دورية أكاديمية
أعرض في EDS

Barriers to and facilitators of implementing colorectal cancer screening evidence-based interventions in federally qualified health centers: a qualitative study.

التفاصيل البيبلوغرافية
العنوان: Barriers to and facilitators of implementing colorectal cancer screening evidence-based interventions in federally qualified health centers: a qualitative study.
المؤلفون: Dias EM; UTHealth Houston School of Public Health, Houston, TX, USA. Emanuelle.Dias@uth.tmc.edu., Padilla JR; UTHealth Houston School of Public Health, Houston, TX, USA., Cuccaro PM; UTHealth Houston School of Public Health, Houston, TX, USA.; UTHealth Houston Institute for Implementation Science, UTHealth Houston School of Public Health, Houston, TX, USA., Walker TJ; UTHealth Houston School of Public Health, Houston, TX, USA.; UTHealth Houston Institute for Implementation Science, UTHealth Houston School of Public Health, Houston, TX, USA., Balasubramanian BA; UTHealth Houston School of Public Health, Houston, TX, USA.; UTHealth Houston Institute for Implementation Science, UTHealth Houston School of Public Health, Houston, TX, USA., Savas LS; UTHealth Houston School of Public Health, Houston, TX, USA., Valerio-Shewmaker MA; UTHealth Houston School of Public Health, Houston, TX, USA., Chenier RS; UTHealth Houston School of Public Health, Houston, TX, USA., Fernandez ME; UTHealth Houston School of Public Health, Houston, TX, USA.; UTHealth Houston Institute for Implementation Science, UTHealth Houston School of Public Health, Houston, TX, USA.
المصدر: BMC health services research [BMC Health Serv Res] 2024 Jul 10; Vol. 24 (1), pp. 797. Date of Electronic Publication: 2024 Jul 10.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Colorectal Neoplasms*/diagnosis , Early Detection of Cancer* , Qualitative Research*, Humans ; Texas ; COVID-19/epidemiology ; Evidence-Based Practice ; Female ; Male ; Quality Improvement/organization & administration
مستخلص: Background: There is an urgent need to increase colorectal cancer screening (CRCS) uptake in Texas federally qualified health centers (FQHCs), which serve a predominantly vulnerable population with high demands. Empirical support exists for evidence-based interventions (EBIs) that are proven to increase CRCS; however, as with screening, their use remains low in FQHCs. This study aimed to identify barriers to and facilitators of implementing colorectal cancer screening (CRCS) evidence-based interventions (EBIs) in federally qualified health centers (FQHCs), guided by the Consolidated Framework for Implementation Research (CFIR).
Methods: We recruited employees involved in implementing CRCS EBIs (e.g., physicians) using data from a CDC-funded program to increase the CRCS in Texas FQHCs. Through 23 group interviews, we explored experiences with practice change, CRCS promotion and quality improvement initiatives, organizational readiness, the impact of COVID-19, and the use of CRCS EBIs (e.g., provider reminders). We used directed content analysis with CFIR constructs to identify the critical facilitators and barriers.
Results: The analysis revealed six primary CFIR constructs that influence implementation: information technology infrastructure, innovation design, work infrastructure, performance measurement pressure, assessing needs, and available resources. Based on experiences with four recommended EBIs, participants described barriers, including data limitations of electronic health records and the design of reminder alerts targeted at deliverers and recipients of patient or provider reminders. Implementation facilitators include incentivized processes to increase provider assessment and feedback, existing clinic processes (e.g., screening referrals), and available resources to address patient needs (e.g., transportation). Staff buy-in emerged as an implementation facilitator, fostering a conducive environment for change within clinics.
Conclusions: Using CFIR, we identified barriers, such as the burden of technology infrastructure, and facilitators, such as staff buy-in. The results, which enhance our understanding of CRCS EBI implementation in FQHCs, provide insights into designing nuanced, practical implementation strategies to improve cancer control in a critical setting.
(© 2024. The Author(s).)
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معلومات مُعتمدة: T32 CA057712 United States CA NCI NIH HHS; 1NU58DP006767-01-00 United States CC CDC HHS; T32/CA057712 United States NH NIH HHS; 1U48DP006408-01-00 United States CC CDC HHS
فهرسة مساهمة: Keywords: Barriers; CFIR; Cancer; Colorectal cancer screening; Content analysis; Evidence-based interventions; Facilitators; Implementation; Oncology
تواريخ الأحداث: Date Created: 20240710 Date Completed: 20240711 Latest Revision: 20240714
رمز التحديث: 20240714
مُعرف محوري في PubMed: PMC11238502
DOI: 10.1186/s12913-024-11163-0
PMID: 38987761
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-6963
DOI:10.1186/s12913-024-11163-0