Incorporating Participatory Approaches and Implementation Science Toward an Integrated Research Paradigm to Promote Equity in Cancer Prevention and Control Research for Sexual and Gender Diverse Populations

Abstract

Multiple, complex factors contribute to cancer disparities for sexual and gender diverse (SGD) individuals, including a high prevalence of behavioral risk factors (e.g., smoking, alcohol consumption, and obesity), higher exposure to sexually transmitted infectious agents (e.g., human immunodeficiency and human papilloma viruses), and low utilization of preventive services including vaccination and cancer screening. While ongoing research focuses on documenting these disparities, few studies have produced interventions to address these disparities and promote equity. Moreover, existing research does not always translate to real-world clinical and/or community practice to achieve meaningful and sustainable improvements in cancer-related health outcomes for SGD populations. In this paper, we propose an integrated research paradigm that incorporates Community Based Participatory Research (CBPR) approaches and Implementation Science (IS) to ensure that we develop interventions that truly benefit SGD communities along the cancer care continuum. Using two ongoing research programs as examples, we demonstrate how participatory approaches and existing implementation frameworks are particularly appropriate for working with medically underserved SGD populations. We discuss ways in which such a research paradigm could lead to informed, actionable, and achievable outcomes for researchers, practitioners, and SGD communities. Combined with resources and training opportunities highlighted in this paper, we call on investigators to employ CBPR approaches and IS to make a shift from research that operates in silos and simply focuses on identifying disparities to one that synergistically promotes and sustains health equity by engaging stakeholders across the research to practice and cancer care continuums.