for Colorectal Cancer Screening technical assistance at Coordinated Care Organizations. UNC’s Dr. Wheeler was sought by the National Community Oncology Research Program (NCORP) Wake Forest Research Base to provide keynote speech at their annual meeting on cancer-related financial toxicity

CPCRN Coordinating Center & Steering Committee The Steering Committee developed a new Mission Statement and Network Strategic Plan outlining the network’s goals, objectives and tactics. The Network’s Annual Scientific Meeting was held in Chapel Hill, NC in May 2017. A total of 49 attendees and virtual participants attended Workgroup meetings, a Steering Committee meeting, and various plenary sessions. Members participated in the CDC Cancer Conference and Conference on the Science of Dissemination and Implementation in Health; the Network had high visibility at both meetings, including two panel discussions and several individual presentations.

CPCRN Coordinating Center Projects During Year 3, the Coordinating Center further developed processes and structures to support the CPCRN by: Revising our progress reporting system to capture the impact of CPCRN work in new and different ways of interest to the funders Developing a new communications and dissemination strategy increasing CPCRN’s social media presence Implementing a quarterly emailed newsletter to audiences inside and outside of the CPCRN Implementing extensive updates to the CPCRN website to broaden its appeal to external (non-member) users Developing a project to feature a searchable and filterable bibliography of all CPCRN publications and their abstracts dating back to 2004.

Conclusion The CPCRN has made substantial impact in cancer prevention and control and dissemination and implementation science in the past year, across the current funding cycle, and across its history dating back to 2004. Its members continue to innovate, develop, implement, and evaluate evidence-based approaches to cancer prevention and control with their local, state, and national partners, influencing everything from local clinic practices to state cancer plans to national organizations’ practices and policies. The Network’s extensive history of publications (over 2,000) and funded grants totaling over $600 million in research dollars demonstrate just two of many ways the Network and its investigators’ expertise has and continues to have significant impact on the nation’s dissemination and implementation of evidence-based cancer prevention and control research.

Note: This presentation is based off of an executive summary of a detailed 90-page report; for more information, please contact Rebecca Williams, Chief Technology Officer of the CPCRN at the Coordinating Center via email: rebeccawilliams@unc.edu.