Using Implementation Mapping to Develop Implementation Strategies for the Delivery of a Cancer Prevention and Control...

Cancer prevention and control (CPC) behaviors, such as cancer screening, human papillomavirus vaccination, and smoking cessation, are critical public health issues. Evidence-based interventions have been identified to improve the uptake of CPC behaviors; however, they are often inconsistently implemented, affecting their reach and effectiveness. Patient navigation is an evidence-based approach to increasing CPC behaviors. Nevertheless, there are few navigation programs that use systematically developed implementation strategies to facilitate adoption, implementation, and maintenance, which affects uptake and outcomes. This article describes the development of a multifaceted implementation strategy designed to facilitate delivery of a CPC phone navigation program to increase breast, cervical, and colorectal cancer screening; human papillomavirus vaccination; and smoking cessation among 2-1-1 Texas helpline callers. Using implementation mapping, a systematic approach for developing implementation strategies, we designed a strategy that involved training 2-1-1 information specialists to deliver the program, developed online tracking and quality-monitoring (audit and feedback) systems, and developed and distributed protocols and other materials to support training and implementation. Through this iterative process and our collaboration with 2-1-1 Texas call centers, our project resulted in a comprehensive training program with a robust curriculum of pertinent program content, for which we identified core components and appropriate delivery modes that are culturally relevant to the population. The results of this study can be applied to the development of more systematic, transparent, and replicable processes for designing implementation strategies. The study also demonstrates a process that can be applied to other contexts and other CPC program implementation efforts.