Measuring Provider and Intervention Characteristic Determinants of Evidence-Based Cancer Care

/ABSTRACT Over the last several decades, numerous healthcare practices achieved the status of evidence-based interven- tion (EBI) for cancer care when scientific evidence supported their use in clinical practice. Identifying the fac- tors preventing or facilitating, collectively called determinants, use of these interventions can bolster implemen- tation efforts to move these EBIs into practice and reduce the overall cancer burden. Determinants are often not assessed before implementing an EBI in clinical practice, although assessment in implementation research has increased. Several critical challenges to assessing determinants when implementing cancer care EBIs are: the lack of accessible, flexible, quantitative tools that are still comparable across time, settings and interven- tions; the use of different quantitative assessment tools; the use of quantitative tools with unestablished validity and reliability; the number of frameworks, models, and theories in implementation science without correspond- ing quantitative measures; and interpreting the results on quantitative measures of determinants. Scores on quantitative tools are continuous but deciding to address a determinant before implementing an EBI is a dichot- omous yes/no decision. This project will address all these critical challenges by using item response theory (IRT) to create flexible, tailorable, easy to interpret quantitative measures of intervention characteristic and pro- vider characteristic determinants that are still comparable across cancer care settings (community oncology, academic) and cancer care populations (treatment, survivorship, end of life) but most importantly can be used to track determinants over time. The measures will be item banks, which are collections of survey items that can be tailored to each individual setting, context, population and EBI. Our preliminary work (pilot studies) col- lected items to assess intervention and provider characteristic determinants of implementing cancer care EBIs. We have also established the content validity of the provider and intervention characteristic determinants item bank. Our pilot studies also initially tested the item banks in a sample of 170 healthcare personnel and 832 cli- nicians and personnel caring for people with small cell lung cancer. Our first aim is to create quantitative measures for each provider and intervention determinant using the item banks and map these to commonly used implementation frameworks and theories. We will use a survey of 750 healthcare personnel (physicians, nurses, advanced practice providers) implementing a cancer care EBI. Our last aim is to create the IRT scoring algorithm and interpretation guidelines for the provider and intervention characteristic determinant item banks. The item banks will be validated against use of the cancer care EBI. The provider and intervention characteris- tic item banks will increase measurement of determinants before implementing a cancer care EBI, helping im- plementation scientists and practitioners and quality improvement directors to address determinants before and during implementation. Project Number: 1R01CA310932-01 | Fiscal Year: 2026 | NIH Institute/Center: National Cancer Institute (NCI) | Principal Investigator: Salene Jones | Institution: FRED HUTCHINSON CANCER CENTER, SEATTLE, WA | Award Amount: $737,945 | Activity Code: R01 | Study Section: Science of Implementation in Health and Healthcare Study Section[SIHH] View on NIH RePORTER: https://reporter.nih.gov/project-details/11336458