Since 2010, the Cancer Prevention and Research Institute of Texas (CPRIT) has funded 244 grants in eight areas of cancer prevention. While individual programs have reported various evaluation measures, there has not yet been an evaluation of the Prevention Program as a whole. As such, Texas Health Institute (THI) has designed the following proposal, in collaboration with The University of Texas MD Anderson Cancer Center in Houston, to answer key evaluation questions outlined in the CPRIT Prevention Program Assessment RFA. The proposed project uses a mixed-methods approach, combining quantitative and qualitative research techniques. It leverages THI's expertise in health equity and evaluation...

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Since 2010, the Cancer Prevention and Research Institute of Texas (CPRIT) has funded 244 grants in eight areas of cancer prevention. While individual programs have reported various evaluation measures, there has not yet been an evaluation of the Prevention Program as a whole. As such, Texas Health Institute (THI) has designed the following proposal, in collaboration with The University of Texas MD Anderson Cancer Center in Houston, to answer key evaluation questions outlined in the CPRIT Prevention Program Assessment RFA.

The proposed project uses a mixed-methods approach, combining quantitative and qualitative research techniques. It leverages THI's expertise in health equity and evaluation, along with its unique role as a neutral party that is dedicated to advancing the health of all Texans. The project also leverages MD Anderson's unparalleled expertise in cancer prevention in Texas, nationally, and internationally. The project will include an evaluability assessment, quantitative analysis of cancer-related health outcomes, surveys, key informant interviews, case studies, and a document review. Anticipated barriers and challenges include the possibility of incomplete grantee reports, difficulty contacting PI/PDs who may no longer have any engagement with CPRIT, hesitancy of PI/PDs to share contact information for survey recipients, and difficulty engaging community-level participants for focus groups. Texas Health Institute and MD Anderson have developed plans of action to address and mitigate these barriers. The mixed-methods design of this project, in concert with the expertise of both THI and MD Anderson, will allow CPRIT to comprehensively understand the effectiveness, reach, and impact of CPRIT-funded cancer prevention programs in Texas.

Evaluation objectives: By the end of the project period, the evaluation will: 1) Conduct an evaluability assessment of the 244 funded grants between 2010-20 2) Propose refinements for the evaluations of future CPRIT Prevention Program grantees. 3) Identify enhancements to the infrastructure for cancer prevention and control services among organizations that received CPRIT Prevention Program funding 4) Describe the reach of CPRIT's Prevention Programs to priority populations in Texas during 2010-20, including underserved and disproportionately impacted populations and regions 5) Identify county- or health service region-level changes in rates of preventable cancer risk factors, early detection, and cancer morbidity and mortality. 6) Describe the engagement and satisfaction of CPRIT Prevention Program stakeholders. 7) Identify ways in which CPRIT-funded prevention programs have developed capacity among public health entities and providers between 2010-20. 8) Describe the sustainable and/or long-term benefits that grantees identify has an outcome of CPRIT funding during 2010-20.

Evaluation methods: The evaluation will involve a mixed methods approach. Methods include: 1) an evaluability assessment, 2) quantitative analysis of state- and county-level cancer prevention outcome measures, 2) two surveys that will include both closed- and open-ended questions, 3) key informant interviews, 4) case studies, and 5) document review. An interdisciplinary team of qualified researchers will analyze data using qualitative and quantitative software. This mixed-methods approach will allow for a triangulation of data that will strengthen validity of findings and provide a greater contextual understanding. Additionally, the evaluation will use a health equity lens, which will consider the extent to which equitable processes, partnerships, and outcomes were achieved.

Innovations: The evaluation uses traditional mixed methods evaluation techniques while applying a health equity lens. We have thoughtfully considered how to build in opportunities to evaluate both the integration of equity priorities and principles from a process perspective, as well as to assess the equity impact. Overall, this approach will ultimately strengthen recommendations and help to facilitate a shift in the CPRIT Prevention Program to be more equity-centered in its approach to measurement. Dissemination: THI and MD Anderson will collaborate to disseminate findings to a broad range of stakeholders, including experts in cancer and public health, key decision-makers, and Texas residents. Messages will include the impact CPRIT funding has made on both the infrastructure for cancer prevention and control services in Texas, particularly in underserved regions and populations, and the progress made on preventable risk factors, early detection, and cancer morbidity and mortality. Additionally, both organizations will disseminate key lessons learned in delivering evidence-based interventions in cancer prevention, as well as best practices in grant-making. Dissemination methods may include peer reviewed publications, presentations/webinars, social media campaigns, and infographics/one-pagers.

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