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Implementation Science at UW

Keywords: Thuy Vu

✪ Characterizing screening champions in the Center for Disease Control and Prevention’s Colorectal Cancer Control Program (CRCCP)

Authors:

Cam Escoffery, Juzhong Sun, Amy DeGroff, Krishna Sharma, Manal Masud, Thuy Vu, Dara Schlueter & Peggy Hannon

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: July 2025

Read the full text in the open access journal Implementation Science Communications

Abstract:

Background

CDC’s Colorectal Cancer Control Program (CRCCP) aims to increase colorectal cancer (CRC) screening prevalence by implementing evidence-based interventions (EBIs) in health system clinics partnering with the program. Program champions, as one of the key program components, are expected to facilitate the implementation of EBIs and support desired changes in many ways. Given limited information about the champions in clinical systems, this study investigated champion types, roles, and sustainability within the CRCCP.

Methods

This mixed methods, cross-sectional study included a survey of 205 respondents (health system and clinic staff) representing 303 clinics and 12 qualitative interviews of CRCCP award recipients and partnering clinics. The survey assessed clinic characteristics, EBI implementation, information about program champions, and sustainability. Interview topics included champion roles, benefits, turnover, and maintenance.

Findings

Champions worked at either the health system or clinic level. Among health systems, champions were quality improvement (QI) managers (48.5%), physicians (36.4%), or high-level administrators (27.3%). In clinics, champions were physicians (37.0%), QI managers (26.1%) or medical assistants (23.9%). Champions in both health systems and clinics were most often assigned the role (45.5% and 45.7%, respectively); yet clinic champions were more likely to naturally emerge than health system champions (26.1% vs. 15.2%). Among naturally emerging champions, 64.3% experienced zero turnover, more than for assigned champions. While champions in both groups received training, more champions in health systems reported being trained than those in clinics (75.8% vs 52.2%). No significant differences in EBIs implemented were observed between those clinics with and without a champion. Zero champion turnover was associated with great or very great leadership support (68.9%), program adaptation (60.7%) and organizational capacity (54.1%). Interviews found that champions’ roles included advocating for CRC screening, providing technical assistance for EBI implementation, creating organizational policies for CRC screening, and overseeing QI. Interviewees reported a desire to address champion sustainability.

Conclusion

These findings inform the use of program champions for clinic-based public health programs. Naturally emerging champions were more stable than those assigned the role.

Contributions to the literature

  • Research has demonstrated that program champions can assist in the implementation of evidence-based interventions; however, there is limited understanding of the types of champions, their roles, and turnover.
  • These findings contribute to this gap by describing the types of program champions, their training and major roles in implementing evidence-based interventions for colorectal cancer screening.
  • Common roles for champions were implementers, advocates, connectors, motivators, changemakers, data wranglers, educators, and sustainability resource.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ Participatory logic modeling in a multi-site initiative to advance implementation science

Authors:

Douglas V. Easterling, Rebekah R. Jacob, Ross C. Brownson, Debra Haire-Joshu, Daniel A. Gundersen, Heather Angier, Jennifer E. DeVoe, Sonja Likumahuwa-Ackman, Thuy Vu, Russell E. Glasgow, & Robert Schnoll

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: August 2023

Read the full text in the open access journal Implementation Science Communications

Abstract:

Background

Logic models map the short-term and long-term outcomes that are expected to occur with a program, and thus are an essential tool for evaluation. Funding agencies, especially in the United States (US), have encouraged the use of logic models among their grantees. They also use logic models to clarify expectations for their own funding initiatives. It is increasingly recognized that logic models should be developed through a participatory approach which allows input from those who carry out the program being evaluated. While there are many positive examples of participatory logic modeling, funders have generally not engaged grantees in developing the logic model associated with their own initiatives. This article describes an instance where a US funder of a multi-site initiative fully engaged the funded organizations in developing the initiative logic model. The focus of the case study is Implementation Science Centers in Cancer Control (ISC3), a multi-year initiative funded by the National Cancer Institute.

Methods

The reflective case study was collectively constructed by representatives of the seven centers funded under ISC3. Members of the Cross-Center Evaluation (CCE) Work Group jointly articulated the process through which the logic model was developed and refined. Individual Work Group members contributed descriptions of how their respective centers reviewed and used the logic model. Cross-cutting themes and lessons emerged through CCE Work Group meetings and the writing process.

Results

The initial logic model for ISC3 changed in significant ways as a result of the input of the funded groups. Authentic participation in the development of the logic model led to strong buy-in among the centers, as evidenced by their utilization. The centers shifted both their evaluation design and their programmatic strategy to better accommodate the expectations reflected in the initiative logic model.

Conclusions

The ISC3 case study demonstrates how participatory logic modeling can be mutually beneficial to funders, grantees and evaluators of multi-site initiatives. Funded groups have important insights about what is feasible and what will be required to achieve the initiative’s stated objectives. They can also help identify the contextual factors that either inhibit or facilitate success, which can then be incorporated into both the logic model and the evaluation design. In addition, when grantees co-develop the logic model, they have a better understanding and appreciation of the funder’s expectations and thus are better positioned to meet those expectations.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ Implementation studio: implementation support program to build the capacity of rural community health educators serving immigrant communities to implement evidence-based cancer prevention and control interventions

Authors:

Linda K. Ko, Thuy Vu, Sonia Bishop, Jennifer Leeman, Cam Escoffery, Rachel L. Winer, Miriana C. Duran, Manal Masud & Yaniv Rait

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published:July 2023

Read the full text open access in the journal Cancer Causes and Control

Abstract:

Purpose

Rural community-based organizations (CBOs) serving immigrant communities are critical settings for implementing evidence-based interventions (EBIs). The Implementation Studio is a training and consultation program focused on facilitating the selection, adaptation, and implementation of cancer prevention and control EBIs. This paper describes implementation and evaluation of the Implementation Studio on CBO’s capacity to implement EBIs and their clients’ knowledge of colorectal cancer (CRC) screening and intention to screen.

Methods

Thirteen community health educators (CHEs) from two CBOs participated in the Implementation Studio. Both CBOs selected CRC EBIs during the Studio. The evaluation included two steps. The first step assessed the CHEs’ capacity to select, adapt, and implement an EBI. The second step assessed the effect of the CHEs-delivered EBIs on clients’ knowledge of CRC and intention to screen (n = 44).

Results

All CHEs were Hispanic and women. Pre/post-evaluation of the Studio showed an increase on CHEs knowledge about EBIs (pre: 23% to post: 75%; p < 0.001). CHEs’ ability to select, adapt, and implement EBIs also increased, respectively: select EBI (pre: 21% to post: 92%; p < 0.001), adapt EBI (pre: 21% to post: 92%; p < 0.001), and implement EBI (pre: 29% to post: 75%; p = 0.003). Pre/post-evaluation of the CHE-delivered EBI showed an increase on CRC screening knowledge (p < 0.5) and intention to screen for CRC by their clients.

Conclusion

Implementation Studio can address unique needs of low resource rural CBOs. An implementation support program with training and consultation has potential to build the capacity of rural CBOs serving immigrant communities to implementation of cancer prevention and control EBIs.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ The special sauce of the Cancer Prevention and Control Research Network: 20 years of lessons learned in developing the evidence base, building community capacity, and translating research into practice

Authors:

Stephanie B. Wheeler, Rebecca J. Lee, Alexa L. Young, Adam Dodd, Charlotte Ellis, Bryan J. Weiner, Kurt M. Ribisl, Prajakta Adsul, Sarah A. Birken, María E. Fernández, Peggy A. Hannon, James R. Hébert, Linda K. Ko, Aaron Seaman, Thuy Vu, Heather M. Brandt & Rebecca S. Williams

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: June 2024

Read the full text in the open access journal Cancer Causes and Control

Abstract:

Purpose

The Cancer Prevention and Control Research Network (CPCRN) is a national network focused on accelerating the translation of cancer prevention and control research evidence into practice through collaborative, multicenter projects in partnership with diverse communities. From 2003 to 2022, the CPCRN included 613 members.

Methods

We: (1) characterize the extent and nature of collaborations through a bibliometric analysis of 20 years of Network publications; and (2) describe key features and functions of the CPCRN as related to organizational structure, productivity, impact, and focus on health equity, partnership development, and capacity building through analysis of 22 in-depth interviews and review of Network documentation.

Results

Searching Scopus for multicenter publications among the CPCRN members from their time of Network engagement yielded 1,074 collaborative publications involving two or more members. Both the overall number and content breadth of multicenter publications increased over time as the Network matured. Since 2004, members submitted 123 multicenter grant applications, of which 72 were funded (59%), totaling more than $77 million secured. Thematic analysis of interviews revealed that the CPCRN’s success—in terms of publication and grant productivity, as well as the breadth and depth of partnerships, subject matter expertise, and content area foci—is attributable to: (1) its people–the inclusion of members representing diverse content-area interests, multidisciplinary perspectives, and geographic contexts; (2) dedicated centralized structures and processes to enable and evaluate collaboration; and (3) focused attention to strategically adapting to change.

Conclusion

CPCRN’s history highlights organizational, strategic, and practical lessons learned over two decades to optimize Network collaboration for enhanced collective impact in cancer prevention and control. These insights may be useful to others seeking to leverage collaborative networks to address public health problems.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**

✪ Aligning implementation science with improvement practice: A call to action

Authors:

Jennifer Leeman, Catherine Rohweder, Matthew Lee, Alison Brenner, Andrea Dwyer, Linda K. Ko, Meghan C. O’Leary, Grace Ryan, Thuy Vu, & Shoba Ramanadhan

University of Washington affiliated authors are displayed in bold.

✪ Open Access

Published: September 2021

Read the full text in the open access journal Implementation Science Communications
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Abstract:

Background

In several recent articles, authors have called for aligning the fields of implementation and improvement science. In this paper, we call for implementation science to also align with improvement practice. Multiple implementation scholars have highlighted the importance of designing implementation strategies to fit the existing culture, infrastructure, and practice of a healthcare system. Worldwide, healthcare systems are adopting improvement models as their primary approach to improving healthcare delivery and outcomes. The prevalence of improvement models raises the question of how implementation scientists might best align their efforts with healthcare systems’ existing improvement infrastructure and practice.

Main body

We describe three challenges and five benefits to aligning implementation science and improvement practice. Challenges include (1) use of different models, terminology, and methods, (2) a focus on generalizable versus local knowledge, and (3) limited evidence in support of the effectiveness of improvement tools and methods. We contend that implementation science needs to move beyond these challenges and work toward greater alignment with improvement practice. Aligning with improvement practice would benefit implementation science by (1) strengthening research/practice partnerships, (2) fostering local ownership of implementation, (3) generating practice-based evidence, (4) developing context-specific implementation strategies, and (5) building practice-level capacity to implement interventions and improve care. Each of these potential benefits is illustrated in a case study from the Centers for Disease Control and Prevention’s Cancer Prevention and Control Research Network.

Conclusion

To effectively integrate evidence-based interventions into routine practice, implementation scientists need to align their efforts with the improvement culture and practice that is driving change within healthcare systems worldwide. This paper provides concrete examples of how researchers have aligned implementation science with improvement practice across five implementation projects.

**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**