Coalitions Linking Action & Science for Prevention (CLASP) Adapted from Jon F. Kerner, Ph.D. Chair-Primary Prevention Action Group Senior Scientific Advisor for Cancer Control & Knowledge Translation
History of Canada s cancer control strategy Broad and diverse coalition of cancer agencies, patient and survivor groups, charities and government agencies (700+ involved) Clear argument the burden of cancer Small amounts of federal funding supported the planning by pan- Canadian networks of experts, patients and practitioners for many years The Canadian Partnership Against Cancer established as an arm s length non-profit corporation to manage the implementation of the strategy Efforts led to funding of $250 million committed over 5 years Operations began April 2007
Multi-Level Determinants of Health & Illness Ecological Social Factors: Income Disparities, Segregation, Social Cohesion Cultural Factors: Ethnic Traditions (Race/Ethnicity) Institutional Factors: Schools, Worksites Healthcare Settings Environmental Factors: Pollution, Occupational Exposures, Built Environment Constitution Individual Healthcare Provider Factors: Quality of Care Disparities, Patient Communication Individual Risk Factors: Physical Activity, Diet, Tobacco, Alcohol, Sun Exposure, Unprotected Sex Disease Incidence Stage at Diagnosis Cellular Individual Factors: SES, Education, Occupation, Health Insurance Biological Factors: Germline Mutations, Normal Population Polymorphisms Individual Illness Monitoring Behaviors: Early Detection, Followup of Symptoms or Findings, Treatment Adherence Co-Morbid Conditions Disease Recurrence Quality of Life Disease Mortality
Research to Practice = Knowledge to Action POLITICAL WILL KNOWLEDGE BASE SOCIAL STRATEGY Source: M Peck ScD, UNMC, adapted from J Richmond
Where are we now? CLASP - Phase 1 Identified over 300 Canadian researchers, public health and clinical practitioners, and policy people engaged in cancer and/or other chronic disease prevention efforts. Invited to one of three consultation workshops co-sponsored by HSFC and CCS: 1) Social/Behavioural, 2) Clinical, and 3) Environmental. Organize and implement pre-workshop brainstorming, sorting, and rating ideas with web-based concept mapping.
CLASP - Phase 1 Objectives of this workshop (working from the bottom up): Identify strategic opportunities to add value to existing cancer and related chronic disease prevention initiatives focused on a healthier environment in Canada through comprehensive primary prevention collaborations across risk factors/chronic diseases, disciplines (research, practice, policy), and provinces/territories. Inform CPAC (and its partners) what, how, and for whom the CLASP funding initiative can best be applied, adjudicated, and administered. Phase 1 was completed March 31, 2009. Report posted to website very soon
CLASP Phase 2 Support those attending Phase 1 workshops to engage others in their networks and coalitions to attend one-day team building and planning assistance meetings supporting potential CLASP funding agreement applications (April-May, 2009). Post CLASP RFP early June 2009 with applications due middle of July 2009. Identify peer reviewers and complete peer review by September 2009.
What Support can CPAC Provide? 9
CLASP Phase 3 Depending on the number of applications submitted, fund 5-10 CLASPs with about $5M annually from CPAC By 2012, depending on the number and scope of CLASPs funded, this initiative will help to: Unite existing Canadian coalitions across provinces/ territories (two or more required), including at the regional and municipal jurisdiction level, supporting collaborations and partnerships integrating research, practice, and policy (required), and cancer prevention (required) with other chronic disease prevention efforts CLASP Funding Priorities D.i.E.T. (Dissemination, implementation, Evaluation, & Translation)
Coalition Action Continuum* Networking Coordinating Cooperating Collaborating Exchange Information EI + Alter Activities EI+AA+ Share Resources EI+AA+SR+ Enhance each other s capacities + Share risks, responsibilities, and rewards *Definitions from Arthur Himmelman s Working Together Strategies
CLASP Phase 3 By 2012, this initiative will help to: Reduce disparities across individual/social/ environmental risk factors in high-risk & underserved populations (e.g. youth, rural, First Nations/Inuit/ Metis populations) Build bridges across social/behavioural, clinical, and environmental approaches to comprehensive prevention (e.g., toxic use reduction, the built environment, physical activity, and sun safety/skin cancer prevention) Proposals that address reducing disparities, multiple risk factors/chronic diseases, and comprehensive approaches will receive extra credit in peer review
ACTION TO DATA: CAnadian Platform To increase Usage of Real-world Evidence (CAPTURE) Establish a platform for common indicators and tools for evaluation of primary prevention policies and programs Provide validated tools for different contexts Create support systems, capacity building, for use of platform tools Develop systems to provide automatic feedback when using platform tools
Knowledge to Action Cycle Knowledge Action Data
Action Research WHOLE SYSTEMS METHODS REFINING METHODS Administrative Databases Concept Mapping System Dynamics Network Analysis Knowledge Integration Surveillance, Info Systems, Report Cards Systematic reviews Better Practices Toolbox STRATEGIC CHANGE Rapid Learning Systems* *Etheredge L, Health Affairs 2007 26(2): w107-w118
Concept Mapping: What it is Web-based (or not) mixed method system for brainstorming, organizing and making sense of action options Diverse actors contribute unique knowledge and perspectives Creates a visual Òmental modeló Suggests interplay between strategic elements in comprehensive plan e.g. ÒattractorsÓ Adapted from: Trochim WM et al. AJPH 2006;96:538-546; and Graham AL et al. American Journal of Lifestyle Medicine 2008;2:241-249.
Concept Mapping: What It Does Provides a common language and logic for agent-based change across diverse stakeholder groups Encourages systems thinking, and integrative planning and action Offers simple rules to guide intervention Undergirds effective knowledge to action