Similar skills, different frames: a thematic analysis exploring conceptualizations held by community-based organization practitioners and academics regarding skills to use evidence-based interventions to address cancer inequities

Abstract

Background Community-based organizations (CBOs) are critical partners in delivering evidence-based interventions (EBIs) to address cancer inequities. However, CBO practitioners do not typically have access to opportunities to build the necessary capacity (skills, knowledge, motivation, and resources) for using EBIs. Although capacity-building interventions can offer a solution, inconsistent definitions and measurements of capacity limit the ability to develop and evaluate such efforts. We explored how and why conceptualizations of core skills for EBI use differ between practitioners and academics addressing cancer and other health inequities. We anchored the inquiry with a commonly used set of target skills for EBI capacity-building efforts. Methods The study was conducted by an interdisciplinary team of academic researchers and CBO practitioners. We gathered data through semi-structured, hour-long interviews with practitioners and academics working to address cancer and other health inequities (n = 19). After hearing a brief vignette about a CBO addressing cervical cancer inequities, participants considered a widely accepted list of skills for EBI use that included assessing needs, engaging stakeholders, and selecting, adapting, implementing, evaluating, and sustaining the EBI. We used a team-based, reflexive thematic analysis approach grounded in critical and constructivist perspectives. Results Overall, the original list resonated with practitioners and academics and they added new skills to the list (cultural humility and systems change). Practitioners’ responses described skills from the reference point of addressing broader community needs and context and achieving change over the long term, emphasizing aspects of health promotion in their descriptions. Academics offered a mix of perspectives, with some focused on addressing community needs (and related flexibility regarding EBIs) but more emphasized skills needed to deliver a specific EBI to achieve a focused set of health and equity outcomes. Conclusions There is a significant opportunity to leverage complementary expertise and perspectives held by practitioners and academics addressing cancer inequities. However, the different frames utilized suggest proactive efforts will be required to find alignment across groups, particularly in valuing diverse contributions and identifying relevant outcomes of interest for each group. Such alignment is critical to designing effective capacity-building interventions and supporting the routine utilization of EBIs to address cancer inequities.

Priority skills for equity-focused, evidence-based cancer control in community-based organizations: A group concept mapping analysis with academics and practitioners

“…This emphasis may reflect the inclusion of practitioners in this exercise. The formative work for this project and our early explorations of the data suggest that the five-cluster solution identified based on all participants’ data may mask important differences between academics and practitioners in their conceptualization of core skills and areas of need for capacity-building [ 11 ]. Similar to other group concept mapping studies involving academic and community groups [ 31 ], important distinctions in the conceptual thinking of the two subgroups may have implications for design, uptake, and sustainability of EBIs at the local level.…”

“…CBO practitioners grounded their discussions of skills in community needs and long-term health promotion goals. In contrast, academics tended to focus on the EBI and other system attributes related to the technology being transferred [ 11 ]. Over the last decade, our team and colleagues have repeatedly found that CBO practitioners and academics often understand research evidence, EBIs, and opportunities to build capacity for EBI use in meaningfully different ways [ 12 – 14 ].…”