Abstract - Overall
After decades of research developing and testing interventions for cancer control, we have the evidence
needed to prevent more than half of all cancers. The impact of these strategies on cancer outcomes is
significant for both the general population and low income and under-represented groups that bear a
disproportionate share of preventable cancer burden, but evidence-based interventions have not been
uniformly used across population groups. Gaps in implementation of the evidence base can be seen for nearly
all known cancer prevention and early detection strategies. As a result, we incur substantial avoidable cancer
morbidity and mortality and tolerate preventable inequities.
The Implementation Science Center for Cancer Control Equity (ISCCCE) will create an ecosystem for robust
implementation science (IS) related to cancer prevention and control in Massachusetts community health
centers (CHCs) and their local communities. Our theme, improving community health by integrating health
equity and implementation science for evidence-based cancer control, reflects our critical mass of expertise in
cancer disparities, IS, and community-based cancer prevention and control research. Our “grand challenge”
is to address the inequitable implementation and limited scale of evidence-based interventions by developing
and testing implementation strategies aimed at narrowing health inequities and by advancing methods that
carefully consider the low-resource, complex nature of CHCs where adaptation and cost-effective solutions are
needed most. The implementation studies we conduct will address inequities within CHC clinical practice as
well as prevention interventions that link to community resources and assets. Our I-Lab is comprised of 31
CHCs who are members of the Mass League of Community Health Centers and use a common EHR vendor-
neutral population management system that has extensive reporting capability within and across CHCs, which
will allow us to study implementation outcomes in different geographic settings across the state using common
measures. Given that achieving equity in community health requires clinical, community, and policy-level
interventions, our pilots will also examine how to expand the impact and sustainability of CHCs’ cancer
prevention efforts through effective partnerships in community and policy settings. Our Network Unit connects
us directly with other Moonshot IS initiatives and national community health leadership, and expands
opportunities for collaboration and synergy, building IS capacity in our own institutions and across the nation.
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