The Chair of the Partnership’s Primary Prevention Action Group discusses a new approach to cancer prevention

Dr. Jon KernerJon Kerner, PhD, is Chair of the Primary Prevention Action Group, as well as the Partnership’s senior scientific advisor for cancer control and knowledge translation. Before joining the Partnership, he was Deputy Director for Research Dissemination and Diffusion of the Division of Cancer Control and Population Sciences at the U.S. National Cancer Institute.

Q. What is your vision for cancer prevention in Canada?

A. When I joined the Partnership last fall, my first goal was to really understand what was going on, to look at all the puzzle pieces and ask, ‘Is there a whole here that is greater than the sum of its parts?’

That’s what led me to propose a more comprehensive approach to cancer prevention — linked with other chronic disease prevention efforts across Canada.

The Primary Prevention Action Group is shifting to supporting larger networks of coalitions building on existing activities within Canada, with the goal of broadening their reach and deepening their impact — and linking the lessons learned from science with those learned in practice.

Thus the overall goal is to bridge gaps between what organizations and individuals are doing on their own and what they could do together — by helping them develop novel partnerships across chronic diseases, disciplines and provinces/territories. This, in turn, supports a more coordinated implementation and evaluation of evidence-based prevention programs — and better outcomes for Canadians.

The centrepiece of this new approach is the Coalitions Linking Action and Science for Prevention (CLASP) project.

Q. What is CLASP, and how does it reflect this new vision?

CLASP logoA. Beginning with three pan-Canadian partnership consultation workshops, CLASP will seek to add value building on existing activities to improve the prevention of cancer and chronic diseases across Canada.

We’re very excited that the Heart and Stroke Foundation of Canada and the Canadian Cancer Society are early collaborators, joining with the Partnership in implementing these CLASP workshops.

The workshops will focus on the social/behavioural, clinical and environmental contexts for prevention. They will bring together researchers, practitioners and policy-makers with the goal of supporting expanded partnerships across disciplines, chronic diseases and provinces/territories.

The idea is to get academic and policy experts and frontline practitioners working on different risk factors — such as obesity or sun safety — and different chronic diseases to come together and exchange knowledge and ideas. By working together these folks can have a greater impact on the health and well-being of Canadians by looking at the common approaches to the prevention of cancer, as well as asthma, diabetes, heart disease and other chronic diseases that plague Canadians.

There is a lot of good work already being done — by scientists, practitioners and policy-makers. So the idea is to get them in a room and see what partnership opportunities emerge. And once they identify potential partnerships that make sense to them, we can see how CLASP resources can support them moving forward.

Q. Do other new projects take this collaborative approach?

A. Yes. The Canadian Platform To increase Usage of Real-World Evidence (CAPTURE) is a major new initiative. It is important because we are collecting what we’re learning from actual fieldwork — and developing tools to help us capture what works and what doesn’t in real-world settings.

CAPTURE involves international experts and brings together stakeholders across Canada. It will reach out to the broad chronic disease prevention community, engaging them to help develop and promote the use of common evaluation tools for assessing practices and policies.

Another key project is CAREX Canada, which works with government agencies, universities and private industry to gather data on Canadians’ exposures to cancer-causing agents in workplaces and communities. As well, we’re conducting a series of environmental scans on critical topics in cancer prevention, to be completed in March 2009. These will further understanding of progress made in cancer risk-factor reduction policies at the federal, provincial/territorial and community levels.

Q. What challenges do you face in facilitating prevention partnerships?

A. For one thing, there’s a certain tension that exists when a disease-specific organization dealing with cancer tries to reach out across chronic diseases to focus on the broader social determinants of health and common risk factor issues.

The Partnership is putting its money where its mouth is. We are saying, ‘The Partnership is committed to a comprehensive prevention approach. We are not going to focus only on cancer prevention.’

If, for example, heart and stroke and cancer organizations can do things together that address cardiovascular disease and cancer, then everyone wins, as those are the two leading causes of death in Canada. The same principle applies to other chronic diseases as well.

We recognize that the conversations that can lead to innovation won’t take place unless those in the room share their knowledge and discover common concerns. So we want to get them together and say, ‘OK, we all agree what needs to be done — now are there things we could make happen more quickly together that we have been slow to make happen working on our own?’

Right now there is both excitement and a little concern about how cancer prevention relates to a more comprehensive approach. There is a lot energy — and if we can work together to harness that energy, I think we can make a huge difference, improving the prevention of cancer in particular — and chronic disease in general — for all Canadians.

Q. What brought you to the Partnership in September 2008?

A. In my 28 years working in the United States on cancer control and prevention, I’ve never seen a commitment to prevention like the one the Partnership is making. Cancer prevention is the second-largest investment made by the Partnership, after research. That impresses me. I’m also a dual citizen of Canada and the U.S., with family in Toronto and roots in Canada, including a BSc from McGill University — so I feel a connection.

For me, joining the Partnership is the continuation of a journey. I started as a researcher, working for 20 years in large academic comprehensive cancer centres. There, I saw first-hand how little research actually impacted practice. Then I moved to government, to the National Cancer Institute, where I asked the question, ‘How can we encourage the integration of the lessons learned from science with the lessons learned from practice?’ Through the Partnership I now have the chance to work with all sectors and disciplines to try to answer that question in a way that leads to action.