TOWARDS LARGE-SCALE ADAPTION AND TAILORED IMPLEMENTATION OF EVIDENCE-BASED PRIMARY CANCER PREVENTION PROGRAMMES IN EUROPE AND BEYOND

The high and growing global burden of cancer urges the need for effective implementation of primary cancer prevention (PCP) programmes targeting modifiable risk factors. However, evidence-based programmes with proven effectiveness under controlled environments often fail when implemented in the real world due to ineffective adaptation and implementation strategies addressing context-specific barriers, leading to programme failures and public health inequities. The PIECES project will develop, assess, and disseminate a cancer-specific methodological implementation framework, the integrated PCP Implementation Toolkit (PCP-IT). PCP-IT will provide an evidence-informed systematic process for (1) identification, selection, and tailoring of PCP programmes, and (2) developing evidence-informed implementation strategies tailored to local barriers and constraints. The PCP-IT will include a comprehensive repository of PCP programmes, their Theories of Change, and materials for systematically adapting the programmes to local needs and cultural constraints. The project involves 16 consortium members and implementation sites from 10 countries of diverse socio-cultural backgrounds and access to up to 77.7 million inhabitants. PIECES provides an ideal naturalistic laboratory to improve and study the up-scaling and implementation of a wide range of primary PCP programmes targeting major risk factors: tobacco, alcohol, low physical activity, HPV infection, sun exposure, and diet. A multi-site case comparison study will be conducted to assess and optimise implementation outcomes. An in-depth realist evaluation using various sociological theories will be conducted to explain the processes by which the outcomes are achieved. The consortium will employ a high-level external Advisory Board with renowned experts, facilitate continuous engagement with stakeholders, and align with the EU and relevant scientific societies to ensure the future continuity of both the repository and PCP-IT. This action is part of the Cancer Mission cluster of projects on ‘Prevention and early detection’.