Implementing Cancer Genomics in State Health Agencies: Mapping Activities to an Implementation Science Outcome Framework

Abstract

<b><i>Objective:</i></b> To show how state health agencies can plan and evaluate activities to strengthen the evidence base for public health genomics, we mapped state cancer genomics activities to the Doyle et al. [<i>Genet Med</i>. 2018;20(9):995–1003] implementation science outcome framework. <b><i>Methods:</i></b> We identified state health agency activities addressing hereditary breast and ovarian cancer and Lynch syndrome by reviewing project narratives from Centers for Disease Control and Prevention Cancer Genomics Program funding recipients, leading discussions with state health agencies, and conducting an environmental scan. <b><i>Results:</i></b> State health agencies’ cancer genomics activities included developing or adding to state surveillance systems, developing educational materials, bidirectional reporting, promoting health plan policy change, training providers, and promoting recommendations and standards. To address health disparities, programs have tracked group differences, developed culturally appropriate educational materials, and promoted access to services for underserved populations. <b><i>Conclusion:</i></b> State health agencies can use the Doyle et al. [<i>Genet Med</i>. 2018;20(9):995–1003] performance objectives and outcome measures to evaluate proposed and ongoing activities. By demonstrating whether activities result in improved outcomes, state health agencies can build the evidence for the implementation of cancer genomics activities.