Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Cancer Communication Science Funding Trends, 2000–2012

Cancer Communication Science Funding Trends, 2000–2012 Abstract Background Since 2000, the field of health communication has grown tremendously, owing largely to research funding by the National Cancer Institute (NCI). This study provides an overview of cancer communication science funding trends in the past decade. Methods We conducted an analysis of communication-related grant applications submitted to the NCI in fiscal years 2000–2012. Using 103 keywords related to health communication, data were extracted from the Portfolio Management Application, a grants management application used at NCI. Automated coding described key grant characteristics such as mechanism and review study section. Manual coding determined funding across the cancer control continuum, by cancer site, and by cancer risk factors. Results A total of 3307 unique grant applications met initial inclusion criteria; 1013 of these were funded over the 12-year period. The top funded grant mechanisms were the R01, R21, and R03. Applications were largely investigator-initiated proposals as opposed to responses to particular funding opportunity announcements. Among funded communication research, the top risk factor being studied was tobacco, and across the cancer control continuum, cancer prevention was the most common stage investigated. Conclusions NCI support of cancer communication research has been an important source of growth for health communication science over the last 12 years. The analysis’ findings describe NCI’s priorities in cancer communication science and suggest areas for future investments. Since 2000, the fields of both health communication science and health communication practice have grown tremendously (1), in large part owing to advances in cancer communication science funded by the National Cancer Institute (NCI). A 1999 review article published in Cancer Epidemiology, Biomarkers & Prevention (2) outlined a framework for cancer prevention and control that recognized behavior as a major determinant of outcomes in cancer control and stated that cancer-related behaviors are inherently multifactorial in nature. The review article, which built upon a framework for research activity adopted by the Advisory Committee on Cancer Control of the National Cancer Institute of Canada (3), launched a proscribed set of initiatives by the NCI, designed to advance the science of cancer control through fundamental research (ie, basic science), surveillance, knowledge synthesis, and program delivery (4). Chief among those activities was an “Extraordinary Opportunity in Cancer Communication,” as initially identified in the NCI’s fiscal year 2001 budget (5) and further delineated in future budgets, prioritizing communication science as one critical mission of the NCI (5–8). The “extraordinary opportunity” designation was the launching pad for initiatives such as the Health Information National Trends Survey (HINTS), the Centers of Excellence in Cancer Communication Research (CECCR) P50 and P20 grant program, as well as investments in extramural research aimed at bridging the “digital divide” (9). The identification of cancer communication science as an “extraordinary opportunity” also led the NCI to invest heavily in scientific research that would advance health communication science against a backdrop of a rapidly changing array of media platforms (10). Just as important as the actual research funding, however, was the articulation of a need for communication science to improve outcomes in cancer prevention and control (11,12). This study provides an overview of cancer communication science funding from 2000 to 2012 and considers cancer communication science research priorities in the changing communication landscape. Of particular interest to social and behavioral scientists planning studies, this paper includes descriptive analyses of the most common funding mechanisms, NIH study sections that review most communication science grants, and the funding announcements that have been supportive of communication science. Methods We conducted an original analysis of all cancer communication science related grant applications submitted to the NCI in fiscal years 2000–2012. Portfolio Management Application, the grants portfolio management application used by the NCI’s Division of Cancer Control and Population Sciences (DCCPS), was used to extract administrative and financial characteristics of grants in the portfolio. We crafted a search term including 103 key words (Supplementary Appendix A, available online) associated with health communication science. We began by considering the referral guidelines for NCI’s Health Communication and Informatics Research Branch (HCIRB), the only NIH branch devoted to funding health communication science. In recognition of the transdisciplinary nature of communication science, the search included grants submitted to all NCI divisions, centers, programs, or branches. Approximately 90 000 Type 1, 2, and 3 grants were submitted to NCI during the period 2000–2012. The search was limited to grants in which NCI was the primary funding institute, and to new, competing, or competing supplemental grant applications (Types 1, 2, or 3). The gross number of grant applications retrieved with these criteria was 4212. From those, further exclusion criteria were implemented upon manual review (eg, animal models, molecular epidemiology; refer to Table 1 for examples) and supplemented with a manual review to ensure that all relevant large center grants (P and U mechanisms) had been also captured, for a final yield of 3307 applications meeting our initial criteria for the analysis. Table 1. Manual coding categories, definitions, examples, and results (N = 1013)*   Definition  Grant title example  N (%)  Cancer control continuum stage   Prevention  Health promotion to prevent cancer; may be interventions or studies of behaviors and behavioral determinants  An Anti-Smoking Video Game for Pre-adolescent Girls  236 (41.1%)   Detection  Grants to persuade audiences to engage in early cancer detection behaviors, or to understand role of communication in cancer screening promotion or behaviors  A Pap Test Intervention to Enhance Decision Making among Pacific Islander Women  150 (26.1%)   Diagnosis  Grants to gather, interpret, or communicate cancer diagnoses to patients and/or caregivers  Penn Center for Innovation in Personalized Breast Screening  16 (2.6%)   Treatment  Grants dealing with communication needs and effects during cancer treatment  Adjuvant Treatment Decision Making for Lung Cancer  103 (17.9%)   Survivorship  Grants dealing with communication needs and effects of cancer survivors; includes end-of-life  Cancer Survivors’ Information Seeking and Lifestyle Behaviors  99 (17.3%)   Cross-cutting  Covers all aspects of cancer control continuum  Breast Cancer Information in Magazines and Websites  44 (7.7%)   Not specified  Not specified or inferable from abstract    10 (1.7%)  Cancer site†   Breast      119 (20.7%)   Colorectal      91 (15.9%)   Cervix      47 (8.2%)   Prostate      43 (7.5%)   Lung‡      16 (2.8%)   Skin      14 (2.4%)   Gynecologic (excluding cervix)      12 (2.1%)   Other (anus, head/neck, leukemia/ lymphoma, myeloma, liver)      16 (2.8%)   Not specified      286 (49.8%)  Cancer risk factor†   Tobacco    Culturally Specific Interventions and Acculturation in African American Smokers  128 (22.3%)   Physical activity    Using Message Framing to Promote Physical Activity in Colorectal Cancer Survivors  48 (8.4%)   Diet    Individual and Contextual Factors Supporting Health Communication via Food Labels  42 (7.3%)   Obesity    Reducing Television Viewing to Prevent Obesity in Hispanic Preschool Children  29 (5.1%)   Virus (HPV, HBV, HIV)    Using Maternal Cancer Screening Visits to Improve Adolescent HPV Vaccination  29 (5.1%)   Genetics    A Web Tutor to Help Women Decide About Testing for Genetic Breast Cancer Risk  17 (3.0%)   UV exposure    Sun Safe Workplaces: A Campaign on Sun Protection Policies for Outdoor Workers  13 (2.3%)   Other (environment, alcohol, tamoxifen)    Tamoxifen Education for Women at Risk for Breast Cancer  3 (0.5%)   Not specified    Intervention to Improve End-of-Life Care for Latinos  330 (57.5%)  Exclusions§   Bench science  Mouse or other animal models; laboratory science  Modeling Breast Carcinoma In Situ: Implications for Prevention and Control     Cancer center support  General cancer center support, core administrative center support  Enhanced Low Animal Tumor Registry Database System     Basic epidemiology  Molecular, genetic epidemiology  Appalachia Community Cancer Network     Methods  Studies evaluating methods with no direct application to human and/or to population studies  Genetic Epidemiology of Osteosarcoma      Definition  Grant title example  N (%)  Cancer control continuum stage   Prevention  Health promotion to prevent cancer; may be interventions or studies of behaviors and behavioral determinants  An Anti-Smoking Video Game for Pre-adolescent Girls  236 (41.1%)   Detection  Grants to persuade audiences to engage in early cancer detection behaviors, or to understand role of communication in cancer screening promotion or behaviors  A Pap Test Intervention to Enhance Decision Making among Pacific Islander Women  150 (26.1%)   Diagnosis  Grants to gather, interpret, or communicate cancer diagnoses to patients and/or caregivers  Penn Center for Innovation in Personalized Breast Screening  16 (2.6%)   Treatment  Grants dealing with communication needs and effects during cancer treatment  Adjuvant Treatment Decision Making for Lung Cancer  103 (17.9%)   Survivorship  Grants dealing with communication needs and effects of cancer survivors; includes end-of-life  Cancer Survivors’ Information Seeking and Lifestyle Behaviors  99 (17.3%)   Cross-cutting  Covers all aspects of cancer control continuum  Breast Cancer Information in Magazines and Websites  44 (7.7%)   Not specified  Not specified or inferable from abstract    10 (1.7%)  Cancer site†   Breast      119 (20.7%)   Colorectal      91 (15.9%)   Cervix      47 (8.2%)   Prostate      43 (7.5%)   Lung‡      16 (2.8%)   Skin      14 (2.4%)   Gynecologic (excluding cervix)      12 (2.1%)   Other (anus, head/neck, leukemia/ lymphoma, myeloma, liver)      16 (2.8%)   Not specified      286 (49.8%)  Cancer risk factor†   Tobacco    Culturally Specific Interventions and Acculturation in African American Smokers  128 (22.3%)   Physical activity    Using Message Framing to Promote Physical Activity in Colorectal Cancer Survivors  48 (8.4%)   Diet    Individual and Contextual Factors Supporting Health Communication via Food Labels  42 (7.3%)   Obesity    Reducing Television Viewing to Prevent Obesity in Hispanic Preschool Children  29 (5.1%)   Virus (HPV, HBV, HIV)    Using Maternal Cancer Screening Visits to Improve Adolescent HPV Vaccination  29 (5.1%)   Genetics    A Web Tutor to Help Women Decide About Testing for Genetic Breast Cancer Risk  17 (3.0%)   UV exposure    Sun Safe Workplaces: A Campaign on Sun Protection Policies for Outdoor Workers  13 (2.3%)   Other (environment, alcohol, tamoxifen)    Tamoxifen Education for Women at Risk for Breast Cancer  3 (0.5%)   Not specified    Intervention to Improve End-of-Life Care for Latinos  330 (57.5%)  Exclusions§   Bench science  Mouse or other animal models; laboratory science  Modeling Breast Carcinoma In Situ: Implications for Prevention and Control     Cancer center support  General cancer center support, core administrative center support  Enhanced Low Animal Tumor Registry Database System     Basic epidemiology  Molecular, genetic epidemiology  Appalachia Community Cancer Network     Methods  Studies evaluating methods with no direct application to human and/or to population studies  Genetic Epidemiology of Osteosarcoma    * HBV = hepatitis B virus; HPV = human papilloma virus; UV = ultraviolet. † Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all. ‡ Of the 327 grants that did not specify cancer site, 122 (42.7%) had tobacco as a risk factor. § Exclusions were eliminated from the counts at various points while creating the universe for analysis (Figure 1); however, some irrelevant articles remained after all manual and automatic exclusions. View Large Figure 1. View largeDownload slide Exclusion and inclusion criteria. 1Search term included 103 key words related to health communication and informatics. Limiting criteria included fiscal year of submission/award, type of grant (new application, supplement, and competing continuation), and NCI as primary sponsor institute. 2Administrative inclusions included all grants that were associated with grants that were retrieved with search term but did not include the search term (eg, parent grants). 3All titles retrieved were read and 637 were excluded due to irrelevance (eg, basic science or core cancer center support). An additional 187 grant titles were deemed potentially irrelevant and their abstracts were examined; 106 of these were excluded. 4Administrative exclusions included duplicate records retrieved and noncompetitive supplements. Noncompetitive supplements were excluded from the count of unique grants but the awarded funds were included in the funding totals reported. 5Abstracts from all funded grants were reviewed manually for coding. Of these, 332 (33%) were excluded for irrelevance and 107 (11%) for lack of abstract. Figure 1. View largeDownload slide Exclusion and inclusion criteria. 1Search term included 103 key words related to health communication and informatics. Limiting criteria included fiscal year of submission/award, type of grant (new application, supplement, and competing continuation), and NCI as primary sponsor institute. 2Administrative inclusions included all grants that were associated with grants that were retrieved with search term but did not include the search term (eg, parent grants). 3All titles retrieved were read and 637 were excluded due to irrelevance (eg, basic science or core cancer center support). An additional 187 grant titles were deemed potentially irrelevant and their abstracts were examined; 106 of these were excluded. 4Administrative exclusions included duplicate records retrieved and noncompetitive supplements. Noncompetitive supplements were excluded from the count of unique grants but the awarded funds were included in the funding totals reported. 5Abstracts from all funded grants were reviewed manually for coding. Of these, 332 (33%) were excluded for irrelevance and 107 (11%) for lack of abstract. Coding All applications were subjected to automatic coding to describe grant mechanism, funding status (awarded vs not awarded for any reason), and study section that reviewed the application. Abstracts of all awarded grants (n = 1013) were manually reviewed to determine relevance to cancer communication; results revealed a total of 574 funded, relevant grants (Table 1). Those 574 funded grants comprise approximately 2% of the total Type 1, 2, and 3 NCI grants awarded (approximately 29 650) during that time period. Three trained coders reviewed the 574 funded, cancer communication science grant abstracts to code for cancer stage, risk factor, and cancer site. Twenty percent of all grants were double coded (n = 200); intercoder reliability was high [92% for theme, 90% for stage, and 100% for risk factor and cancer site; (13)]. Pairs of coders reconciled their differences in nearly all cases; in the few instances where agreement could not be reached after discussion, a third coder coded the grant. Consensus was reached among all three coders in those cases. Results Characterizing Communication Science Grant Applications The 3307 grant applications that met our initial criteria were characterized according to grant mechanism, funding announcement, and NIH scientific review study section. The most popular grant mechanisms for communication science applications were R01, R21, and R03, respectively, accounting for 61.7% of all applications in our dataset (Figure 2). Most applications were investigator-initiated proposals to the parent R01 announcement, as well as broad funding opportunities for behavioral science (Supplementary Figure 1, available online). Among funding opportunity announcements generating the most communication science proposals, specific topics surrounding health disparities, decision making, and health literacy received significant numbers of proposals. Figure 2. View largeDownload slide Communication science applications to the National Cancer Institute by mechanism, 2000–2012. Figure 2. View largeDownload slide Communication science applications to the National Cancer Institute by mechanism, 2000–2012. With regard to where communication science grants are reviewed, the most common scientific review study section was Risk, Prevention, and Health Behavior (RPHB), where twice as many communication science grants as any other single study section were reviewed (Supplementary Figure 2, available online). Substantial numbers of communication science grants were also reviewed in Community-Level Health Promotion (CLHP), Behavioral Medicine, Interventions, and Outcomes (BMIO), Subcommittee G—Education, Health Services Organization and Delivery (HSOD), and Community Influences on Health Behavior (CIHB) (Supplementary Figure 2, available online). Characterizing Awarded Communication Science Grants—by Cancer Control Continuum Stage, Cancer Site, and Risk Factor—Including Trend Information Among risk factors associated with cancer, tobacco was the topic of investigation for the majority of funded grants related to cancer communication (22%). This reflects the composition of the overall NCI behavioral research portfolio (Table 1 and Figure 3). Across the cancer control continuum, the majority of awarded grants focused on prevention (41%), followed by detection (26%) (Table 1 and Figure 4). In terms of cancer sites, breast and colorectal cancers received the highest number of funded communication research grants from 2000 to 2012. Overall, our data point to variation in the portfolio’s mix of awarded grants by cancer risk factor and cancer control continuum area over the past 12 years (Figures 3 and 4). Figure 3. View largeDownload slide Trends in cancer risk factors addressed in communication science awarded grants, 2000–2012. Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all (see Table 1 for additional coding details). Figure 3. View largeDownload slide Trends in cancer risk factors addressed in communication science awarded grants, 2000–2012. Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all (see Table 1 for additional coding details). Figure 4. View largeDownload slide Trends in cancer control continuum stage addressed in communication science awarded grants, 2000–2012. Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all (see Table 1 for additional coding details). Cross-cutting grants addressed all stages of the cancer control continuum. Figure 4. View largeDownload slide Trends in cancer control continuum stage addressed in communication science awarded grants, 2000–2012. Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all (see Table 1 for additional coding details). Cross-cutting grants addressed all stages of the cancer control continuum. It is important to point out that many grants included in the analysis would not appear solely to be communication science grants per se, but do feature communication science prominently among their research questions and hypotheses. For example, patient navigator programs, projects that use mass media channels for community outreach and education, and individually or culturally tailored behavior change interventions qualified as communication science research for the purpose of this analysis. This breadth of scope is reflected in the diversity of administrative holdings across NCI: Just 59.0% (n = 339) of the 574 funded grants that met our inclusion criteria are held in the Behavioral Research Program of the Division of Cancer Control and Population Sciences (DCCPS) portfolio; the rest are spread across other programs within DCCPS, the Office of the Director of the NCI, and the Division of Cancer Prevention (data not shown). Further, the inclusion of communication science as a central component of many types of investigations represented in the portfolio points to the designation of communication as a cross-cutting theme within the cancer control continuum. Discussion Cancer communication funding support from the NCI has been an important source of growth for the field of health communication research. The findings from our analysis describe where NCI’s investment in cancer communication science has been focused and suggest key areas for future investments. We found substantial evidence of cancer communication science being done as part of noncommunication-based projects, and in fact, these grants are spread across the NCI portfolio. On the one hand, this is an indicator of the centrality of communication processes across the cancer enterprise. On the other hand, it also points to opportunities for communication scientists to partner more directly with other scientists to accelerate diffusion of cancer knowledge across areas of specialization. The “diffusion of innovations”—in this case, the diffusion of evidence-based treatments in cancer care and knowledge in preventive oncology as mandated by the National Cancer Act of 1971—is itself a communication problem (14,15). By combining the expertise and methodologies of communication scientists with the systems focus of health systems researchers, for example, it should be possible to overcome some of the more intractable obstacles that have been preventing an equitable diffusion of evidence-based practices across systems of care. Moreover, by taking full advantage of the diffusion of health communication technologies, such as those associated with the adoption of electronic health records in clinical settings or mobile health technologies in the consumer sector, it should be possible to engineer evidence-based communication practices into the implementation and improvement of practice across the cancer control continuum (15–17). In our analyses, only seven funded grants that met our inclusion criteria for communication science were submitted in response to NIH’s existing Dissemination and Implementation funding announcements, from which NCI has funded a total of 36 grants and 19 supplements/competitive revisions to date (data not shown). Given the centrality of communication processes to diffusion and implementation success, it may be reasonable to expect that new opportunities for funding communication science through translational science funding mechanisms in the future (18). Finally, our analyses uncovered a preference for communication science conceptualized as interventions (eg, message design, risk communication, and health literacy promotion targeting consumers and patients at the individual level), and to a lesser extent, in support of clinical care (such as patient–provider communication and health-care decision making). This preference for research investigating individual-level, often interpersonal communication interventions, although important, does not encompass the broader understanding of health communication, wherein exposure to health information from the public information environment is conceptualized as having multiple levels of influence on health behavior and health policy (19). In fact, largely neglected in research funding has been the area of media and health journalism research, which influences cancer communication at both individual and policy levels, and may be leveraged to improve cancer control outcomes (20). Expanding research in these areas is especially warranted in light of two important and converging trends: 1) the increasing demand on individuals to participate in medical and prevention-related decision making and 2) the increasing complexity of the health information environment (11,21,22). Limitations This analysis is limited by the high rate of irrelevant grants retrieved (ie, those not about cancer communication science), even after automated and manual exclusions. This limitation is a direct result of our a priori decision to be more inclusive in our search. Because of this limitation, we cannot make definitive statements about funding rates. Additionally, we are mindful that communication theory and processes relevant to cancer control may have been funded by other NIH institutes or centers, and NIH-wide funding is not captured in the present analysis of NCI grants. This review characterized NCI’s investment in cancer communication research over the past 12 years; however, we stopped short of describing what that investment has yielded (readers may be interested in visiting the DCCPS website for a log of active and archived funded grants and related publications [http://maps. cancer.gov/overview/index.jsp], although this would not include the non-DCCPS grants included in this review). It will be worthwhile to examine the knowledge produced by this crucial investment in cancer communication science, and, importantly for the future of the field of cancer prevention and control, to know where key knowledge gaps continue to exist. References 1. Ratzan SC . Health communication grows in significance—the 100th issue. J Health Commun . 2012; 17( 1): 1– 3. Google Scholar CrossRef Search ADS   2. Hiatt RA Rimer BK . A new strategy for cancer control research. Cancer Epidemiol Biomarkers Prev . 1999; 8( 11): 957– 964. Google Scholar PubMed  3. Advisory Committee on Cancer Control. Bridging research to action: a framework and decision making process for cancer control. Can Med Assoc J . 1994; 151( 8): 1141– 1146. Google Scholar 4. Nelson DE Kreps GL Hesse BW et al.   The Health Information National Trends Survey (HINTS): development, design, and dissemination. J Health Commun . 2004; 9( 5): 443– 460; discussion 81-4. Google Scholar CrossRef Search ADS PubMed  5. National Cancer Institute. The Nation’s Investment in Cancer Research: A Budget Proposal for Fiscal Year 2000 . Washington, DC: U.S. Department of Health and Human Services; 1999. Google Scholar 6. Kreps G Viswanath K . Communication interventions and cancer control: a review of the National Cancer Institute’s health communication intervention research initiative. Fam Community Health . 2001; 24( 3): ix– xiii. Google Scholar CrossRef Search ADS PubMed  7. National Cancer Institute. The Nation’s Investment in Cancer Research: A Budget Proposal for Fiscal Year 2001 . Washington, DC: U.S. Department of Health and Human Services; 2000. Google Scholar 8. National Cancer Institute. The Nation’s Investment in Cancer Research: A Budget Proposal for Fiscal Year 2002 . Washington, DC: U.S. Department of Health and Human Services; 2001. Google Scholar 9. Kreps GL Gustafson D Salovey P et al.   The NCI Digital Divide Pilot Projects: implications for cancer education. J Cancer Educ . 2007; 22( 1 suppl): S56– S60. Google Scholar CrossRef Search ADS PubMed  10. Hesse BW . Harnessing the power of an intelligent health environment in cancer control. Stud Health Technol Inform . 2005; 118: 159– 176. Google Scholar PubMed  11. Umar A Dunn BK Greenwald P . Future directions in cancer prevention. Nat Rev Cancer . 2012; 12( 12): 835– 848. Google Scholar CrossRef Search ADS PubMed  12. Cancer Center Directors Working Group. Accelerating Successes Against Cancer . Washington, DC: U.S. Department of Health and Human Services; 2006. Google Scholar 13. Neuendorf KA . The Content Analysis Guidebook . Thousand Oaks, CA: Sage Publications; 2002. 14. Rogers EM . Diffusion of Innovations . 5th ed. New York, NY: Free Press; 2003. 15. Dearing JW Kreuter MW . Designing for diffusion: how can we increase uptake of cancer communication innovations? Patient Educ Couns . 2010; 81: S100– S110. Google Scholar CrossRef Search ADS PubMed  16. Bernhardt JM Mays D Kreuter MW . Dissemination 2.0: closing the gap between knowledge and practice with new media and marketing. J Health Commun . 2012; 16( suppl 1): 32– 44. Google Scholar CrossRef Search ADS   17. Olsen L Saunders RS McGinnis JM , eds; Institute of Medicine. Patients Charting the Course: Citizen Engagement and the Learning Health System: Workshop Summary . Washington, DC: National Academies Press; 2011. 18. Glasgow RE Vinson C Chambers D Khoury MJ Kaplan RM Hunter C . National Institutes of Health approaches to dissemination and implementation science: current and future directions. Am J Public Health . 2012; 102( 7): 1274– 1281. Google Scholar CrossRef Search ADS PubMed  19. Frieden TR . A framework for public health action: the health impact pyramid. Am J Public Health . 2010; 100( 4): 590– 595. Google Scholar CrossRef Search ADS PubMed  20. Viswanath K Blake KD Meissner HI et al.   Occupational practices and the making of health news: a national survey of US Health and medical science journalists. J Health Commun . 2008; 13( 8): 759– 777. Google Scholar CrossRef Search ADS PubMed  21. Ramírez AS Freres D Martinez LS et al.   Information seeking from media and family/friends increases the likelihood of engaging in healthy lifestyle behaviors. J Health Commun . 2013; 18( 5): 527– 542. Google Scholar CrossRef Search ADS PubMed  22. Kris MA Meropol NJ Winer EP . Accelerating Progress Against Cancer: ASCO’s Blueprint for Transforming Clinical and Translational Cancer Research . Alexandria, VA: American Society of Clinical Oncology; 2011. Published by Oxford University Press 2013. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JNCI Monographs Oxford University Press

Cancer Communication Science Funding Trends, 2000–2012

Download PDF
7 pages

Loading next page...
 
/lp/oxford-university-press/cancer-communication-science-funding-trends-2000-2012-jeIXl6egGS

References (17)

Publisher
Oxford University Press
Copyright
Published by Oxford University Press 2013.
Subject
Article
ISSN
1052-6773
eISSN
1745-6614
DOI
10.1093/jncimonographs/lgt030
pmid
24395982
Publisher site
See Article on Publisher Site

Abstract

Abstract Background Since 2000, the field of health communication has grown tremendously, owing largely to research funding by the National Cancer Institute (NCI). This study provides an overview of cancer communication science funding trends in the past decade. Methods We conducted an analysis of communication-related grant applications submitted to the NCI in fiscal years 2000–2012. Using 103 keywords related to health communication, data were extracted from the Portfolio Management Application, a grants management application used at NCI. Automated coding described key grant characteristics such as mechanism and review study section. Manual coding determined funding across the cancer control continuum, by cancer site, and by cancer risk factors. Results A total of 3307 unique grant applications met initial inclusion criteria; 1013 of these were funded over the 12-year period. The top funded grant mechanisms were the R01, R21, and R03. Applications were largely investigator-initiated proposals as opposed to responses to particular funding opportunity announcements. Among funded communication research, the top risk factor being studied was tobacco, and across the cancer control continuum, cancer prevention was the most common stage investigated. Conclusions NCI support of cancer communication research has been an important source of growth for health communication science over the last 12 years. The analysis’ findings describe NCI’s priorities in cancer communication science and suggest areas for future investments. Since 2000, the fields of both health communication science and health communication practice have grown tremendously (1), in large part owing to advances in cancer communication science funded by the National Cancer Institute (NCI). A 1999 review article published in Cancer Epidemiology, Biomarkers & Prevention (2) outlined a framework for cancer prevention and control that recognized behavior as a major determinant of outcomes in cancer control and stated that cancer-related behaviors are inherently multifactorial in nature. The review article, which built upon a framework for research activity adopted by the Advisory Committee on Cancer Control of the National Cancer Institute of Canada (3), launched a proscribed set of initiatives by the NCI, designed to advance the science of cancer control through fundamental research (ie, basic science), surveillance, knowledge synthesis, and program delivery (4). Chief among those activities was an “Extraordinary Opportunity in Cancer Communication,” as initially identified in the NCI’s fiscal year 2001 budget (5) and further delineated in future budgets, prioritizing communication science as one critical mission of the NCI (5–8). The “extraordinary opportunity” designation was the launching pad for initiatives such as the Health Information National Trends Survey (HINTS), the Centers of Excellence in Cancer Communication Research (CECCR) P50 and P20 grant program, as well as investments in extramural research aimed at bridging the “digital divide” (9). The identification of cancer communication science as an “extraordinary opportunity” also led the NCI to invest heavily in scientific research that would advance health communication science against a backdrop of a rapidly changing array of media platforms (10). Just as important as the actual research funding, however, was the articulation of a need for communication science to improve outcomes in cancer prevention and control (11,12). This study provides an overview of cancer communication science funding from 2000 to 2012 and considers cancer communication science research priorities in the changing communication landscape. Of particular interest to social and behavioral scientists planning studies, this paper includes descriptive analyses of the most common funding mechanisms, NIH study sections that review most communication science grants, and the funding announcements that have been supportive of communication science. Methods We conducted an original analysis of all cancer communication science related grant applications submitted to the NCI in fiscal years 2000–2012. Portfolio Management Application, the grants portfolio management application used by the NCI’s Division of Cancer Control and Population Sciences (DCCPS), was used to extract administrative and financial characteristics of grants in the portfolio. We crafted a search term including 103 key words (Supplementary Appendix A, available online) associated with health communication science. We began by considering the referral guidelines for NCI’s Health Communication and Informatics Research Branch (HCIRB), the only NIH branch devoted to funding health communication science. In recognition of the transdisciplinary nature of communication science, the search included grants submitted to all NCI divisions, centers, programs, or branches. Approximately 90 000 Type 1, 2, and 3 grants were submitted to NCI during the period 2000–2012. The search was limited to grants in which NCI was the primary funding institute, and to new, competing, or competing supplemental grant applications (Types 1, 2, or 3). The gross number of grant applications retrieved with these criteria was 4212. From those, further exclusion criteria were implemented upon manual review (eg, animal models, molecular epidemiology; refer to Table 1 for examples) and supplemented with a manual review to ensure that all relevant large center grants (P and U mechanisms) had been also captured, for a final yield of 3307 applications meeting our initial criteria for the analysis. Table 1. Manual coding categories, definitions, examples, and results (N = 1013)*   Definition  Grant title example  N (%)  Cancer control continuum stage   Prevention  Health promotion to prevent cancer; may be interventions or studies of behaviors and behavioral determinants  An Anti-Smoking Video Game for Pre-adolescent Girls  236 (41.1%)   Detection  Grants to persuade audiences to engage in early cancer detection behaviors, or to understand role of communication in cancer screening promotion or behaviors  A Pap Test Intervention to Enhance Decision Making among Pacific Islander Women  150 (26.1%)   Diagnosis  Grants to gather, interpret, or communicate cancer diagnoses to patients and/or caregivers  Penn Center for Innovation in Personalized Breast Screening  16 (2.6%)   Treatment  Grants dealing with communication needs and effects during cancer treatment  Adjuvant Treatment Decision Making for Lung Cancer  103 (17.9%)   Survivorship  Grants dealing with communication needs and effects of cancer survivors; includes end-of-life  Cancer Survivors’ Information Seeking and Lifestyle Behaviors  99 (17.3%)   Cross-cutting  Covers all aspects of cancer control continuum  Breast Cancer Information in Magazines and Websites  44 (7.7%)   Not specified  Not specified or inferable from abstract    10 (1.7%)  Cancer site†   Breast      119 (20.7%)   Colorectal      91 (15.9%)   Cervix      47 (8.2%)   Prostate      43 (7.5%)   Lung‡      16 (2.8%)   Skin      14 (2.4%)   Gynecologic (excluding cervix)      12 (2.1%)   Other (anus, head/neck, leukemia/ lymphoma, myeloma, liver)      16 (2.8%)   Not specified      286 (49.8%)  Cancer risk factor†   Tobacco    Culturally Specific Interventions and Acculturation in African American Smokers  128 (22.3%)   Physical activity    Using Message Framing to Promote Physical Activity in Colorectal Cancer Survivors  48 (8.4%)   Diet    Individual and Contextual Factors Supporting Health Communication via Food Labels  42 (7.3%)   Obesity    Reducing Television Viewing to Prevent Obesity in Hispanic Preschool Children  29 (5.1%)   Virus (HPV, HBV, HIV)    Using Maternal Cancer Screening Visits to Improve Adolescent HPV Vaccination  29 (5.1%)   Genetics    A Web Tutor to Help Women Decide About Testing for Genetic Breast Cancer Risk  17 (3.0%)   UV exposure    Sun Safe Workplaces: A Campaign on Sun Protection Policies for Outdoor Workers  13 (2.3%)   Other (environment, alcohol, tamoxifen)    Tamoxifen Education for Women at Risk for Breast Cancer  3 (0.5%)   Not specified    Intervention to Improve End-of-Life Care for Latinos  330 (57.5%)  Exclusions§   Bench science  Mouse or other animal models; laboratory science  Modeling Breast Carcinoma In Situ: Implications for Prevention and Control     Cancer center support  General cancer center support, core administrative center support  Enhanced Low Animal Tumor Registry Database System     Basic epidemiology  Molecular, genetic epidemiology  Appalachia Community Cancer Network     Methods  Studies evaluating methods with no direct application to human and/or to population studies  Genetic Epidemiology of Osteosarcoma      Definition  Grant title example  N (%)  Cancer control continuum stage   Prevention  Health promotion to prevent cancer; may be interventions or studies of behaviors and behavioral determinants  An Anti-Smoking Video Game for Pre-adolescent Girls  236 (41.1%)   Detection  Grants to persuade audiences to engage in early cancer detection behaviors, or to understand role of communication in cancer screening promotion or behaviors  A Pap Test Intervention to Enhance Decision Making among Pacific Islander Women  150 (26.1%)   Diagnosis  Grants to gather, interpret, or communicate cancer diagnoses to patients and/or caregivers  Penn Center for Innovation in Personalized Breast Screening  16 (2.6%)   Treatment  Grants dealing with communication needs and effects during cancer treatment  Adjuvant Treatment Decision Making for Lung Cancer  103 (17.9%)   Survivorship  Grants dealing with communication needs and effects of cancer survivors; includes end-of-life  Cancer Survivors’ Information Seeking and Lifestyle Behaviors  99 (17.3%)   Cross-cutting  Covers all aspects of cancer control continuum  Breast Cancer Information in Magazines and Websites  44 (7.7%)   Not specified  Not specified or inferable from abstract    10 (1.7%)  Cancer site†   Breast      119 (20.7%)   Colorectal      91 (15.9%)   Cervix      47 (8.2%)   Prostate      43 (7.5%)   Lung‡      16 (2.8%)   Skin      14 (2.4%)   Gynecologic (excluding cervix)      12 (2.1%)   Other (anus, head/neck, leukemia/ lymphoma, myeloma, liver)      16 (2.8%)   Not specified      286 (49.8%)  Cancer risk factor†   Tobacco    Culturally Specific Interventions and Acculturation in African American Smokers  128 (22.3%)   Physical activity    Using Message Framing to Promote Physical Activity in Colorectal Cancer Survivors  48 (8.4%)   Diet    Individual and Contextual Factors Supporting Health Communication via Food Labels  42 (7.3%)   Obesity    Reducing Television Viewing to Prevent Obesity in Hispanic Preschool Children  29 (5.1%)   Virus (HPV, HBV, HIV)    Using Maternal Cancer Screening Visits to Improve Adolescent HPV Vaccination  29 (5.1%)   Genetics    A Web Tutor to Help Women Decide About Testing for Genetic Breast Cancer Risk  17 (3.0%)   UV exposure    Sun Safe Workplaces: A Campaign on Sun Protection Policies for Outdoor Workers  13 (2.3%)   Other (environment, alcohol, tamoxifen)    Tamoxifen Education for Women at Risk for Breast Cancer  3 (0.5%)   Not specified    Intervention to Improve End-of-Life Care for Latinos  330 (57.5%)  Exclusions§   Bench science  Mouse or other animal models; laboratory science  Modeling Breast Carcinoma In Situ: Implications for Prevention and Control     Cancer center support  General cancer center support, core administrative center support  Enhanced Low Animal Tumor Registry Database System     Basic epidemiology  Molecular, genetic epidemiology  Appalachia Community Cancer Network     Methods  Studies evaluating methods with no direct application to human and/or to population studies  Genetic Epidemiology of Osteosarcoma    * HBV = hepatitis B virus; HPV = human papilloma virus; UV = ultraviolet. † Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all. ‡ Of the 327 grants that did not specify cancer site, 122 (42.7%) had tobacco as a risk factor. § Exclusions were eliminated from the counts at various points while creating the universe for analysis (Figure 1); however, some irrelevant articles remained after all manual and automatic exclusions. View Large Figure 1. View largeDownload slide Exclusion and inclusion criteria. 1Search term included 103 key words related to health communication and informatics. Limiting criteria included fiscal year of submission/award, type of grant (new application, supplement, and competing continuation), and NCI as primary sponsor institute. 2Administrative inclusions included all grants that were associated with grants that were retrieved with search term but did not include the search term (eg, parent grants). 3All titles retrieved were read and 637 were excluded due to irrelevance (eg, basic science or core cancer center support). An additional 187 grant titles were deemed potentially irrelevant and their abstracts were examined; 106 of these were excluded. 4Administrative exclusions included duplicate records retrieved and noncompetitive supplements. Noncompetitive supplements were excluded from the count of unique grants but the awarded funds were included in the funding totals reported. 5Abstracts from all funded grants were reviewed manually for coding. Of these, 332 (33%) were excluded for irrelevance and 107 (11%) for lack of abstract. Figure 1. View largeDownload slide Exclusion and inclusion criteria. 1Search term included 103 key words related to health communication and informatics. Limiting criteria included fiscal year of submission/award, type of grant (new application, supplement, and competing continuation), and NCI as primary sponsor institute. 2Administrative inclusions included all grants that were associated with grants that were retrieved with search term but did not include the search term (eg, parent grants). 3All titles retrieved were read and 637 were excluded due to irrelevance (eg, basic science or core cancer center support). An additional 187 grant titles were deemed potentially irrelevant and their abstracts were examined; 106 of these were excluded. 4Administrative exclusions included duplicate records retrieved and noncompetitive supplements. Noncompetitive supplements were excluded from the count of unique grants but the awarded funds were included in the funding totals reported. 5Abstracts from all funded grants were reviewed manually for coding. Of these, 332 (33%) were excluded for irrelevance and 107 (11%) for lack of abstract. Coding All applications were subjected to automatic coding to describe grant mechanism, funding status (awarded vs not awarded for any reason), and study section that reviewed the application. Abstracts of all awarded grants (n = 1013) were manually reviewed to determine relevance to cancer communication; results revealed a total of 574 funded, relevant grants (Table 1). Those 574 funded grants comprise approximately 2% of the total Type 1, 2, and 3 NCI grants awarded (approximately 29 650) during that time period. Three trained coders reviewed the 574 funded, cancer communication science grant abstracts to code for cancer stage, risk factor, and cancer site. Twenty percent of all grants were double coded (n = 200); intercoder reliability was high [92% for theme, 90% for stage, and 100% for risk factor and cancer site; (13)]. Pairs of coders reconciled their differences in nearly all cases; in the few instances where agreement could not be reached after discussion, a third coder coded the grant. Consensus was reached among all three coders in those cases. Results Characterizing Communication Science Grant Applications The 3307 grant applications that met our initial criteria were characterized according to grant mechanism, funding announcement, and NIH scientific review study section. The most popular grant mechanisms for communication science applications were R01, R21, and R03, respectively, accounting for 61.7% of all applications in our dataset (Figure 2). Most applications were investigator-initiated proposals to the parent R01 announcement, as well as broad funding opportunities for behavioral science (Supplementary Figure 1, available online). Among funding opportunity announcements generating the most communication science proposals, specific topics surrounding health disparities, decision making, and health literacy received significant numbers of proposals. Figure 2. View largeDownload slide Communication science applications to the National Cancer Institute by mechanism, 2000–2012. Figure 2. View largeDownload slide Communication science applications to the National Cancer Institute by mechanism, 2000–2012. With regard to where communication science grants are reviewed, the most common scientific review study section was Risk, Prevention, and Health Behavior (RPHB), where twice as many communication science grants as any other single study section were reviewed (Supplementary Figure 2, available online). Substantial numbers of communication science grants were also reviewed in Community-Level Health Promotion (CLHP), Behavioral Medicine, Interventions, and Outcomes (BMIO), Subcommittee G—Education, Health Services Organization and Delivery (HSOD), and Community Influences on Health Behavior (CIHB) (Supplementary Figure 2, available online). Characterizing Awarded Communication Science Grants—by Cancer Control Continuum Stage, Cancer Site, and Risk Factor—Including Trend Information Among risk factors associated with cancer, tobacco was the topic of investigation for the majority of funded grants related to cancer communication (22%). This reflects the composition of the overall NCI behavioral research portfolio (Table 1 and Figure 3). Across the cancer control continuum, the majority of awarded grants focused on prevention (41%), followed by detection (26%) (Table 1 and Figure 4). In terms of cancer sites, breast and colorectal cancers received the highest number of funded communication research grants from 2000 to 2012. Overall, our data point to variation in the portfolio’s mix of awarded grants by cancer risk factor and cancer control continuum area over the past 12 years (Figures 3 and 4). Figure 3. View largeDownload slide Trends in cancer risk factors addressed in communication science awarded grants, 2000–2012. Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all (see Table 1 for additional coding details). Figure 3. View largeDownload slide Trends in cancer risk factors addressed in communication science awarded grants, 2000–2012. Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all (see Table 1 for additional coding details). Figure 4. View largeDownload slide Trends in cancer control continuum stage addressed in communication science awarded grants, 2000–2012. Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all (see Table 1 for additional coding details). Cross-cutting grants addressed all stages of the cancer control continuum. Figure 4. View largeDownload slide Trends in cancer control continuum stage addressed in communication science awarded grants, 2000–2012. Cancer site and risk factor are not mutually exclusive, and neither is required, so that individual grants may have addressed multiple cancer sites and/or risk factors, or none at all (see Table 1 for additional coding details). Cross-cutting grants addressed all stages of the cancer control continuum. It is important to point out that many grants included in the analysis would not appear solely to be communication science grants per se, but do feature communication science prominently among their research questions and hypotheses. For example, patient navigator programs, projects that use mass media channels for community outreach and education, and individually or culturally tailored behavior change interventions qualified as communication science research for the purpose of this analysis. This breadth of scope is reflected in the diversity of administrative holdings across NCI: Just 59.0% (n = 339) of the 574 funded grants that met our inclusion criteria are held in the Behavioral Research Program of the Division of Cancer Control and Population Sciences (DCCPS) portfolio; the rest are spread across other programs within DCCPS, the Office of the Director of the NCI, and the Division of Cancer Prevention (data not shown). Further, the inclusion of communication science as a central component of many types of investigations represented in the portfolio points to the designation of communication as a cross-cutting theme within the cancer control continuum. Discussion Cancer communication funding support from the NCI has been an important source of growth for the field of health communication research. The findings from our analysis describe where NCI’s investment in cancer communication science has been focused and suggest key areas for future investments. We found substantial evidence of cancer communication science being done as part of noncommunication-based projects, and in fact, these grants are spread across the NCI portfolio. On the one hand, this is an indicator of the centrality of communication processes across the cancer enterprise. On the other hand, it also points to opportunities for communication scientists to partner more directly with other scientists to accelerate diffusion of cancer knowledge across areas of specialization. The “diffusion of innovations”—in this case, the diffusion of evidence-based treatments in cancer care and knowledge in preventive oncology as mandated by the National Cancer Act of 1971—is itself a communication problem (14,15). By combining the expertise and methodologies of communication scientists with the systems focus of health systems researchers, for example, it should be possible to overcome some of the more intractable obstacles that have been preventing an equitable diffusion of evidence-based practices across systems of care. Moreover, by taking full advantage of the diffusion of health communication technologies, such as those associated with the adoption of electronic health records in clinical settings or mobile health technologies in the consumer sector, it should be possible to engineer evidence-based communication practices into the implementation and improvement of practice across the cancer control continuum (15–17). In our analyses, only seven funded grants that met our inclusion criteria for communication science were submitted in response to NIH’s existing Dissemination and Implementation funding announcements, from which NCI has funded a total of 36 grants and 19 supplements/competitive revisions to date (data not shown). Given the centrality of communication processes to diffusion and implementation success, it may be reasonable to expect that new opportunities for funding communication science through translational science funding mechanisms in the future (18). Finally, our analyses uncovered a preference for communication science conceptualized as interventions (eg, message design, risk communication, and health literacy promotion targeting consumers and patients at the individual level), and to a lesser extent, in support of clinical care (such as patient–provider communication and health-care decision making). This preference for research investigating individual-level, often interpersonal communication interventions, although important, does not encompass the broader understanding of health communication, wherein exposure to health information from the public information environment is conceptualized as having multiple levels of influence on health behavior and health policy (19). In fact, largely neglected in research funding has been the area of media and health journalism research, which influences cancer communication at both individual and policy levels, and may be leveraged to improve cancer control outcomes (20). Expanding research in these areas is especially warranted in light of two important and converging trends: 1) the increasing demand on individuals to participate in medical and prevention-related decision making and 2) the increasing complexity of the health information environment (11,21,22). Limitations This analysis is limited by the high rate of irrelevant grants retrieved (ie, those not about cancer communication science), even after automated and manual exclusions. This limitation is a direct result of our a priori decision to be more inclusive in our search. Because of this limitation, we cannot make definitive statements about funding rates. Additionally, we are mindful that communication theory and processes relevant to cancer control may have been funded by other NIH institutes or centers, and NIH-wide funding is not captured in the present analysis of NCI grants. This review characterized NCI’s investment in cancer communication research over the past 12 years; however, we stopped short of describing what that investment has yielded (readers may be interested in visiting the DCCPS website for a log of active and archived funded grants and related publications [http://maps. cancer.gov/overview/index.jsp], although this would not include the non-DCCPS grants included in this review). It will be worthwhile to examine the knowledge produced by this crucial investment in cancer communication science, and, importantly for the future of the field of cancer prevention and control, to know where key knowledge gaps continue to exist. References 1. Ratzan SC . Health communication grows in significance—the 100th issue. J Health Commun . 2012; 17( 1): 1– 3. Google Scholar CrossRef Search ADS   2. Hiatt RA Rimer BK . A new strategy for cancer control research. Cancer Epidemiol Biomarkers Prev . 1999; 8( 11): 957– 964. Google Scholar PubMed  3. Advisory Committee on Cancer Control. Bridging research to action: a framework and decision making process for cancer control. Can Med Assoc J . 1994; 151( 8): 1141– 1146. Google Scholar 4. Nelson DE Kreps GL Hesse BW et al.   The Health Information National Trends Survey (HINTS): development, design, and dissemination. J Health Commun . 2004; 9( 5): 443– 460; discussion 81-4. Google Scholar CrossRef Search ADS PubMed  5. National Cancer Institute. The Nation’s Investment in Cancer Research: A Budget Proposal for Fiscal Year 2000 . Washington, DC: U.S. Department of Health and Human Services; 1999. Google Scholar 6. Kreps G Viswanath K . Communication interventions and cancer control: a review of the National Cancer Institute’s health communication intervention research initiative. Fam Community Health . 2001; 24( 3): ix– xiii. Google Scholar CrossRef Search ADS PubMed  7. National Cancer Institute. The Nation’s Investment in Cancer Research: A Budget Proposal for Fiscal Year 2001 . Washington, DC: U.S. Department of Health and Human Services; 2000. Google Scholar 8. National Cancer Institute. The Nation’s Investment in Cancer Research: A Budget Proposal for Fiscal Year 2002 . Washington, DC: U.S. Department of Health and Human Services; 2001. Google Scholar 9. Kreps GL Gustafson D Salovey P et al.   The NCI Digital Divide Pilot Projects: implications for cancer education. J Cancer Educ . 2007; 22( 1 suppl): S56– S60. Google Scholar CrossRef Search ADS PubMed  10. Hesse BW . Harnessing the power of an intelligent health environment in cancer control. Stud Health Technol Inform . 2005; 118: 159– 176. Google Scholar PubMed  11. Umar A Dunn BK Greenwald P . Future directions in cancer prevention. Nat Rev Cancer . 2012; 12( 12): 835– 848. Google Scholar CrossRef Search ADS PubMed  12. Cancer Center Directors Working Group. Accelerating Successes Against Cancer . Washington, DC: U.S. Department of Health and Human Services; 2006. Google Scholar 13. Neuendorf KA . The Content Analysis Guidebook . Thousand Oaks, CA: Sage Publications; 2002. 14. Rogers EM . Diffusion of Innovations . 5th ed. New York, NY: Free Press; 2003. 15. Dearing JW Kreuter MW . Designing for diffusion: how can we increase uptake of cancer communication innovations? Patient Educ Couns . 2010; 81: S100– S110. Google Scholar CrossRef Search ADS PubMed  16. Bernhardt JM Mays D Kreuter MW . Dissemination 2.0: closing the gap between knowledge and practice with new media and marketing. J Health Commun . 2012; 16( suppl 1): 32– 44. Google Scholar CrossRef Search ADS   17. Olsen L Saunders RS McGinnis JM , eds; Institute of Medicine. Patients Charting the Course: Citizen Engagement and the Learning Health System: Workshop Summary . Washington, DC: National Academies Press; 2011. 18. Glasgow RE Vinson C Chambers D Khoury MJ Kaplan RM Hunter C . National Institutes of Health approaches to dissemination and implementation science: current and future directions. Am J Public Health . 2012; 102( 7): 1274– 1281. Google Scholar CrossRef Search ADS PubMed  19. Frieden TR . A framework for public health action: the health impact pyramid. Am J Public Health . 2010; 100( 4): 590– 595. Google Scholar CrossRef Search ADS PubMed  20. Viswanath K Blake KD Meissner HI et al.   Occupational practices and the making of health news: a national survey of US Health and medical science journalists. J Health Commun . 2008; 13( 8): 759– 777. Google Scholar CrossRef Search ADS PubMed  21. Ramírez AS Freres D Martinez LS et al.   Information seeking from media and family/friends increases the likelihood of engaging in healthy lifestyle behaviors. J Health Commun . 2013; 18( 5): 527– 542. Google Scholar CrossRef Search ADS PubMed  22. Kris MA Meropol NJ Winer EP . Accelerating Progress Against Cancer: ASCO’s Blueprint for Transforming Clinical and Translational Cancer Research . Alexandria, VA: American Society of Clinical Oncology; 2011. Published by Oxford University Press 2013.

Journal

JNCI Monographs – Oxford University Press

Published: Dec 26, 2013

There are no references for this article.