PIECES Project: Developing the Primary Cancer Prevention Toolkit to support tailored implementation across 10 countries

Background: Up to 50% of deaths related to cancer are considered to be preventable. Despite the existence of effective primary cancer prevention programmes (PCPs), impact often falls short due to poor adaptation and ineffective implementation strategies.

Purpose: The PIECES project, a large multi-national project funded by Horizon Europe, aims to adapt and implement existing evidence-based interventions to improve implementation outcomes and by that, improve reach and effectiveness of PCP interventions in 10 countries. The project addresses six risk behaviors, including poor physical health, focusing on the specific behaviour change mechanisms that promote healthy behaviours.

Methods: Through an adaptive co-creation process we developed an online Primary Cancer Prevention Implementation Toolkit (PCP-IT). The toolkit enables tailored implementation and is theory- and evidence-based. It underwent refinement through workability and technical piloting workshops. The toolkit focuses on tailored implementation and empowers local implementers to adapt evidence-based PCP programs and develop implementation strategies that are tailored to local needs.

Results: The toolkit consists of structured yet flexible work processes to guide implementation teams, including evidence-informed repositories for PCP programs, determinants of practice and implementation strategies, a special module for stakeholder engagement throughout this process, and a community of practice.

Conclusions: The project anticipates that the toolkit’s focus on adaptation and tailoring improves implementation outcomes of evidence-based interventions across diverse sites, associated with a reduction of cancer incidence in the European Union and beyond. The planned mixed-methods evaluation will provide insight into the toolkit’s applicability and inform future cancer prevention strategies.

Practical implications:
We will conduct a multi-site case comparison design, assessing key implementation outcomes (acceptability, feasibility, adoption, sustainability), guided by a realist evaluation approach to explore mechanisms of action. This positions the PCP-IT as a valuable resource for researchers and implementers to improve PCP implementation.

Funding:
Funded by the European Union. Project reference: 101104390.