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Piloting Performance Measurement for Comprehensive Cancer Control Programs

Rochester, Phyllis PhD; Porterfield, Deborah S. MD, MPH; Richardson, Lisa C. MD, MPH; McAleer, Kelly MSPH; Adams, Elizabeth MS; Holden, Debra PhD

Journal of Public Health Management & Practice: May/June 2011 - Volume 17 - Issue 3 - p 275–282
doi: 10.1097/PHH.0b013e3181fd4d19
Original Article

Objective: To implement a pilot test of performance measures for National Comprehensive Cancer Control (CCC) programs funded by the Centers for Disease Control and Prevention (CDC).

Design: A cross-sectional assessment conducted in 2008.

Setting: A total of 65 CCC-funded entities (51 states, 7 tribes, and 7 territories or jurisdictions) representing 69 CCC programs. Participants: Comprehensive Cancer Control program staff.

Main Outcome Measures: In a process that involved stakeholders from funded programs, academia, and nonprofit organizations, the CDC developed a framework for evaluation and a performance measures worksheet containing 11 performance measures for CCC programs that assessed grantee attainment of key components of CCC as required in the funding announcement. The framework was based on a CCC logic model. The performance measures worksheet contained detailed description of the measures, definitions, and suggested data sources for the 11 measures.

Results: Of the 69 programs, 61 completed the worksheets. The median time reported to complete the worksheet was 10 hours (interquartile range = 6-20). Almost all programs reported having representation of relevant populations in their coalition and having conducted a recent assessment of the burden of cancer. Less frequently, programs reported having a written evaluation plan or having enacted policy changes. Additional performance measures described non-CDC funding, the percentage of partners implementing CCC activities, and the percentage of implemented interventions that were evidence-based.

Conclusions: This pilot test of the performance measures worksheet established the feasibility of conducting a standardized survey of CCC programs to identify issues of importance to developing and implementing the CCC program at national and program levels. The performance measures provided unique data on CCC grantees to the CDC funders and feedback on performance measures for improving questions on future surveys. Refinement of the performance measures will provide a tool for monitoring processes of action and accountability of grantees and will encourage a culture of quality improvement through systematic evaluation.

This study details the process of developing a performance measurement system for Comprehensive Cancer Control grantees that is an initial step in program evaluation for the Comprehensive Cancer Control program, and describes the results from the 2008 pilot test of a performance measures worksheet.

Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Rochester and Richardson); RTI International, Research Triangle Park, North Carolina (Drs Porterfield and Holden and Mss McAleer and Adams); and Additional Members of the Centers for Disease Control and Prevention Performance Measures Workgroup (Mss Gardner, Gill, Fairly and Moore, and Mr Lowry). Dr Rochester has retired.

Correspondence: Lisa C. Richardson, MD, MPH, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Atlanta, GA 30341 (

The study was funded by Centers of Disease Control and Prevention (Contract 200-2002-00575 to 16) to RTI International.

The authors thank the Comprehensive Cancer Control program staff who reviewed drafts of the Performance Measures worksheet, and the Comprehensive Cancer Control program staff who piloted the instrument and provided valuable feedback for future efforts.

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

© 2011 Lippincott Williams & Wilkins, Inc.