Patient outcomes are a primary measure by which we assess health-care delivery quality. Those outcomes are influenced by numerous other factors in the multilevel context of care described in this monograph (1). Factors include policies that enable or impede health-care access, social support from friends and family, processes of health-care teams, organizational procedures in settings where care is delivered, and the environmental context where these behaviors occur. A few years ago, an internal team of researchers at the National Cancer Institute (NCI) within the Division of Cancer Control and Population Sciences recognized the importance of studying the context in which health care is received to intervene on multiple levels of influence. However, the science of multilevel interventions was in an early stage of development. Thus, the NCI researchers (henceforth “the NCI planning team”) reached out to the extramural community to identify expertise that would help advance this science. The collaborations led to a set of draft articles presented at a conference titled Multilevel Interventions in Health Care: Building a Foundation for Future Research (Las Vegas, NV, March 4–5, 2011). Comments from that conference led to the final articles presented in this issue.
The purpose of this article is to describe the relationship between the research articles and the conference to provide richer context for this monograph. We include a summary of the conference events to reflect the complementary development of the articles, to promote more open discussion of the issues among researchers, and to acknowledge the contribution of the meeting participants. In addition, this article summarizes the history behind the conference, its structure, the themes that developed there, and efforts that began after the conference to encourage discussion about multilevel interventions.