Behavioural and implementation research and evaluation

The Behavioural and Implementation Research and Evaluation (BIRdE) Group investigates the impact of interventions to promote the uptake of cancer research findings within the healthcare system and evaluates the impact of cancer control programs, including our own programs and services, designed to prevent cancer and support cancer patients. As the state’s largest charity with our research funded by the community, our BIRdE team can do this work independently, according to community need, to inform a priority-driven pathway to a cancer-free future. The group’s current areas of focus include: 

Improving detection of those with a high risk of Lynch syndrome 

The BIRdE Group leads the Pathways to a Cancer Free Future work focused on cancers related to Lynch syndrome and hereditary cancers. The group is testing the cost-effectiveness of a theory-based implementation method to improve the detection of Lynch syndrome patients and their relatives within the Australian population as part of a cluster randomised controlled trial. 

Reducing barriers and improving referrals for Lynch syndrome diagnosis 

The group is leading a cluster randomised controlled trial, called the Hide and Seek Project, at eight hospitals across Australia that looks at identifying and overcoming barriers to Lynch syndrome referral. The project aims to result in better screening of at-risk patients and early diagnosis. It will inform policy makers on the best value approaches for implementing clinical guidelines for genetic testing.  

Investigating factors affecting the impact of implementation approaches  

To complement the Hide and Seek Project, the group is conducting a study in parallel to investigate how changes in the health system occur (or do not occur), why, in what contexts, and at what costs. The aim of this study is to conduct an in-depth, mixed methods process evaluation to gain an understanding of the factors influencing the effectiveness of the implementation approaches being tested in the trial. 

Assessing the cost-effectiveness of implementation approaches 

The group is using Policy1-Lynch to test the cost-effectiveness of implementation packages for enhancing Lynch syndrome testing and referral practices nationally to inform the best approaches for implementing genetic and genomic evidence into the health system in the future.  

Understanding the factors affecting decisions behind genetic testing uptake for detecting Lynch syndrome 

Given that the cost-effectiveness of systematic LS testing programs is sensitive to uptake rates of genetic testing and surveillance for both carriers and relatives, we are undertaking a semi-structured telephone interview study to explore the factors affecting patient decisions to undergo a genetic test, and share the test results with at risk relatives. This interview study involves hypothetical scenarios regarding tumour testing, genetic counselling, sharing test results with at-risk relatives and genetic testing. Findings from this study can refine Policy1-Lynch to improve its cost-effectiveness estimates. 

Improving the healthcare for women with, and at risk of, ovarian cancer 

Using systematic reviews, epidemiology, modelling and implementation science, the group is developing evidence to help inform policy and improve the way healthcare is delivered for women with, and at risk of, ovarian cancer. This includes: scanning emerging evidence on early detection and new diagnostic techniques; identifying trends in diagnostic pathways; developing a modelling platform to assess the impact of different cancer control interventions; and improving health system referral processes for women at higher risk. 

Evaluating the effectiveness of Cancer Council programs and services 

Cancer Council NSW runs a variety of community-facing programs designed to help prevent cancer, and to inform and support people with cancer, their carers and family, and the wider community. A dedicated evaluation team within the BIRdE Group provides independent evaluation support to over 20 different projects across the organisation to assist them with assessing the impact of their programs. 

 “We’re working across many aspects of the cancer patient journey to understand healthcare professional and patient perspectives, co-design evidence-based interventions to improve the health system and assess costs and impact through rigorous research and evaluation methods.”