Reducing the chasm in behavioral health care for older adults with cancer: Development of the Center for Implementation Research in Cancer in Later Life (CIRCL)

Older adults with cancer (OACs) comprise a large and growing proportion of cancer patients and survivors. Many OACs have unmet behavioral health needs with significant negative implications for their quality of life, physical health, and adherence to and recovery from cancer care. Efficacious interventions to address these needs have been developed but their implementation into cancer care is limited. Dissemination and implementation (D&I) research can address this gap by creating implementable interventions and identifying strategies for integrating these interventions into routine cancer care. Existing D&I research resources are limited by a lack of tailoring to project-specific needs, a focus on trainees and early career faculty, and insufficient resources to meet current demand. The proposed project addresses these limitations by developing a new interdisciplinary research Center, the Center for Implementation Research in Cancer in Later Life (CIRCL) that will infuse D&I research methods into new and existing projects across all stages of behavioral intervention development for OACs. CIRCL will consist of Administrative, Training, and Research Cores. The Administrative Core will provide leadership, support, and oversight to ensure that the mission and aims of CIRCL are accomplished. The Core will consist of an Executive Committee, Administrative Support Team, External Advisory Council, and OAC and Caregiver Council. The Training Core will provide resources and networking opportunities to train investigators to integrate D&I science methods into their research including a webinar series, work-in-progress webinar, mentorship program, and resource library. CIRCL’s Research Core will evaluate the research needs of investigators and provide resources to facilitate research on the D&I of behavioral interventions for OACs. The Core will administer a national research needs assessment to inform the format and content of CIRCL resources and will support a pilot awards program and annual research conference. The overall project objectives will be met across two phases. During the R21 phase (years 1-2), core components of CIRCL will be developed including hiring administrative staff, launching the CIRCL website, establishing the Advisory and OAC and Caregiver Councils, administering the research needs assessment, and developing standard operating procedures for all CIRCL activities. During the R33 phase (years 3-5), CIRCL’s three cores will work to train researchers and support D&I research projects. The resources available through CIRCL will be advertised nationally with outreach to researchers in academic medicine and community hospital settings. Benchmark evaluation during the R21 phase will ensure CIRCL resources are developed in a timely manner in preparation for the R33 phase. Evaluation of the R33 phase will assess utilization of CIRCL resources and the impact of those resources on the advancement of D&I research on behavioral interventions for OACs.