Heine group

Within this research area we focus on the co-creation and adaptation of evidence-based (or informed) pediatric oncology innovations to improve effective and sustainable quality care while aligning with the contextual needs and capabilities. One of the central challenges is balancing fidelity to evidence-based practices with the flexibility required in resource-limited settings. Emphasis on participatory co-design safeguards that innovations are shaped by local clinicians, families, and patients, enhancing both cultural relevance and long-term implementation success.

Within this research area we focus on the implementation strategies and actions that translate ideas into sustained practice. The aspired process-focused research will explore which strategies (for example mentorship networks, audit and feedback, task-shifting, or community-based outreach activities) can be most effective for scaling and sustaining oncology interventions in low-resource settings. This topic also includes questions around how implementation strategies evolve over time, how and when strategies need to be stacked in order to maximise implementation outcomes, and how evidence from pilots or localized efforts is translated into policy, system-wide  or multi-national programs.

Within this research area we focus on understanding the characteristics and roles of diverse stakeholders, including patients, caregivers, providers, policy makers and others that affect the successful implementation of evidence-based interventions into routine care. Their capabilities, opportunities and motivation can profoundly shape behaviour and implementation outcomes. Example research questions may center around the role of tacit knowledge on treatment uptake or public sector role dynamics affecting treatment delays. Research in this domain may for example examine the role clinician self-efficacy, workload, burn-out or professional identity in shaping sustained uptake of interventions into practice, or for instance strategies to support caregiver engagement and patient-centered communication to reduce treatment abandonment.

This research topic focusses on the organizational contexts, which may include hospitals, primary care facilities, referral centers or others organizational settings where pediatric oncology care is, or can be, delivered. Implementation success often hinges on factors like the internal culture, leadership engagement, communication structures, or readiness for change within these institutions. Research within this topic is expected to explore for instance how hospitals coordinate multidisciplinary care, manage limited resources or set priorities, or foster environments that support continuous professional development and quality improvement. Strengthening organizational context often involves strengthening leadership, improving data infrastructure, and creating monitoring and feedback systems that encourage reflection and adaptation.

Within this topic we aspire to focus on the broader policy, economic, and sociocultural environment that influences implementation outcomes, service outcomes and clinical outcomes. These may include national cancer control plans, essential medicines policies, health system priorities, financing systems, and the structure of international partnerships. In pediatric oncology, global–local collaborations often play a critical role (as illustrated through the various twinning partnerships facilitated by the Prinses Máxima Center), though they must navigate power dynamics and sustainability challenges to avoid dependency. Community factors such as stigma, traditional beliefs about cancer, and trust in the health system may further shape whether children are diagnosed early or complete treatment.

Capacity Building in Implementation Science Education for Non-Communicable Disease Prevention and Management in Africa (IS4NCDs), European Union's Erasmus+ programme under Grant Agreement no. 101179511, 2024 – 2027 (www.is4ncds.org) - In collaboration with UMC Utrecht

1.     Klootwijk L, Apadet Osamong L, El Salih I, Dandis R, Kimaiyo S, Vik TA, van de Vijver S, Kaspers G, Njuguna F. Innovative Training to Improve Childhood Cancer Knowledge Among Primary Health Care Providers: Evaluating a Blended Learning Program in Kenya. JCO Global Oncology. 2025 Sep;11:e2500071.

2.     Klootwijk L, Osamong LA, Langat S, Njuguna F, Kimaiyo S, Vik TA, Kaspers G, Mostert S. Childhood Cancer Awareness Program in Bungoma County, Kenya. Journal of Cancer Education. 2025 Feb;40(1):54-64.

3.     Lemmen J, Mageto S, Vik T, Olbara G, Kaspers G, Njuguna F. Non-randomised prospective clinical trial to improve follow-up adherence, survivorship knowledge and late effects documentation at a childhood cancer clinic in Western Kenya: a study protocol. BMJ open. 2025 Jun 1;15(6):e096741.

4.     Bauer MS, Damschroder L, Hagedorn H, Smith J, Kilbourne AM. An introduction to implementation science for the non-specialist. BMC psychology. 2015 Sep 16;3(1):32.