Table 2.

Multilevel Framework Examples

Level	Hiatt and Breen (3)	Warnecke et al. (22)	Taplin et al. (23) Gorin et al. (24)	Morrissey et al. [26]
Macro- Environment	Defined by Factors: Social determinants and Health Care Systems	Defined by sub-levels (from largest to smallest): Social conditions (e.g., discrimination), Institutions (e.g., Families), Neighbor- hood, Social Relationships	Defined by sub-levels: National/state policy, local community, organization or practice setting, health care providers, family/ social support	Defined by sub- levels from Taplin et al. (23) Gorin et al. (24)
Individual	Defined by Factorsy: Social Determinants, Behavioral/ Psychological factors	Defined by Factors: Age, Socioeconomic status, Education, Obesity, Tobacco Use, Acculturation, Diet, Race	Defined by Factors: Biological Factors, Sociodemographics, insurance coverage, risk status, comorbidities, knowledge, attitudes, beliefs, decision- making preferences, psychological reaction/coping	Similar to Taplin et al. (23) Gorin et al. (24) where individual is described as the patient.
Biologic	Defined by Factors: genes and biomarkers	Defined by Factors: Allostatic Load (e.g., combination of stress markers or other biomarkers), Metabolic Processes, Genetic Mechanisms		Defined by sub- levels (largest to smallest level): Organ, Tissue, Cell, Gene, Molecule, Atom
Primary Outcome of Interest	Cancer Control Continuum (Pre-disease, pre-clinical, incidence, morbidity/ survival, mortality) Interventions (Prevention, early detection, diagnosis/treat- ment, quality of life)	Cancer Health Disparities	Cancer Care Continuum (Risk assessment, primary prevention, detection, diagnosis, treatment, survivorship, end of life)	Cancer Care Continuum