(February 2, 2005) The American Cancer Society (ACS) aims to achieve a 50 percent reduction in cancer deaths, and a 25 percent reduction in new cases, by 2015. In order to reach these ambitious goals, ACS will need to develop stronger links in cancer control between researchers and practitioners. In a recent Prevention Dialogue sponsored by the Harvard Center for Cancer Prevention, Randy Schwartz discussed barriers to such collaboration and posed some potential solutions. Mr. Schwartz is the Senior Vice President of Cancer Control for the New England Division of ACS.

Barriers to collaboration
Despite longstanding concerns about the length of time required to translate research findings into practice, diffusion into community practice still takes an average of 17 years. Building partnerships between researchers and practitioners would allow for more rapid dissemination of clinical advances and preventive measures. Mr. Schwartz identified four gaps that are currently preventing such collaboration.

• The communication gap is a lack of shared language between researchers and practitioners that prevents identification of mutual priorities and joint definition of research questions.
• The access gap exists because practitioners in some parts of the country have little or no access to the public health community.
• The credibility gap occurs when practitioners discount the observations of researchers as unrealistic, and researchers discount the observations of practitioners as simplistic. Credibility doubts are a major barrier to collaboration between academic institutions and community practitioners.
• The expectation gap describes how the practitioners’ view of realistic practice falls below the standards of scientific rigor demanded by researchers.

Bridging the gaps
To eliminate these gaps, ACS has been calling for collaboration and interdependence among the many organizations that share common goals related to cancer control. Partnerships enable easier transitions between discovery, development, and delivery; they allow more individuals and communities to be served and also allow for more efficient use of resources.

A relatively new approach to collaboration between researchers and practitioners is community-based participatory research, in which communities themselves participate in the design of interventions and evaluations. This type of collaborative research leads to interventions that are likely to reflect the community’s needs, interests, and values, while still meeting the researchers’ rigorous demands.

Mr. Schwartz noted that the New England Division of ACS recently conducted 135 community assessments as part of a larger effort to create cancer-control community-action plans. Such evaluations, coupled with the collaboration of health systems, integrated community systems, and local government relations, represent crucial steps toward reducing the cancer burden. Collaborative efforts are central to accelerating dissemination of research findings beyond medical journals and into the communities where they are needed.

written by Anne Mobley