Improving cancer prevention and control through implementing academic-local public health department partnerships - protocol for a cluster-randomized implementation trial using a positive deviance approach.

Abstract

Background: Local public health departments in the United States are responsible for implementing cancer-related programs and policies in their communities; however, many staff have not been trained to use evidence-based processes, and the organizational climate may be unsupportive of evidence-based processes. A promising approach to address these gaps is through academic-public health department (AHD) partnerships, in which practitioners and academics collaborate to improve public health practice and education through joint research projects and educational opportunities. Prior research has demonstrated the benefits of AHD partnerships to public health practice and education. However, knowledge about how AHD partnerships should be structured to support implementation of programs and policies is sparse.

Methods: This is a mixed methods, two-phase study, guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework, in which AHD partnerships are a relational type of bridging factor. A positive deviance approach will be used to understand how AHD partnerships are best structured and supported. In the formative phase, we will survey academics and local health department staff (n = 500) to characterize AHD partnerships and understand contextual influences. We will conduct in-depth interviews with eight AHD partnerships (four high and four low engagement), to identify differences between high and low engagement partnerships. The second, experimental phase will be a paired group randomized trial with 28 AHD partnerships (n = 14 randomized to implementation arm and n = 14 to the control arm). A menu of strategies will be refined through survey and interview findings, literature, and our team's previous work. The trial will assess whether these strategies can be used to strengthen partnerships and improve adoption of cancer prevention and control programs and policies. We will evaluate changes in AHD partnership engagement and implementation of evidence-based programs and policies.

Discussion: This first-of-its-kind study will focus on collaborations that leverage complementary expertise of health department staff and academics to improve public health practice. Our results can impact the field by identifying new, sustainable models for how public health practitioners and academics can work together to meet common goals, increase the use of evidence-based programs and policies, and expand our understanding of bridging factors within the EPIS framework.

Trial registration: Prospective registered on 9/17/2024 at clinicaltrials.gov no. NCT06605196 ( https://clinicaltrials.gov/study/NCT06605196 ).