This section of the Comp Cancer 101 Wiki will walk you through the series of tasks that take place during CCC plan development, and heavily features guidance from the Centers for Disease Control and Prevention’s (CDC) Cancer Plan Self-Assessment Tool.
- Gathering and including key information
Review CCC plan content recommendations
- The CDC’s Cancer Plan Self-Assessment Tool lists indicators of CCC plan elements that are critical to the CDC
Review other CCC plans for inspiration
- The CDC provides a list of all full text cancer plans, and a search engine that searches the full text of all plans.
Review local cancer data
- Cancer burden (see Tool indicator 29)
- Cancer risk factors (see Tool indicator 30)
- Incidence data from the Central Cancer Registry (see Tool indicator 31)
- Disease burden on diverse populations (see Tool indicator 32)
- Demographic data in the CCC plan location (see Tool indicator 33)
- Other social and environmental data relevant to public health (see Tool indicator 34)
- Populations at highest risk for cancer or cancer mortality and how the disparities will be addressed (see Tool indicators 37-40)
Review relevant national priorities, standards, guidances and information
- Use the GW Cancer Center’s Priority Alignment Tool to see how well your CCC plan content covers priority topic areas by national organizations, including CDC, Healthy People 2030, U.S. Surgeon General, U.S. Preventive Service Task Force, National Guideline Clearinghouse, and NCI’s Physician Data Query
Scan political, fiscal, organizational and cultural landscape
- CCC plans should describe circumstances expected to exert major influence during the CCC plan period (see Tool indicator 35).
- Resources to conduct a scan include: Govtrack.us and the National Conference of State Legislatures searchable databases of bills.
Scan your location’s current public health and chronic disease initiatives to involve in planning
- The CCC plan should describe how its goals and strategies relate to the location’s public health goals, existing programs, and chronic disease plan. The CCC plan should include goals, objectives and strategies that reflect input from the location’s tobacco programs, nutrition and physical activity programs, and obesity programs (see Tool indicators 3, 15, 26).
Address NCCCP priority areas
The NCCCP priority areas that all plans should address are:
- Primary prevention of cancer,
- Early detection and treatment,
- Public health needs of cancer survivors,
- Policy, system, and environmental changes,
- Health equity as it relates to cancer control, and
- Outcomes demonstrated through evaluation (see Tool indicator 13).
Address the whole cancer continuum
Plans should include goals that encompass the entire cancer continuum:
- Primary prevention
- Screening/Early detection
- Palliation/End-of-Life Care
- Survivorship (see Tool indicator 14)
Demonstrate support from your region’s leadership
- Include endorsement letters from a high-ranking official relevant to your location and constituency (see Tool Section VIII).
Describe the CCC plan development process
- The plan should describe the process used to prioritize strategies, and revise the plan throughout implementation (see Tool indicators 6-7).
Negotiate roles and responsibilities with stakeholders
- Describe how stakeholders and organizations were chosen for involvement in developing the plan. Consider factors such as expertise, diversity and implementation capacity (see Tool indicator 25, 27).
- Include goals, objectives, and strategies that reflect input from the location’s tobacco programs, nutrition and physical activity programs, and obesity programs (see Tool indicator 26).
- Describe (in the resource plan) the lead funding agency for plan strategies and how funds will be allocated to/from stakeholders to implement the plan (see Tool indicator 8).
- Identify the person or agency that will evaluate each CCC plan portion, goal, or strategy (see Tool indicator 41).
- The CCC plan should describe stakeholder roles in plan implementation (e.g. funding, training, etc.), and assign a lead agency or organization to hold responsibility for implementing strategies. It should be clear who (e.g. organization, subcommittee members) is responsible for implementing which activities (see Tool indicator 4-5, 28).
Describe resources needed to implement CCC plan
- A resource plan or budget can be included with the cancer plan or mentioned and kept as a separate document. The resource plan should indicate inputs needed to implement the CCC plan, describing the lead funding agency for plan strategies and how funds will be allocated to/from stakeholders to implement the plan (see Tool indicator 8).
Describe your evaluation plan
- CCC plan evaluation is required. The evaluation plan can be included in the CCC plan or mentioned and kept as a separate document, and should use the CDC Framework for Program Evaluation in Public Health’s 6 steps. The CCC plan should identify which person or agency will be responsible for evaluating each CCC plan section, goal, and strategy (see Tool indicators 41, 43-44).
- Developing goals, objectives and strategies
Learn about writing good goals
- Goals are short, simple, general statements of intent that identify the desired effect or improvement and the target population. Goals should be clearly labeled, describe effects relevant to the entire location covered by the program, and include goals covering a multiyear period and focused on changing long-term outcomes (see Tool indicators 9-12).
Learn about writing SMART process and outcome objectives
- Objectives are statements describing what must be accomplished at what level in order to achieve related goals. Objectives should be clearly labeled, logically related to goals, and SMART (Specific, Measurable, Attainable, Results-oriented, and Time-phased) (see Tool indicators 16-19).
Identify indicators and methods to measure progress
- Plans should include short-term, intermediate, and long-term indicators that can measure progress toward goals and objectives (see Tool indicator 42-43). See examples of indicators on major cancer topics in the GW Cancer Center’s Priority Alignment Tool.
Set targets based on your local data, stakeholder input and national priorities
- CCC plan objectives should be SMART, implying that you will need to specify targets in order to make your objectives specific and measurable (see Tool indicator 18).
- Create realistic targets using baseline or current data found. Resources to find data include:
- The National Cancer Institute’s State Cancer Profiles include each state’s cancer incidence, prevalence, mortality, screening and risk factor data.
- The North American Association of Central Cancer Registries provides epidemiological cancer data.
- CDC’s National Program of Cancer Registries has a directory to help you contact a local registry.
- Explore national survey data from CDC’s Behavioral Risk Factor Surveillance System and Youth Risk Behavior Surveillance System.
- The U.S. Census consolidates population-level data across national censuses and American Community Surveys, and allows you to search for topics of interest by geography, demographics, or other factors.
- See National Cancer Institute’s list of cancer statistics resources.
- Healthy People 2030
Choose evidence-based interventions or promising practices
- Strategies are activities designed to meet the state objectives. Strategies should be clearly labeled, specific, and logically related to objectives. Strategies should be evidence-based or have strong justification for hypothesized effectiveness. The plan should describe criteria and rationale for choosing the selected strategies, and how strategies will integrate with existing activities (see Tool indicators 3, 20-24). Resources to identify strategies include:
- Community Guide for systematic reviews summarizing the evidence for cancer control interventions.
- Evidence-Based Cancer Control Programs from the NCI for a searchable database of evidence-based cancer control programs.
- The Cochrane Collaboration systematic reviews summarize primary research in order to establish whether there is conclusive evidence for specific treatments or interventions.
- NCI’s Physician Data Query summarizes information and evidence on a wide range of cancer topics.
- NACCHO’s Model Practice Database
- AHRQ’s Health Care Innovations Exchange
- PubMed for scholarly articles on specific topics.
- Organizing plan content
Summarize plan content and key information at the beginning of the plan
- Include a brief executive summary or other brief summary that accurately condenses the entire CCC plan’s content (see Tool Section VIII).
Make the plan as readable and easy to navigate as possible to encourage use
- Include features to make components of your CCC plan easy to navigate, such as a table of contents, page numbers, and a glossary (see Tool Section VIII).
- Options to increase readability and navigation include:
- Hyperlinks in the table of contents
- Clear organization, formatting, heads, tables and labels
- Lists of action items for target audiences
Make yourself accessible
- Include contact information and instructions for obtaining additional copies of CCC plan (see Tool Section VIII)
- Options to increase access include:
- Make sure your plan is up-to-date online so that everyone else in the CCC world can see it! Check your plan on your program/coalition’s and the CDC’s website.
- Make sure your contact information is up-to-date online so that people interested in your CCC plan can contact you. Check your contact information on your program/coalition’s and the CDC’s website.
- Choosing a plan development process
Identify and engage key stakeholders to involve
- Note: Stakeholder engagement is mentioned here only in relation to CCC plan revision
- Plan development should involve a diverse group of key stakeholders. Stakeholders should include members capable of carrying out evidence-based and policy, systems, and environmental change interventions. Stakeholders should include the location’s tobacco, nutrition and physical activity, and obesity programs. Plans should describe how stakeholders and organizations were chosen for involvement in developing the plan (see Tool indicators 25-27). Resources to assist in stakeholder identification include:
- The National Association of County & City Health Officials (NACCHO) has a directory of local health departments by state.
- CDC’s National Tobacco Control Program has a directory of each state’s tobacco control website.
- Learn what states and communities are doing through the CDC’s Division of Nutrition, Physical Activity, and Obesity.
- The National Association of Chronic Disease Directors (NACDD) has a directory allowing searches by topic/group for local NACDD member representatives.
- CDC’s National Program of Cancer Registries has a directory of local registries.
- CDC’s National Breast and Cervical Cancer Early Detection Program has a directory of local programs.
- CDC’s Colorectal Cancer Control Program has a directory of local programs.
- The National Association of State Offices of Minority Health has a directory of state offices.
- The U.S. Department of the Interior has a tribal leaders directory, providing contact information for all federally-recognized tribes.
- The Association of Asian Pacific Community Health Organizations (AAPCHO) has a directory of member community health organizations targeting medically underserved Asian Americans, Native Hawaiian, and other Pacific Islander communities.
- The Asian Pacific Partners for Empowerment, Advocacy & Leadership (APPEAL) provides a network map of members working toward social justice and a tobacco-free Asian American, Native Hawaiian and Pacific Islander (AA and NHPI) community.
- The National Council on Behavioral Health (NCBH) has a directory of member organizations supporting adults with mental illness and addiction disorders.
- The Geographic Health Equity Alliance is a national network of coalitions, state programs, public health departments, national organizations, researchers and other community-based agencies dedicated to addressing tobacco and cancer-related geographic health disparities.
- The Commission on Cancer has a hospital locator for finding cancer programs by geography.
- NCI has a directory of NCI-designated cancer centers, including their reported research programs and shared resources.
- NCI has a directory of cancer genetics service providers.
- The American Cancer Society has Cancer Action Network chapters across the country.
- USA.gov has a listing of websites and contacts for governments of states and U.S. territories and associated states.
Choose how to delegate responsibility for gathering information and creating plan content
- A variety of ways exist to gather information and create plan content. Stakeholders should be involved in the planning and decision-making process of the CCC plan based on interest and expertise. Small workgroups or subcommittees may work on different plan sections (see Tool indicators 2, 25).
- Options include:
- Decentralized topic-specific workgroups by plan topics to gather information, draft content, make recommendations, and comprised of topic-area experts
- Centralized plan revision workgroup of a core planning team to execute major tasks of plan development
- Topic area experts identified from coalition membership
- Program/coalition staff participate in topic-specific workgroups, facilitate revisions, and/or conduct final revision
- Coalition leadership as champions, workgroup leads, guidance or frameworks, and/or synthesize information provided by workgroups
Consider communication channel options for facilitating stakeholder contributions
- Stakeholders should be involved in the planning and decision-making process of the CCC plan based on interest and expertise (see Tool indicators 2, 25).
- Options include:
- Large in-person meeting or summit for active plan revision, convening workgroups, communicating results or decisions, discussing gathered information, and/or kicking off plan implementation
- Conference calls for workgroup communication or full membership conference calls to solicit feedback.
- Emails to vet proposed revisions and drafts with membership.
- Electronic survey to ask coalition members to prioritize or assess coalition member capacity to implement proposed strategies.
- Coalition website to post current or drafts of plan documents and processes
Create criteria to prioritize plan content and a process for decision making
- The plan should describe the process for prioritizing strategies including decisions on what topics, goals, objectives or strategies should be added, kept, removed, and how new trends could be incorporated
- Develop a formal rubric or criteria for goals, objectives, and strategies to determine potential reach, impact, feasibility, resources, stakeholder buy-in, supporting evidence, and immediacy of the issue.
Identify a plan revision timeline and a process to update the plan throughout implementation
- Rolling revision process: Specific sections of the plan are revised in a pre-determined order on a rolling basis.
- Fixed plan cycle: Updated at pre-determined intervals.
Consider and determine the use of tools and/or consultants to facilitate the process. Options include:
- Use of external consultant or contractor
- To help increase input from hundreds of coalition stakeholders.
- To help create a decision-making process to confirm revision content.
- To develop tools and implement a tailored revision approach.
- To help develop a CCC plan outline.
- Use of a tool or workbook
- To organize information and structure the revision process of existing plan content.
- To help coordinate and facilitate uniform work across workgroups.