The PIECES multi-site comparative case study protocol: mixed methods implementation evaluation of adapting,...

Area of Science:

• Implementation Science
• Public Health
• Cancer Prevention

Background:

• Evidence-based primary cancer prevention (PCP) programs often struggle with real-world implementation due to context-specific challenges.
• Existing frameworks for program adaptation and tailoring lack practical guidance for operationalization.
• The PIECES project addresses this gap by developing and evaluating structured support for tailored PCP program implementation.

Purpose of the Study:

• To evaluate the usability, feasibility, and impact mechanisms of a co-developed toolkit designed to support tailored implementation of PCP programs.
• To strengthen practitioners' and researchers' implementation competencies through structured planning and evidence-informed decision-making.
• To provide practical guidance for adapting, tailoring, implementing, and evaluating PCP programs across diverse settings.

Main Methods:

• A multi-site pre-post comparative case study design with mixed-methods implementation evaluation across 11 European and Australian sites.
• Process evaluation guided by the UK MRC Process Evaluation Framework and Proctor's implementation outcomes, examining usability, feasibility, and satisfaction.
• Realist evaluation to explore how, why, and under what conditions the toolkit supports tailored implementation, using quantitative and qualitative data.

Main Results:

• The primary outcome is the change in implementation competencies among toolkit users.
• Data collection includes quantitative and qualitative data, toolkit logs, and field notes from 2025-2027.
• The study will provide insights into the mechanisms and contextual factors influencing tailored implementation.

Conclusions:

• The PIECES study is expected to advance implementation science by evaluating a structured, evidence-informed tool for tailored PCP program implementation.
• The multi-country design will explore the functioning of implementation support tools across diverse contexts.
• Integrating process and realist evaluations aims to generate evidence for scalable, context-sensitive strategies to enhance prevention efforts.