Identified barriers and facilitators to stroke risk screening in children with sickle cell anemia: results from the DISPLACE consortium.
Identified barriers and facilitators to stroke risk screening in children with sickle cell anemia: results from the DISPLACE consortium.
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DOI：
10.1186/s43058-021-00192-z
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发表时间：
2021-08-10
影响因子：
--
通讯作者：
Kanter J
中科院分区：
文献类型：
--
作者：
Phillips SM;Schlenz AM;Mueller M;Melvin CL;Adams RJ;Kanter J
患有镰状细胞性贫血的儿童有中风的风险。使用经颅多普勒超声可以确定2-16岁镰状细胞贫血儿童的缺血性卒中风险。尽管国家心脏、肺和血液研究所发布的指南中强烈建议进行经颅多普勒筛查，但经颅多普勒筛查在镰状细胞性贫血中的实施仍不理想。本研究的目的是在一个大型的国家联盟中确定经颅多普勒筛查的障碍和促进因素，以告知随后的实施干预措施。采用定性描述方法对52名镰状细胞贫血患者、其父母或主要照顾者以及分散在美国各地的医疗保健提供者进行了半结构化访谈。访谈于2018年9月至2019年3月进行。定向内容分析是以2019年7月完成的多层次健康生态模型的改编版本作为初始编码框架进行的。进行频率分析，以确定主要的障碍和促进者的主题。出现了14个障碍主题和12个促进者主题，代表了生态框架的各个层面。两个障碍主题（物流困难和竞争的生活需求和差距，在调度和协调），和5个促进者的主题（协调，调度和提醒;教育和信息;供应商和工作人员的投资和援助;积极的患者体验;和方便的位置）占主导地位。镰状细胞贫血儿童经颅多普勒筛查的障碍和促进因素是复杂的，并发生在多个生态水平。一个障碍的主题和3个促进者的主题被认为是最佳的解决在随后的实施干预。在线版本包含补充材料，可通过10.1186/s43058-021-00192-z获得。
Children with sickle cell anemia are at risk for stroke. Ischemic stroke risk can be identified among children ages 2–16 years with sickle cell anemia using transcranial Doppler ultrasound. Despite strong recommendations for transcranial Doppler screening in guidelines released by the National Heart, Lung, and Blood Institute, implementation of transcranial Doppler screening in sickle cell anemia remains suboptimal. The purpose of this study was to identify barriers and facilitators to transcranial Doppler screening in a large national consortium to inform subsequent implementation interventions. A qualitative descriptive approach was used to conduct 52 semi-structured interviews with a sample of patients with sickle cell anemia, their parents or primary caregivers, and healthcare providers dispersed across the United States. Interviews took place from September 2018 through March 2019. Directed content analysis was conducted with an adapted version of the Multilevel Ecological Model of Health as an initial coding framework, completed July 2019. Frequency analysis was conducted to determine predominant barrier and facilitator themes. Fourteen barrier themes and 12 facilitator themes emerged representing all levels of the ecological framework. Two barrier themes (Logistical Difficulties and Competing Life Demands and Gaps in Scheduling and Coordination), and 5 facilitator themes (Coordination, Scheduling and Reminders; Education and Information; Provider and Staff Investment and Assistance; Positive Patient Experience; and Convenient Location) were predominant. Barriers and facilitators to transcranial Doppler screening in children with sickle cell anemia are complex and occur across multiple ecological levels. One barrier theme and 3 facilitator themes were found to be optimal to address in subsequent implementation interventions. The online version contains supplementary material available at 10.1186/s43058-021-00192-z.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
3.2
作者：
Raphael, Jean L.;Shetty, Priya B.;Mueller, Brigitta U.
通讯作者：
Mueller, Brigitta U.
影响因子：
7.5
作者：
Hodges, Jason R.;Phillips, Shannon M.;Porter, Jerlym
通讯作者：
Porter, Jerlym
影响因子：
2.2
作者：
Cabana, Michael D;Kanter, Julie;Bardach, Naomi S
通讯作者：
Bardach, Naomi S