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NCI portfolio review finds few grants focused on sustainability of cancer control interventions
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Summary
A portfolio analysis of NCI‑funded implementation‑science grants (2017–2023) found that, while many grants examined factors affecting sustainability, relatively few explicitly measured sustainment or tested strategies to sustain interventions, highlighting research gaps in community/policy‑level determinants and experimental tests of sustainment strategies.
Maggie Mendez, a presenter on the National Cancer Institute webinar on sustainability research, presented a portfolio analysis of implementation‑science grants funded by the National Cancer Institute (NCI) between 2017 and 2023 that examined sustainment or sustainability of evidence‑based practices for cancer control.
Mendez said the analysis drew on two prior reviews: an NCI review of 71 awarded grants in which “only 7 studied sustainability,” and an NIH R01 review of U.S. projects (2004–2016) that found 51 projects referenced sustainability but only three focused on it exclusively. Building on those reports, the team assembled a final analytic sample of 72 grants that broadly captured maintenance, sustainment and sustainability measures.
Key findings included that 55 of the 72 grants proposed examining factors that affect sustainability (many using mixed methods), 40 proposed to measure sustainability outcomes, and only one grant proposed to experimentally evaluate the impact of a strategy (organizational champions) on sustainment of cancer screening programs. Mendez also reported that 31 grants planned to measure continuation of program activities, 17 planned to measure maintenance of organizational practices or policies, and five proposed to document adaptations and reasons for them.
The analysis captured proposals’ use of theories, models and frameworks to plan for sustainability and noted that most work focused on organizational, provider and patient/consumer levels while fewer studies proposed to examine community or policy‑level determinants. Mendez said all coded follow‑up timepoints (ranging from 12 to 24 months and beyond) will be reported in the team’s forthcoming publication.
The portfolio review identifies opportunities for future work: more explicit measurement of sustainment, increased attention to community and policy contexts, and more experimental tests of strategies to promote long‑term sustainment of cancer control interventions.
Mendez said the team is preparing a full paper with the coded variables and timing details and encouraged investigators to consider where measuring adaptations and longer follow‑up could fill gaps in the literature.
