Collaboration In Education Research Articles

Health Professions Students' Reflections About Principles of Interprofessional Collaboration after Shadowing Interprofessional Palliative Care Rounds.

Future healthcare professionals are educated on collaborative practice methods through interventions that may include shadowing. While shadowing allows students to learn from and about other health professions, it often fails to offer an opportunity for the student to work and collaborate with other health professionals. This study sought to investigate themes regarding interprofessional students' experiences during a palliative care shadowing activity and their understanding of collaborative patient-centered care, social determinants of health, and health disparities. Twenty-eight students representing 13 health professions from the Interprofessional Palliative Care program at Jefferson Center for Interprofessional Practice and Education at Thomas Jefferson University submitted reflection essays at the conclusion of their shadowing experience. Four hundred ninety-eight sentences from 28 essays were analyzed via qualitative directed content analysis. Coding categories were determined a priori using definitions of collaborative practice from the 2023 Interprofessional Education Collaborative (IPEC) competencies and definitions of social determinants of health from Healthy People 2030. Thirty-two percent of sentences described IPEC competencies, 18% described social determinants of health/ health disparities, 4% included student emotional reactions, and 2% included student descriptions of the development of their professional role. These results suggest that shadowing offers an opportunity to identify and learn interprofessional competencies in interprofessional palliative care curricula, as made evident through student reflection assignments.

Rajabhat University Concept for Local Development: Strategies, Implementation, and Community Impact

Background and Aims: The Rajabhat University concept for local development is critical because it tailors educational and research efforts to meet specific regional needs, promoting targeted growth and innovation. These universities benefit local communities in both the short and long term by incorporating community engagement and sustainable practices. The purpose of this paper is to investigate Rajabhat University's contribution to community development. Methodology: This paper conducts a comprehensive literature review to assess Rajabhat University's role in regional development, focusing on academic research and case studies to highlight effective strategies and outcomes. This methodological approach yields a thorough understanding of universities' impact and best practices for promoting local development. Results: The finding found that Rajabhat Universities contribute to local development by providing tailored educational programs, conducting targeted research, and forming strong community partnerships. Their comprehensive approach not only addresses immediate regional needs, but also encourages long-term economic, social, and cultural growth. By incorporating sustainable practices and adapting to emerging trends, these universities ensure that their initiatives have a long-term and significant impact on the communities they serve. Conclusion: The findings show that Rajabhat Universities effectively promote local development through tailored education, targeted research, and strong community collaboration. Their strategies not only address current regional needs, but also promote long-term economic, social, and cultural development, ensuring a long-term impact on the communities they serve.

Views of Peidu: Mothers Accompanying Children with Autism and Other Developmental Disorders to School in China

Abstract Educational opportunities for children with disabilities in China have increased recently, often due to parent efforts. This qualitative study sought to understand the practice of parents (mothers) accompanying their children with autism and other developmental disabilities to school (peidu), providing individualized support in a variety of school settings. Through interviews with parents of 12 children, and four teachers, four themes emerged from data analysis: 1) lack of formal support resources; 2) building relationships with leaders and teachers; 3) mothers as a bridge with other children; and 4) the essential role of managing behavior. This research shows the important role mothers play in securing and maintaining educational opportunities for their children, by going to school with their children (peidu); yet peidu is not a universal or desirable long-term solution. Challenges of effectively supporting students with disabilities in classrooms are not unique to China, and solutions involve and point to the importance of collaboration in education. We conclude with recommendations for supporting parents and teachers, and directions for future research.

유아기 자녀를 둔 부모의 제품구매 태도가 ESG 교육 및 홍보 필요도에 미치는 영향: ESG 중요성의 매개효과

Objectives The purpose of this study is to investigate the impact of parents with young children's product purchasing attitudes on the need for ESG (environmental, social, and governance) education and promotion. Additionally, the study aims to explore the mediating effect of ESG importance in this relationship Methods The study participants consisted of 254 parents with young children residing in Seoul, Gyeonggi, Chungcheong, and Gyeongsang. The trends and normality of the research variables, as well as their reliability coefficients, were examined using SPSS 25.0 and AMOS 23.0. The relationships among the research variables were analyzed using Pearson's correlation analysis. Additionally, structural equation modeling (SEM) was employed to examine the structural relationships. Furthermore, the mediating effect was investigated using the bootstrapping method. Results The research findings are as follows. First, the mean of the research variables was above 4.0, indicating high levels. Additionally, the data met the assumption of normality. Second, the findings indicate a positive correlation between the need for ESG education and promotion and product purchasing attitudes, as well as the importance of ESG and its subfactors, which include environmental importance, social importance and governance importance. Third, the results revealed that attitudes towards product purchasing had a statistically significant impact on the importance of ESG and the need for ESG education. However, attitudes towards product purchasing did not have a statistically significant impact on the necessity of promoting ESG. Additionally, the importance of ESG was found to influence both the need for ESG education and the need for ESG promotion. Fourth, in the process where attitudes towards product purchasing influence the need for ESG education, the importance of ESG partially mediates the relationship. However, in the case of the need for promoting ESG(environmental, social, governance) practices, the importance of ESG fully mediates the relationship. Conclusions The research findings suggest the importance of promoting early awareness of the concept of ESG (Environmental, Social, and Governance) through play.Additionally, the study aims to propose practical approaches to promoteESGpractices, distinguishing between initiatives focused on thehomeenvironment and collaboration in early childhood education.

How can we improve AI competencies for tomorrow's leaders: Insights from multi-stakeholders’ interaction

This study investigates factors influencing artificial intelligence (AI) competencies in higher education for sustainable development using learning theories. Utilizing a mixed-method approach, it analyzes responses from 525 students and interviews with 35 faculty members from five Indian universities. The study employs confirmatory factor analysis (CFA) and structural equation modeling (CB-SEM) to explore relationships between various learning approaches and AI competencies. Findings indicate that collaborative learning, problem-solving, and cognitive competence significantly contribute to AI proficiency. Human-tool collaboration and self-learning also enhance students' understanding of AI concepts, fostering strategic decision-making in business contexts. Additionally, thematic analysis from qualitative interviews identifies critical themes for developing an AI curriculum framework, including curriculum design, pedagogical strategies, ethical considerations, and global perspectives. The research provides an integrated theoretical model and offers practical recommendations for enhancing AI education, emphasizing the importance of interdisciplinary collaboration and ethical AI usage in management education.

EPortfolio-based Professional Development: Insights from a Southeast Asian Online Educators’ Community of Practice

This study examines the implementation and impacts of an ePortfolio-based professional learning initiative within a Southeast Asian online community of practice (CoP), part of the SEAMEO-AUS EduLink Project. Targeting the development of educators' competencies in ePortfolio pedagogy, the project engaged 541 educators from various Southeast Asian countries in two online self-paced courses and a series of four expert-led webinars, culminating in a final project webinar. The research utilised course analytics and post-webinar surveys to analyse participant engagement, satisfaction, and perceived learning outcomes. The findings indicate substantial engagement with the courses and positive reception of the webinar series. About 75% of participants completed the asynchronous courses, while 64% found the webinar content immediately applicable to their practice. The webinars, focusing on diverse aspects of ePortfolio use, successfully complement the online courses, with 91% of participants expressing intent to attend future events. This study underscores the effectiveness of combining asynchronous and synchronous learning modalities in professional development, particularly in the context of ePortfolios. It highlights the role of ePortfolios in promoting reflective practice, collaborative learning, and authentic assessment. Additionally, the project's success in fostering a supportive CoP model illustrates the potential of online communities in professional development, especially in regions with emerging ePortfolio practices. The paper concludes by emphasising the value of ePortfolio-based initiatives in enhancing educators' skills and fostering cross-cultural educational collaborations. It offers recommendations for educators and policymakers on implementing similar initiatives, underlining the need for sustainable and contextually sensitive approaches in professional development.

Academic Capacity Building of Lecturers through International Collaboration:

This international community service program aims to enhance the academic capacity of lecturers through collaboration with universities in Malaysia. The program is designed to address the issue of lecturer quality by leveraging the exchange of knowledge and innovative teaching methods. The implementation method includes establishing a baseline, analyzing needs, conducting workshops, evaluating results, developing sustainable solutions, and the role of contributions from related parties. This article highlights the importance of international collaboration in higher education and its contribution to the development of lecturer capacity and the improvement of educational quality. Through this program, an increase in lecturer competence is expected, which in turn can strengthen the bilateral relations between Indonesia and Malaysia in the higher education sector learning.

Game-based learning about the circular economy in building sustainable communities: a case of international and interdisciplinary university collaboration

PurposeThis study aims to enhance integration of game-based learning (GBL) as a tool for conveying intricate circular economy (CE) concepts effectively into international and interdisciplinary higher education collaborations for the development of sustainable communities.Design/methodology/approachA series of game-based workshops by the Circular EELISA Community of the EELISA European University program were examined in terms of their compliance with literature-based GBL characteristics and their international, interdisciplinary and online conduct. An online survey conducted with 17 workshop and/or challenge organizers from four participating universities in different countries revealed expert experiences and perceptions on these points.FindingsIt was found that sensory elements, rewards and game choice enhanced engagement and motivation in all gamification, serious game and storytelling experiences, and that a combination of multiple GBL approaches was more effective than a single-method challenge design. Diversity-friendly collaboration, cooperation and immersion were particularly important when involving culturally and disciplinarily diverse participants.Practical implicationsThis study offers practical recommendations to improve both the performance of GBL-based learning environments in current and future education alliances and collaborations and the potential of GBL approaches to motivate youth to contribute to more sustainable communities across and beyond Europe.Originality/valueThe findings underscore the value of innovative pedagogical methods in shaping environmentally conscious mindsets and practices across institutions of higher education. To that end, this is the first study that investigates GBL in CE education with implications for international university cooperation.

Exploring prompt pattern for generative artificial intelligence in automatic question generation

ABSTRACT The construction of questions is an essential component in educational assessment and student learning processes. However, manually constructing questions is a complex task that requires not only professional training, substantial experience, and extensive resources from teachers but is also time-consuming. This article introduces an Automatic Question Generation (AQG) technology based on a prompt pattern to alleviate this burden and address the ongoing need for new questions in education. The essence of this method lies in constructing a prompt pattern grounded on a collective knowledge base derived from teachers, thereby enhancing the quality of the questions produced. Practical applications and expert evaluations demonstrate that integrating a prompt pattern with a collective knowledge base into Large Language Models (LLMs) results in high-quality questions with statistically significant results. These questions not only meet educational standards but also approach the quality of manually constructed questions by teachers in certain aspects. Our research further emphasizes the feasibility of AI-teacher collaboration in education.

Managing Personalization and Collaboration in Education: A Systematic Review of Educational Practices

This systematic literature review analyzes 20 carefully selected documents from the Scopus database. This study explores ways that align with Islamic educational management's principles to balance personalized learning outcomes and community empowerment in academic settings. The selection of documents is based on relevance to the focus and recent developments in Islamic education. The qualitative analysis method uses thematic coding and VOS Viewer. The analysis results indicate that Islamic approaches like collaboration, reflection, and feedback can achieve balanced learning outcomes. Collaborative filtering helps select learning materials according to student's needs, while reflection and feedback strengthen positive interactions and ukhuwah within the learning community. In addition, computer-based learning and e-learning allow students to learn at their own pace. A flexible curriculum allows for adjustments to students' interests by the principle of taysir (making it easy). These findings recommend that educational institutions integrate a multifaceted approach to create an inclusive, adaptive, and Islamic-oriented learning environment.

Quest for Equity: Using multiple methodologies to promote collaboration and engagement in anti-racism education

This article explores how multiple methodologies can create new spaces to reimagine anti-racism work and enhance engagement in anti-racist education. Through the combination of two methodologies, namely design-based research (DBR) and gamification, the paper describes the design formation of the game Quest for Equity, a collaborative and engaging speaking tool. The game improved player engagement and effective collaboration, while challenging performative and racist practices in higher education. This paper provides methodological contributions such as the unique use of facilitation observation and presents an interesting way to extract elements of multiple research approaches to suit contextual goals, reimagining new solutions to historical and contemporary problems.

Playing to Collaborate: Using Cooperative Board Games to Experience and Reflect on Collaboration in Upper Secondary Education

There is a growing interest among researchers in using board games for supporting learning in school contexts. Co-op board games is a relatively new and promising type of games, which seems well-suited for improving students’ collaboration skills. In this paper, we explore how two groups of Danish high school students interact when playing two different co-op games, The Mind and Forbidden Island, and how they reflect upon their shared game experiences. The data collection is based on video observations of group interaction and student interviews, which use stimulated video recall. In this way, we are able not only to describe the students’ perceived outcomes of the gaming activities, but also their in-game practices. Our data analysis is informed by microsociological perspectives (Goffman and Collins), which are used to map the group interaction rituals and social norms of the students’ gaming encounters. Based on the data analysis, we identify two analytical themes, which concern the students’ use of verbal and non-verbal communication practices as well as their socialisation processes. The findings suggest that co-op games may be used as a valuable educational tool for qualifying high school students’ collaboration skills as well as strengthening their group relations. The students especially valued playing The Mind, which they tried playing for multiple game rounds. Based on these findings, we discuss recommendations for the further use and study of co-op board games in educational settings.

Rethinking internationalization of higher education for society from an outside-in perspective

ABSTRACT Amid increasing criticism of the internationalization of higher education (IoHE) for its Anglo-centric tendencies, there has been discussion of the need to reconsider the rationales for and approaches to IoHE. Specifically it has been argued that there is an urgent need to focus IOHE more sharply on addressing the many complex and persistent issues faced by local and global communities. As part of the discussion, a new model of IoHE, ‘internationalisation of higher education for society’ (IHES) has been proposed by prominent scholars in the field. This paper seeks to make a positive contribution to the discussion of IHES. Our aim is to refine the concept by integrating an ‘outside-in’ perspective, a viewpoint currently missing from the existing conceptualization of IHES. The paper answers three unique research questions: 1) What are the implications of contemporary societal transitions for IoHE? 2) How can universities use their internationalization activities to more effectively facilitate societal transformations? 3) What are the implications of reforming the rationales of IoHE from the perspective of university–society relations? We highlight that collaborations in higher education between East Asian and Nordic countries offer an optimal platform to explore and promote the potential of a new paradigm of IoHE.

A Systematic Literature Review of Soft Skills in Information Technology Education.

This research addresses the importance of the soft skills approach, which encompasses problem-solving, collaboration, interpersonal and communication skills for higher education in the information technology (IT) field. IT graduate students continue to face difficulties in meeting the employability criteria of the global information technology sector due to mismatching capabilities, such as the discrepancy between the technical knowledge obtained in academia and the practical skills expected by employers. This systematic literature review used PRISMA guidelines for data collection. Papers were examined using the inclusion-exclusion criteria, which included concentrating on full-text studies about soft skills in higher education published in English between 2018 and 2024. The keywords used by the inclusion and exclusion criteria are soft skills, higher education, university, undergraduate, graduate, IT, information technology, software, computer science, programming, information systems and IS. The SCOPUS search engine platform found 2088 documents, and the (WOS) database obtained 1383 documents. To comprehend the significance of soft skills in the field and its effect on graduates' employability, 69 papers were carefully examined. The rapid change following Industrial Revolution 4.0 has transformed the working environment, challenging new IT graduates to be competent in the working environment. This study highlights the importance of soft skills and self-awareness in university education, revealing that current curricula must adapt to the rapidly changing job market, especially post Industry 4.0. The literature review indicates that despite high technical competence, graduates lack essential soft skills like communication, teamwork, and problem-solving, creating a gap between new graduates and industry expectations. Hopefully, this study's results will contribute to understanding the functionality and necessity of soft skills in the behavioral sciences literature. To bridge the skills gap between industry demands and technical proficiency, academic institutions should incorporate creative teaching approaches prioritizing soft skills like problem-solving, teamwork, and communication. Universities, recent graduates, and companies must work together to modify courses to meet the needs of a job market that is changing quickly.

Description of a Longitudinal Interprofessional Education Plan and Outcomes From an Inaugural Student Cohort

ObjectiveTo describe a longitudinal interprofessional education (IPE) plan at 1 school of pharmacy including inaugural student cohort outcomes. MethodsStandards 2016 prompted the creation of an IPE task force at the University of Wisconsin–Madison School of Pharmacy to develop and implement an IPE plan consisting of outcome-based goals, a deliberate design, and a formalized assessment strategy (an approach that inspired national consensus guidance from the Health Professions Accreditors Collaborative). Beginning with the 2022 graduating class, required interprofessional learning activities were embedded longitudinally across a 4-year Doctor of Pharmacy program and included classroom-, simulation-, and clinical-based IPE activities. Student learning outcomes, focused on attitudes, skills, and behaviors, were assessed longitudinally using 3 self-reported, validated measures allowing before and after comparisons: Student Perceptions of Interprofessional Clinical Education–Revised, Version 2, Interprofessional Education Collaborative Competency Self-Assessment Tool, Version 3, and Interprofessional Collaborative Competencies Attainment Survey–Revised, coupled with the Individual Teamwork Observation and Feedback Tool. ResultsEnd point Student Perceptions of Interprofessional Clinical Education–Revised, Version 2 and Interprofessional Education Collaborative Competency Self-Assessment Tool, Version 3 average scores were in the agree to strongly agree range with statistically significant before and after change in 80% (4 of 5) of subscales. Students’ attainment and demonstration of positive teamwork behaviors were evidenced by statistically significant before and after changes in advanced pharmacy practice experience student Interprofessional Collaborative Competencies Attainment Survey–Revised scores and universal satisfactory ratings of advanced pharmacy practice experience students on the Individual Teamwork Observation and Feedback Tool. ConclusionA developmentally progressive, longitudinal IPE plan was implemented into a 4-year Doctor of Pharmacy program. Inaugural student cohort assessment results documented students were prepared for interprofessional practice upon graduation.

The Interconnectedness of Interprofessional Education and Professional Identity Formation

Professional identity formation (PIF) is the transformative process by which an individual, “thinks, feels and acts” in accordance with professional norms. In the pharmacy academy, institutions are required to support students on this transformative journey, however the most efficient and effective way to do so has yet to be determined. Interprofessional Education (IPE) in pharmacy programs typically consist of activities and assessments across most of the professional years. These IPE activities designed in accordance with the Interprofessional Education Collaborative (IPEC) Core Competencies include key elements of PIF such as, individual growth opportunities, socialization and “pivotal” moments that can propel an individual’s professional identity development. In light of curricular overload and attempt for curricular efficiency, pharmacy programs might consider using already existing IPE programming to help augment student PIF.

Nursing Students’ Perceived Ability to Practice Interprofessional Collaboration after the Inclusion of Virtual and Immersion Interprofessional Education Activities: A Quantitative Exploration

BackgroundLittle is known about the influence of interprofessional education (IPE) on interprofessional collaboration (IPC), particularly following the COVID 19 pandemic. AimTo examine nursing students’ perceived ability to practice IPC after exposure to virtual lectures and immersive clinical IPE activities founded on the competencies from the National Interprofessional Competency Framework. DesignA cross-sectional design was used. MethodsThird year nursing students (n=105) enrolled in a pediatric theory and clinical completed surveys including: Demographic items, the revised Interprofessional Collaborative Competency Attainment Survey (ICCAS) and the Interprofessional Education Collaborative Competency Self-Assessment (IPEC) (Version 3). Students completed reflective questions about their IPE experiences. Descriptive statistics, paired t-tests, confidence intervals and odds ratio measured the difference from pre- to post-participation for all items of the ICCAS and IPEC. ResultsParticipants reported improved IPC competence on every item and overall, after the IPE activities. Participants from urban campuses had lower ICCAS scores (OR 0.38, 95% CI, 0.12-0.65) than those from rural campuses (OR 0.45 95% CI 0.18 - 0.72). Students who identified as men had significantly higher team functioning scores before participating in the IPE activities than women (OR 0.50; 95% CI: 0.05 - 0.95). The IPEC Interaction items mean score was 4.03 ±.50 and IPE values items were higher with a mean of 4.62 ± 0.46. ConclusionsThe findings can guide development and implementation of IPE experiences for nursing and allied healthcare students.

Development of interprofessional educational module for understanding the musculoskeletal basis of sports injury

ABSTRACT Context: Interprofessional education (IPE) is crucial in promoting a better understanding of collaborative practices within the healthcare system. Unfortunately, healthcare professionals are still working in isolation. To address this issue, a study was conducted to develop a module-based teaching and learning activity focusing on sports injuries and to promote IPE. Aims: The aim of the study was to develop, implement, and evaluate an IPE module. Settings and Design: An educational mixed-method study was conducted on 25 facilitators and 108 students. Methods, Materials and Statistical Analysis: The facilitators were interviewed for an assessment of the need for the IPE module. Qualitative analysis was done on the interview data. An interprofessional team was created to develop the sports injury prevention module (SIPM). The SIPM consisting of 11 objectives was developed and validated by experts. After the implementation of SIPM students’ performance was analysed with the help of pre and post-tests. The perception of students and facilitators about IP SIPM were recorded with the help of questionnaires. Results: Need assessment data showed that the facilitators were not very familiar with the concept of IPE. There was a significant increase in students’ performance with a P value ≤ 0.05 after learning with SIPM. Both facilitators and students agreed that module-based IPE increases students’ attentiveness and learning. Conclusions: For effective interprofessional educational collaboration for training students of the healthcare profession, there is a need for an interprofessional educational module. SIPM can enhance the learning of musculoskeletal anatomy and create awareness about sports injuries among students.

Barriers and Facilitators to Dental Care Services Utilization Among Children With Disabilities: A Systematic Review and Thematic Synthesis.

This systematic review investigates barriers and enablers to dental care utilization by disabled children. Given the high global prevalence of disabilities in children, coupled with poor oral hygiene and a 45% rate of dental caries in this group, developing inclusive oral health strategies is critical. The review aims to synthesize literature on factors affecting oral healthcare improvement for disabled children, identifying barriers, facilitators and knowledge gaps. The review was conducted following the Joanna Briggs Institute's methods and reported according to PRISMA guidelines. A comprehensive search spanned multiple databases, considering perspectives from carers, parents, dentists and health professionals. The focus was on studies involving children up to age 17 with disabilities, as defined by WHO, using dental care services. Exclusions included non-qualitative studies, populations over 18 and nondisabled children. There were no restrictions on publication date or language. Thematic synthesis of the studies extracted themes related to barriers and enablers in oral healthcare for disabled children. Thematic synthesis identified five overarching themes: stigma, communication issues, professional development, oral health education and medical-dental collaboration. Facilitators included enhancing accessibility and availability of dental care through a holistic approach, improving dental care facility environments and ensuring skilled dental care providers. The review underscores the importance of interprofessional collaboration, improved parent/caregiver education and specialized dental facilities to support children with disabilities. It identifies key barriers and facilitators in dental care, including challenging stereotypes, improving communication between providers and parents, enhancing holistic training and addressing gaps in oral health education and integrated healthcare systems. Addressing the complex dynamics of dental care for disabled children is essential for developing inclusive and effective preventive and therapeutic strategies. This review highlights the need for tailored approaches and enhanced support systems to improve oral health outcomes in this vulnerable population. The members of the family support department, Middle East and North Africa (MENA) Organization for Rare Disease and Disability who provided the disability voice and contributed to providing input to the review protocol.

Progress and Challenges in Canada's Path Toward the Elimination of Cervical Cancer.

Cervical cancer is almost entirely preventable and treatable when detected early, making its elimination within reach for Canada and the world. However, cervical cancer is now the fastest-increasing cancer (+3.7% per year since 2015) in Canada as of 2023, marking the first significant increase in cervical cancer incidence since 1984. The human papillomavirus (HPV) vaccine and cervical screening are key preventive measures, with targets set by the WHO and the Canadian Partnership Against Cancer (CPAC) to eliminate cervical cancer in Canada by 2030 and 2040, respectively. These targets include increasing HPV vaccination rates, implementing primary HPV screening, and improving follow-up for abnormal HPV+ results. However, Canada's progress has been impeded by significant challenges. As of the most recent data, HPV vaccine coverage rates in Canada range from 47% to 81%, with an estimated national HPV vaccination completion rate of 64% in Canada, far below the target of 90% by 2025 set by the CPAC. With the exception of British Columbia and Prince Edward Island, the adoption of HPV DNA testing as the primary screening method has been slow across the Canadian provinces and territories despite its superior sensitivity compared with traditional cytology. This article reviews the current state of HPV vaccination and screening in Canada, emphasizing the need for coordinated efforts, transparency, and resource sharing to overcome barriers. Key recommendations include the dissemination of accessible educational materials, partnerships, and collaboration, including nationwide task forces and roundtables, and the implementation of standardized guidelines for HPV screening. Achieving cervical cancer elimination requires a united approach involving federal, provincial, and territorial health authorities, researchers, clinicians, NGOs, community groups, and patients' voices working together to ensure consistent, effective, timely, and meaningful cervical cancer prevention strategies are used across the country.