In CCSN’s first year, we were focused on providing a strong foundation for its three initial programs. Once this foundation was set, we realized we needed to focus more on our communication strategies. Mainly focusing on how we communicate with those outside of our network, and how to promote our efforts to other stakeholders working in cancer disparities. This blog explains the process of how I have learned to use visuals as communication tools to create brand recognition and convey messaging to multiple target audiences- without being an expert in communications or design.
 
The first promotional item I developed was our logo. CCSN needed its own logo because it would provide a unifying image that would remain with our network, even as we continue to grow and expand. Logos can also convey core values and provide brand recognition, having people equate the image with an initiative’s, hopefully positive, reputation at a quick glance. Since I do not have experience in logo creation, I sought out a webtool with the following features to help me create a high quality image:

1. A comprehensive library of original images to pick from
2. The ability to customize components of the image’s color and font style
3. Provide purchasing rights for our exclusive use of the logo 

I discovered the website BrandCrowd met each of these requirements, all while being an extremely user-friendly platform. Selecting and customizing the logo was a collaborative effort within our leadership team. Tobi Cawthra, the Program Manager for CCSN and one if its original founders, noticed symbolism in the logo’s shape. She found it to resemble how CCSN brings people together with different experiences and perspectives around a central unifying purpose. And after she explained this symbolism, our team completely agreed! 
 
Color choice for a logo is also an important component because color can convey its own messaging within an image. After playing around with a variety of color palates and multiple team deliberations, we decided on the logo above to represent CCSN. Greens are often associated with growth, and felt organic and neutral. Blue tones are often associated with trust and clarity, and the orange provides energy and vibrancy. And just like that, it all came together, and we had created and purchased CCSN’s logo!
 
In addition to a logo, we needed a website that could reflect the vastness of our partners, help increase our visibility, and legitimize CCSN in an ever-growing digital world. Tobi had already created a domain/web address for CCSN through a web building platform called Weelby. Weebly has a plethora of tools delivering customization of nearly every aspect of a website, which is awesome, but can also be daunting to figure out where to begin.
 
Thankfully, Collaborative Work Group’s Co-leader, David Frazer helped Tobi and I think about the website’s audiences, which content was necessary for those audiences, and consider the styles of other websites to start envisioning what CCSN’s could be. We quickly agreed that both community members and cancer researchers would use the website for information and as a way to connect with CCSN. From there, I had a lot of creative freedom with the website. I really liked the idea of having the home page show off multiple communities throughout Milwaukee, and a drone video-banner was able to accomplish that better than a still photo could. I also decided to incorporate the logo and logo colors throughout the website to reinforce brand recognition.
 
All of these visual aspects have come together nicely in combination with the written content our teams have developed over the past years. And as our initiatives progress, we can continue to reimagine and adjust using these tips I’ve learned along the way:

• Use logo colors to stay on brand and create brand recognition
  • Use the Hex/ Red, Blue, Green color numbers to be precise
• Experiment and have fun with new tools such as Canva or Weebly to enhance your skillset
• Use arrows, text bubbles, or section blocks to create a visual flow or progression
• Understand the purpose of the communication tool
  • Who is your audience and what do they need to get from the tool?
  • Is your style more casual or formal? Which style would resonate better with your audience?
• Use concise wording to prevent text overload
  •  You can always link out to a website, QR code, or email address for more information
• Be open to critiques from trusted colleagues
  • Multiple perspectives can create better products! Which is a core value of CCSN-

​“Group project”- two words that earn a groan from just about any classroom. Most kids don’t enjoy working on team projects and neither do adults. Collaboration is hard. It is especially challenging when you are bringing together people from many different fields and experiences.

So, if collaboration is so hard, why do we do it?
“Collaboration” is a bit of a buzzword; we hear it everywhere. But what does it really mean? By strict definition, when you collaborate two or more people cooperate; they work to achieve something. It’s from Latin, collaboratus, -to labor together. The theory is that in laboring together we can accomplish more than we can alone.

This is especially true when we are working with complex problems, those with numerous interconnected elements. No one person can address every facet of a problem. If one person just works on what they know, they will miss a lot of information and opportunity. An if multiple people are only working on one part of the issue, well, they probably won’t be very effective either.

The more complex or seemingly intractable a problem is, the more broad the knowledge and expertise is needed to find an answer. This requires transdisciplinary collaboration (or transdisciplinary research in academic settings). In transdisciplinary collaboration, people come together representing multiple disciplines and experiences. They work to integrate their individual knowledge to create a new knowledge or understanding .

Transdisciplinary Collaboration- the How of Collaboration
Just bringing multiple disciplines together doesn’t automatically produce good transdisciplinary collaboration. In fact, good transdisciplinary collaboration is often messier and less straightforward than simple multi-disciplinary or interdisciplinary collaboration. Our collaborative, known as the Community and Cancer Science Network (CCSN), consists of researchers, community organizations, providers of care, individuals with direct experience with cancer and disparities, funders and more. When our collective work began, we didn’t use the same language to talk about the problem we were addressing; we didn’t use the same methods to solve problems; we didn’t have exactly the same resources at our disposal and we didn’t have the same motivation for being there. 

Yet, through transdisciplinary collaboration, we have been able to build these differences into collective strengths and develop several transdisciplinary teams whose efforts center on reducing cancer disparities. The process to develop these teams has contributed to our learning on ways that transdisciplinary teams can work.

Start with a consolidated understanding of the problem
When CCSN brings partners together, we start by finding ways to help them see the wealth of knowledge and expertise each partner brings. This comes through facilitated discussion that surfaces the collective awareness of the group. In one CCSN team, we used the “5-whys” exercise to explore the collective knowledge of the root causes of disparities for specific cancers. The illustration produced from this exercise demonstrated three things. First, it showed visually the breadth and depth of knowledge and expertise on the team. Next, it pointed to linkages across disciplines. Last, and perhaps most importantly, it illustrated each person’s unique contribution to solving the problem.

This team returned to this document on several occasions to reground the team on the interconnections between team members. The team also updated the document periodically to reflect new knowledge or understanding allowing them to document their progress and learning. This simple and important exercise proved helpful whenever the team struggled with collaboration or were not advancing as quickly as they would like. It reminded them that they need all the perspectives to fully understand and address cancer disparities.

Coach and convene; don’t dictate and control
A shared understanding is not enough. CCSN also uses coaching tools. Instead of focusing facilitation on moving through an agenda, we used meetings to coach collaboration and identify barriers and promoters for collaboration. Tobi, who served as the primary facilitator, focused on developing trust among team members and identifying group communication styles and preferences, while still advancing the work. As the developmental evaluator, Laura, focused on frameworks and processes to draw out nuanced perspectives.

After each meeting, we reflected together on how the meeting went, where collaboration could be enhanced and what strategy would get us there. For example, when team members did not offer opinions or insights in a meeting, we provided opportunities to get insights and feedback between meetings via email or one-on-one conversations. We also led the team in small group activities, always assigning team members to groups to expand the interaction among team members. Through these types of activities, we were able to draw out engagement across the different sectors represented.

​In this process, we also modeled an inquisitive approach. We did not discourage any ideas or threads of inquiry. We allowed agendas to be flexible or even set aside when a topic arose that was of particular relevance. This approach welcomed others to do the same and developed an environment where everyone was free to explore questions and not be the expert.

Let the collaborators benefit from messiness
Our teams experience a great degree of learning during their time together. And this learning is not a straightforward process. All of the teams have felt stuck and confused at times. Often, team members felt that they were re-hashing decisions or rethinking steps. At times, they were, but they were approaching those decisions and steps with a new and deeper understanding of an issue.

CCSN teams are eager to advance solutions. As a result, they struggle, at times, to be patient with learning and incorporating new knowledge. This happens most frequently when a collaboration is struggling or when necessary information to solve the problem is missing. At these times, we intentionally slow down progress to either address how the team could work better together, or perhaps find ways to draw in missing information.

CCSN teams mature as collaboratives by working through this messiness and discomfort together. We have observed that the harder the challenge, the more connected the team becomes once they push past this discomfort. For example, the original CCSN team members continue to stay connected as well as bring in other partners. Initial team members have gone on to lead a transdisciplinary team or participate on one, and many report seeing how a transdisciplinary approach could benefit their other collaborations. They describe the original team as the “Dream Team” and continue to reflect upon how this collaboration changed how they do their work and how they understand the issue.

And, this is why we struggle through collaboration. Yes, it can make work go more smoothly and yes, it can streamline processes. But, why we struggle through collaboration is that it changes us. It makes us better at our vocations and our avocations.

Most programs and initiatives gather a lot of data. Having the capacity to hone in on the most important data to help improve the process is a common challenge. This is where a dashboard can be useful. A dashboard is a visual snapshot of your data. Dashboards use charts and graphs built from underlying data in a spreadsheet or database to highlight patterns in data. What elements get included in a dashboard are based on specific questions about how a strategy is expected to perform. Although it seems simple, it is a powerful way to synthesize and interpret data in a visual form. 

Why a Dashboard 
Creating a dashboard from the existing Scholars Program tracking tool addressed several challenges: (1) project leadership was primarily focused on executing program activities and had little time for record-keeping; (2) the tracking tool dataset was getting too big to focus on the most critical information; and (3) notes about required follow-up and next steps were getting lost with so much information. Providing a quick visual snapshot of the data helped direct the project team’s attention to the most important information. 

There are many dashboard tools on the market for purchase that will populate dashboards at the click of a button. We built our visual dashboard in the same Excel workbook we use to track outreach and recruitment. While we are not experts in creating dashboards, we found we could create a customized dashboard with minimal effort. The visual elements of our dashboard, once developed, allowed us to quickly answer questions about the size and strength of our recruitment pool and what immediate actions we needed to take to course correct. 

Using Dashboards to Grow Our Recruitment Strategy 
Since our tracking tool was designed to hold a lot of data, we first had to determine the most critical data points for understanding our immediate recruitment goals. We chose fields that would trigger further conversation between team members that would encourage them to think about next steps or strategy. For example, listing how many contacts were “closed” vs. “open” led to a discussion about whether follow-up communication was needed. A graph showing which sectors our contacts belonged to led to a conversation about whether we had enough scholars interested from the sectors we needed. Charts displaying the outcomes from our contacts led to conversations about what strategies they were responding to and what they were not. These discussions helped us identify critical next steps to adapt recruitment and outreach strategies to meet our recruitment goals. 

In order to identify action steps to achieve recruitment goals, we made reviewing the data dashboard a standing agenda item. The team dedicated time on each agenda to debrief on closed contacts and focus on new strategies for open contacts. The discussion further strengthened the quality of our data. As the team reflected on the visual dashboard components, it reminded them of the details of their outreach; they could focus on strategic approaches and ways in which to make the best use of their time. As a standing agenda item, it created a great opportunity to discuss the communication and recruitment process and provided a context for the team to identify areas for immediate improvement, and surfaced important questions to strengthen future cycles. 

Implementing a Dashboard in Your Own Work 
Dashboards are effective tools to help a team focus on progress toward meeting goals and identifying critical steps in a process. Dashboards focus a team’s attention where it is needed most, which is helpful when team members are engaged in different aspects of the work. Lastly, and most importantly, they are a simple tool you can use whenever you need to stay on track and make data-informed decisions. 
During the recruitment period, we learned a lot about how to get the most out of our data. Below are recommendations for teams considering a similar process. 

Be flexible and reasonable 

• Don’t be a perfectionist. You may have missing data or an incomplete picture especially when you are gathering data in real time. Focus on what the data tells you and make decisions accordingly. The point is to use your data, not make it look pretty. 
• Start with a simple dashboard that summarizes totals and focuses your attention on the most important issues. You can always add on more nuanced data and interactivity, such as pivot tables, once you have a better feel for what you want to know and how you’ll use this extra information. 

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Actually use your data 

• Agree upon targets and measure progress against those targets. The data collected is arbitrary if you do not know what you’re aiming for. 
• Set a recurring time to review the data and engage your team in what it means. Leave with clear action steps to move forward with the project. 
• Realize that what you want to know about your program may change over time and that’s okay. Adjust your tracking tool and dashboard accordingly to serve your goals. 
• Set aside time at the end of your program cycle for a debrief or After Action Review to reflect and improve for the future. 

It’s nearly impossible today to find someone whose life has not been impacted by cancer in some way – it might be someone they know fighting a cancer battle, or even their own life-changing diagnosis. While decades of research, innovation, and prevention efforts have resulted in life-saving improvements in diagnosis, care, and survivorship, thousands of families still lose a loved one to cancer each year.

Yet while mortality rates are declining nationally, cancer remains a leading cause of death and some groups of people experience a higher burden of cancer incidence and mortality.  In Wisconsin, the disproportionate impact of cancer is startling.

Wisconsin has the nation’s second largest Black–White disparity in lung cancer mortality, and the Milwaukee metropolitan area has the largest Black–White disparity in lung cancer mortality among metropolitan areas nationwide. Additionally, Wisconsin has the nation’s third largest Black–White disparity in female breast cancer mortality. Alongside differences by race and ethnicity, geographic mapping led by the MCW Division of Epidemiology has identified disparities in mortality of twice the expected rate in some areas of the state.

Today, through a multi-year, nearly $10 million AHW investment, a broad coalition of partners called the Community and Cancer Science Network (CCSN) is convening community organizations and academic medicine researchers to identify innovative solutions to address these disparities.

While the project’s aims are stated simply – to eliminate cancer disparities – addressing the complexities of the root causes contributing to these issues require a thoughtful, multi-faceted approach that take into consideration a variety of factors and needs.

The Community and Cancer Science Network grew out of an innovative developmental phase originated by AHW, which brought together a team of experts from community organizations and academic medicine to develop a deeper understanding of Wisconsin’s breast and lung cancer disparities and propose solutions.

“AHW provided the foundation for CCSN. It allowed a team to look at cancer disparities from many different perspectives and use that understanding to propose solutions, which include three initiatives coordinated by a central body known as the Integration Hub,” said Jenelle Elza, RN, strategic partnerships manager at the American Cancer Society and community co-PI for the CCSN Integration Hub.

“We’re seeing the impact within organizations and structures. Our peers from across the state are looking to us because they’re hungry to do something different.” - Kim Kinner
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In its initial year, the CCSN Integration Hub established a full advisory team, built developmental evaluation capacity, and identified community and academic leaders who would collaboratively shape proposals for impacting three key areas identified as needing focus: a pilot curriculum for community members and early-career biomedical researchers to address issues of mistrust and misunderstanding, understanding the role of mammographic quality in breast cancer disparities, and supporting multi-sector collaborative workgroups focused on furthering the work around critical issues of cancer disparities.

“The idea behind the integration hub is to build collaborative infrastructure across the state,” said Dr. Melinda Stolley, Anne E. Heil Professor of Cancer Research, Professor of Medicine, and associate director of cancer control and prevention at the Medical College of Wisconsin, who is the initiative’s academic Co-PI . “This initiative provides that environment; a structure and framework to do this work together and create sustainable solutions that can be applied to other focal areas in the future.”

In 2020 and 2021, the network launched its initiatives to address each of these areas. Supported by $4.8 million in AHW investment, the initiatives are bringing together the efforts of the world-renowned MCW Cancer Center with the expertise and experience of Wisconsin-based organizations including the Wisconsin Women’s Health Foundation, Center for Urban Population Health, House of Grace, Kingdom Ministries, the Wisconsin Women’s Health Foundation, the Wisconsin Cancer Collaborative and more.

A Research and Community Scholars Program has formed its inaugural class aimed at building a generational change in how medical mistrust and misunderstanding is approached.

A Mammographic Quality Project, whose team is growing to include partners from across the state, is examining whether mammography imaging, interpretation, and follow-up quality are influencing breast cancer disparities in Wisconsin while working to develop local and regional collaborative teams to sustain quality metrics.

The Collaborative Work Group initiative is working to build teams of diverse community and academic perspectives who will develop and implement integrated approaches addressing Wisconsin’s breast and lung cancer disparities. The teams will learn together, create collectively, and overcome issues of trust and power imbalances.

The Integration Hub recognizes that in addressing the complexities of cancer, tangible results may not be seen in health outcomes for years.

“Our wins are different than a traditional initiative,” said Kim Kinner, MA, senior director of cancer control partnerships at the American Cancer Society and community co-PI for the CCSN Integration Hub. “We’re seeing the impact within organizations and structures. Our peers from across the state are looking to us because they’re hungry to do something different.”

It's the foundation for innovation that has promise to impact the health of Wisconsinites for generations to come.

*Cross posted on Advancing a Healthier Wisconsin Endowment*

Using data in real time can strengthen any initiative. The Community and Cancer Science Network (CCSN) is an initiative of the Medical College of Wisconsin and the American Cancer Society. CCSN brings together partners from the community and academic medicine to address the different outcomes for different groups of people in the breast and lung cancer space. Evaluation Plus (E+) is the developmental evaluation partner of CCSN. E+’s role is to support a learning using different methods to answer design questions and use data in real-time to execute on strategy.

One of CCSN’s initiatives is the Research and Community Scholars Curriculum (“Scholars Program”). This Scholars Program brings together community leaders and biomedical researchers to learn about cancer disparities and cancer research from different perspectives, discuss the role of science and lived experience with bias and racism, and experiment with community-academic partnerships for problem-solving.

The Case for Real-time Data Tracking
The first cohort of the Scholars Program started in September 2021. To recruit scholars, program leadership used a combination of general outreach and targeted recruitment strategies. Outreach included making connections with community leaders and researchers to create awareness about the program and to explain CCSN and its value proposition. More targeted recruitment strategies followed up on referrals as well as direct asks to potential applicants.
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While we were hopeful we would meet our recruitment goals through these strategies, we still wanted to understand not just if the strategies were working, but how. To support the learning need, the team decided it needed a way to track the connections being developed, recruitment progress, and what challenges were surfacing. The solution: develop an easy-to-use and cost-effective tracking tool to capture the this data in real-time.

What is a tracking tool?
While we had made the case for real-time data tracking, we still need a way to gather the data. Tracking tools keep a record of what’s happening in a project. It can be as simple or as complex as required to meet the needs of the project. Some tracking tools are built into program management or other software packages. If you don’t have a software, you can easily build a tool using every day word processing or spreadsheet programs. The Scholars Program designed its tracking tool in Excel to document communication efforts and collect data to answer important evaluation learning questions, including:

• Are we on target to meet our recruitment goals? Why or why not?
• What questions do our networks have that could help us improve recruitment materials and strategies?
• Who is responsive to our outreach and who is not? And why?
• What kind of follow-up is needed in the recruitment phase?

How to Build the Tool
A quality tracking tool captures information consistently to make decisions about strategy. It can take time to identify and prioritize the most important data points to track. In the Scholars Program tracking tool, we wanted information like contact names, types of outreach efforts and outcomes of these efforts. To make it easy to use and consistent, we used drop-down options to get rid of inconsistencies in data entry. We knew our first version of the tool was not final, so, we met weekly during roll out to review the data being entered and make adjustments.

Getting the Most from the Tool
During recruitment, we used the tool to track the process and outcomes of different strategies. To make good decisions about strategy, its important to get good data and use it. One of our challenges was finding the time to get the data into the tool. To address this challenge, we appointed one person “information gatekeeper.” While the full team took responsibility for recruitment, the only person entering data was the information gatekeeper. The information gatekeeper regularly sent emails to team members with questions about their outreach. Additionally, team members copied the information gatekeeper on any recruitment emails.

To be sure we were using the tool and that the information was quality, E+ and the information gatekeeper met before each bi-weekly meeting to identify where more information was needed. We would then go into the program meetings with additional questions to address these information gaps and talk about what we were learning. These questions and discussions kept the project moving forward, but also allowed time to build out best practices for future recruitment.

Using a Tracking Tool in Your Own Work
Using this tool with the Scholars Program helped us manage processes and deadlines. It also helped us make near real-time adjustments to our plan. Further, it not only provided information about the success of our strategies, but helped manage multiple team members with different responsibilities for the project. By being intentional about the use of the tool, we also learned a lot about how to get the most out of our data. If you have a need for real time data, consider some of these ideas before building your tool.

Start with good data

• Define fields clearly. Don’t assume anything is common knowledge!
• Don’t leave cells blank. Instead, develop a way of noting missing data or data that is not applicable.
• Use drop down boxes rather than open text to maintain consistent data.
• Be clear and specific when asking for information from your contacts.
• Agree on a process for data entry. Once the process is decided, set up a training for people entering the data.

Be Flexible

• Focus only on most important information and how it will be used. Do not spend time and energy tracking data you won’t use.
• Know that it may take more than one communication to get the information you need.
• Offer multiple ways for people to provide data.
• Don’t be a perfectionist. It is okay to have missing data. The goal is to use the data you have right now. If you are using the data in real-time, it will get better.

Be intentional about data use

• Agree on the targets and assess your progress against those targets. The data collected mean little if you don’t know what you’re aiming for.
• Set a recurring time to review the data and engage your team in helping understand what it means. Each person should leave with clear action steps that will move the project forward.
• Realize that what you want to know may change overtime. Adjust your tool to serve your goals instead of your goals to serve your tool.

*Cross posted on Evaluation Plus*