Background: The context of an intervention may influence its effectiveness and success in meeting the needs of the targeted population. Implementation science frameworks have been developed, but previous literature in this field has been mixed. This paper aimed to assess the implementation success of interventions, identified from a systematic review, that reduced inequalities in cancer screening between people in low and high socioeconomic groups.
Design and Methods: The implementation framework by Proctor et al. was utilised to assess the potential success of 6 studies reporting on 7 interventions in the “real-world” environment. A standardised rating system to identify the overall implementation success of each intervention was established.
Results: Four interventions (57%) demonstrated high potential to be implemented successfully. Interventions included enhanced reminder letters and GP-endorsed screening invitations, containing evidence on the acceptability, from participants and stakeholders, appropriateness and direct cost of the intervention.
Conclusion: While some interventions reduced socioeconomic inequalities in cancer screening participation, there have been missed opportunities to integrate the experiences of the targeted population into design and evaluation components. This has limited the potential for transferability of outcomes to other settings.
Pfadenhauer L, Gerhardus A, Mozygemba K, et al. Making sense of complexity in context and implementation: The context and implementation of complex interventions (CICI) framework. Implement Sci 2017;12:21. DOI: https://doi.org/10.1186/s13012-017-0552-5
Waters E, Hall B, Armstrong R, et al. Essential components of public health evidence reviews: capturing intervention complexity, implementation, economics and equity. J Public Health (Oxf) 2011;33:462-5. DOI: https://doi.org/10.1093/pubmed/fdr064
Wells M, Williams B, Treweek S, et al. Intervention description is not enough: Evidence from an in-depth multiple case study on the untold role and impact of context in randomised controlled trials of seven complex interventions. Trials 2012;13:95. DOI: https://doi.org/10.1186/1745-6215-13-95
Ugalde A, Gaskin C, Rankin N, et al. A systematic review of cancer caregiver interventions: Appraising the potential for implementation of evidence into practice. Psycho-Oncology 2019;28:687-701. DOI: https://doi.org/10.1002/pon.5018
Proctor E, Silmere H, Raghavan R, et al. Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health Health 2011;38:65-76. DOI: https://doi.org/10.1007/s10488-010-0319-7
Bygrave A, Whittaker K, Aranda S. The impact of interventions addressing socioeconomic inequalities within cancer-related outcomes in high-income countries: A systematic review. J Public Health Res 2020;9:1711.
Kerrison R, Shukla H, Cunningham D, et al. Text-message reminders increase uptake of routine breast screening appointments: A randomised controlled trial in a hard-to-reach population. Br J Cancer 2015;112:1005-10. DOI: https://doi.org/10.1038/bjc.2015.36
Lo S, Good A, Sheeran P, et al. Preformulated implementation intentions to promote colorectal cancer screening: A cluster-randomized trial. Health Psychol 2013;33:998-1002. DOI: https://doi.org/10.1037/a0033507
Puliti D, Miccinesi G, Manneschi G, et al. Does an organised screening programme reduce the inequalities in breast cancer survival? Ann Oncol 2011;23:319-23. DOI: https://doi.org/10.1093/annonc/mdr121
Raine R, Moss S, von Wagner C, et al. A national cluster-randomised controlled trial to examine the effect of enhanced reminders on the socioeconomic gradient in uptake in bowel cancer screening. Br J Cancer Cancer 2016;115:1479-86. DOI: https://doi.org/10.1038/bjc.2016.365
Raine R, Duffy S, Wardle J, et al. Impact of general practice endorsement on the social gradient in uptake in bowel cancer screening. Br J Cancer 2016;114:321-6. DOI: https://doi.org/10.1038/bjc.2015.413
Wardle J, von Wagner C, Kralj-Hans I, et al. Effects of evidence-based strategies to reduce the socioeconomic gradient of uptake in the English NHS Bowel Cancer Screening Programme (ASCEND): Four cluster-randomised controlled trials. Lancet Oncol 2016;387:751-9. DOI: https://doi.org/10.1016/S0140-6736(15)01154-X
Berry N, Lobban F, Emsley R, Bucci S. Acceptability of interventions delivered online and through mobile phones for people who experience severe mental health problems: A systematic review. J Med Internet Res 2016;18:e121. DOI: https://doi.org/10.2196/jmir.5250
Firmino-Machado J, Varela S, Mendes R, et al. Stepwise strategy to improve cervical cancer screening adherence (SCAN Cervical Cancer) – Automated text messages, phone calls and reminders: Population-based randomized controlled trial. Prev Med 2018;114:123-33. DOI: https://doi.org/10.1016/j.ypmed.2018.06.004
Green B, Coronado G, Schwartz M, et al. Using a continuum of hybrid effectiveness-implementation studies to put research-tested colorectal screening interventions into practice. Implement Sci 2019;14:53. DOI: https://doi.org/10.1186/s13012-019-0903-5
Crowder S, Broome M. A framework to evaluate the cultural appropriateness of intervention research. West J Nurs Res 2012;34:1002-22. DOI: https://doi.org/10.1177/0193945912451656
Kemp C, Jarrett B, Kwon C, et al. Implementation science and stigma reduction interventions in low- and middle-income countries: A systematic review. BMC Med 2019;17:6. DOI: https://doi.org/10.1186/s12916-018-1237-x
Reeves P, Edmunds K, Searles A, Wiggers J. Economic evaluations of public health implementation-interventions: A systematic review and guideline for practice. Public Health 2019;169:101-13. DOI: https://doi.org/10.1016/j.puhe.2019.01.012