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Investigating facilitator-driven, multi-level implementation strategies in Federally Qualified Health Centers to improve uptake of a cancer control evidence-based intervention

Award Number: R01CA272757
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2023
PERIOD OF PERFORMANCE END DATE: 02/28/2029

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Investigating facilitator-driven, multi-level implementation strategies in Federally Qualified Health Centers to improve uptake of a cancer control evidence-based intervention - Approximately 46,143 new cases of human papillomavirus-associated cancers occur annually in the U.S., and there are health differences based on racial, ethnic, socioeconomic, geographic, and sex in the incidence and mortality of HPV-related cancers. Despite the availability of a highly effective cancer control evidence-based intervention (EBI) that can reduce human papillomavirus-associated cancer mortality, it is underused in Texas. Federally Qualified Health Centers (FQHCs) often need support implementing and improving access to evidence-based preventive services. However, the current literature around implementation comes from large integrated healthcare systems, and there is limited research around what works in FQHC settings. Implementation studies in these resource-limited settings, like FQHCs, are essential to make progress towards state and national targets to improve uptake of the cancer control EBI. Preliminary data from our previous work suggest practice facilitation is a feasible approach for building the capacity in FQHCs to select and implement provider- and practice-level strategies to improve uptake of the cancer control EBI. Using a stepped-wedge cluster randomized trial, we will randomize three FQHCs (n=9 practices, 3 per FQHC) to receive facilitator-driven provider- (i.e., education, clinical practice plan) and practice-level (i.e., technical assistance plus assessment and feedback, training, and education of immunization navigators) implementation strategies. Informed by our conceptual framework and i-PARIHS, we will measure effectiveness (i.e., parents choosing the cancer control EBI for their 11-12 and 13-17 year olds) and implementation outcomes (i.e., increase the number of providers and their confidence in communicating with parents about the cancer control EBI; increase parental confidence and reduce perceived barriers to accessing the cancer control EBI for their children). We will conduct a baseline assessment at each clinical practice, which will provide comprehensive data to assist the practice facilitator in engaging with the providers and leadership using a participatory approach to develop an implementation plan with strategies for each practice. Along with quantitative evaluations, we will employ theory-guided, qualitative methods to assess the complexity associated with context and the recipients involved in the implementation of strategies in practices, along with sustainability. The study will advance our understanding of what it means to conduct implementation research in resource-limited practices that work with populations experiencing substantial disparities. Findings from the current study will inform national implementation efforts and contribute towards future research targeting dissemination and scale-up.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $594,236 )
2026	2026	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Cancer Cause and Prevention Research	000	4	2/27/2026	NON-COMPETING CONTINUATION	$594,236
														Subtotal = $594,236

Issue Date FY: 2025 ( Subtotal = $615,981 )
2025	2025	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Cancer Cause and Prevention Research	002	3	8/15/2025	NON-COMPETING CONTINUATION	$615,981
2025	2023	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Cancer Cause and Prevention Research	000	2	1/16/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2025	2023	UNIVERSITY OF TEXAS AT AUSTIN	110 INNER CAMPUS DR	AUSTIN	TX	78712	TRAVIS	USA	Cancer Cause and Prevention Research	001	1	1/16/2025	NEW	$0
														Subtotal = $615,981

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Cancer Cause and Prevention Research	001	2	8/14/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$271,412
2024	2023	UNIVERSITY OF TEXAS AT AUSTIN	110 INNER CAMPUS DR	AUSTIN	TX	78712	TRAVIS	USA	Cancer Cause and Prevention Research	000	1	8/14/2024	NEW	-$271,412
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $622,806 )
2023	2023	UNIVERSITY OF TEXAS AT AUSTIN	110 INNER CAMPUS DR	AUSTIN	TX	78712	TRAVIS	USA	Cancer Cause and Prevention Research	000	1	8/18/2023	NEW	$622,806
														Subtotal = $622,806

Grand Total All Awards = $1,833,023

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Investigating facilitator-driven, multi-level implementation strategies in Federally Qualified Health Centers to improve uptake of a cancer control evidence-based intervention

Award Number: R01CA272757

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2023

PERIOD OF PERFORMANCE END DATE: 02/28/2029

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