Disseminating Public Health Evidence to Support State Health Department Prevention of Cancer and Other Chronic Diseases

Disseminating Evidence-Based Interventions to Control Cancer

The purpose of this study is to identify and evaluate dissemination strategies to promote the uptake of evidence-based cancer and other chronic disease prevention among state-level public health practitioners. Dissemination strategies such as multi-day in-person training workshops and electronic information exchange modalities are hypothesized to associate with improved access and use of public health evidence and organizational supports for program and policy decision making based on evidence-based public health.

Evidence-based public health approaches to prevent cancer and other chronic diseases have been identified in recent decades and have the potential for high impact. Yet barriers to implement prevention approaches persist as a result of multiple factors including lack of organizational support, limited resources, competing priorities, and limited skill among the public health workforce. The purpose of this study was to learn how best to promote the adoption of evidence based public health practice related to chronic disease prevention. This cluster randomized trial aimed to evaluate the dissemination of public health knowledge about evidence-based prevention of cancer and other chronic diseases and test receptivity and usefulness of dissemination strategies directed toward state health department chronic disease practitioners to enhance capacity and organizational support for evidence-based chronic disease prevention. Twelve state health department chronic disease units were randomly selected and assigned to intervention or control. State health department staff and the university-based study team jointly identified, refined, and selected dissemination strategies. Intervention strategies included multi-day in-person training workshops, remote telephone follow-up and technical assistance, supplemental brief remote trainings, and health department work unit procedural changes to support and strengthen evidence-based decision making. Evaluation methods included pre-post surveys and structured qualitative phone interviews.

Inclusion Criteria:

• State Health Department chronic disease units (cluster) in the United States and corresponding public health workforce (individuals within cluster)

Exclusion Criteria:

• State health department has received extensive technical assistance and training comparable to our intervention (dissemination activities)
• Origin state has no logical matching pair matched state based on state population size
• Origin state has the lowest excess burden of cancer and other chronic risk and disease
• Origin state health department has lowest or highest capacity for EBDM as determined from previous research