Implementation of a novel program to support colorectal cancer screening in a community health center consortium before and after the onset of COVID-19: a qualitative study of stakeholders' perspectives.
Implementation of a novel program to support colorectal cancer screening in a community health center consortium before and after the onset of COVID-19: a qualitative study of stakeholders' perspectives.
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DOI：
10.1186/s43058-023-00439-x
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发表时间：
2023-05-22
影响因子：
--
通讯作者：
Potter, Michael B.
中科院分区：
文献类型：
--
作者：
Santiago-Rodriguez, Eduardo J.;Hoeft, Kristin S.;Lugtu, Kara;Mcgowen, Matthew;Ofman, David;Adler, Jaime;Somsouk, Ma;Potter, Michael B.
关键词：
2017 年，旧金山癌症倡议 (SF CAN) 设立了结直肠癌 (CRC) 筛查计划，为旧金山低收入社区服务的社区健康中心 (CHC) 联盟提供技术援助和财政支持，以改善 CRC 筛查流程和结果。本研究的目的有两个：评估 CRC 筛查计划工作组提供的支持对这些环境中 CRC 筛查过程和结果的感知影响，并确定在 COVID-19 大流行爆发前后 SF CAN 支持的 CRC 筛查活动的促进因素和障碍。与联盟领导人、医疗主管、质量改进团队成员和临床筛查冠军进行了半结构化的关键知情人访谈。采访经过录音、专业转录并进行主题分析。实施研究综合框架（CFIR）用于制定访谈问题并组织分析。二十二名参与者接受了采访。最常被提及的改进筛查流程的促进因素包括工作组提供的专业知识、资金、筛查资源、定期随访以及与诊所领导的持续接触。确定的最突出的障碍是患者特征，例如住房不稳定；人员配置挑战，例如人手不足和人员流动率高；以及诊所层面的挑战，例如缺乏实施和维持正式患者导航策略的能力，以及由于 COVID-19 大流行和其他相互竞争的医疗保健优先事项而导致诊所优先事项发生变化。在 CHC 联盟中实施 CRC 筛查项目本身就具有挑战性。工作组的技术援助受到积极评价，并有助于缓解大流行之前和期间的挑战。未来的研究应探索机会，提高 SF CAN 等团体提供的技术援助的稳健性，以支持为低收入社区服务的 CHC 的癌症筛查活动。 在线版本包含可在 10.1186/s43058-023-00439-x 获取的补充材料。
In 2017, the San Francisco Cancer Initiative (SF CAN) established the Colorectal Cancer (CRC) Screening Program to provide technical assistance and financial support to improve CRC screening processes, and outcomes in a consortium of community health centers (CHCs) serving low-income communities in San Francisco. The purpose of this study was twofold: to evaluate the perceived influence of the support provided by the CRC Screening Program’s Task Force on CRC screening processes and outcomes in these settings and to identify facilitators and barriers to SF CAN-supported CRC screening activities before and after the onset of the COVID-19 pandemic. Semi-structured key informant interviews were conducted with consortium leaders, medical directors, quality improvement team members, and clinic screening champions. Interviews were audio-recorded, professionally transcribed, and analyzed for themes. The Consolidated Framework for Implementation Research (CFIR) was used to develop the interview questions and organize the analysis. Twenty-two participants were interviewed. The most commonly cited facilitators of improved screening processes included the expertise, funding, screening resources, regular follow-up, and sustained engagement with clinic leaders provided by the task force. The most salient barriers identified were patient characteristics, such as housing instability; staffing challenges, such as being understaffed and experiencing high staff turnover; and clinic-level challenges, such as lack of ability to implement and sustain formalized patient navigation strategies, and changes in clinic priorities due to the COVID-19 pandemic and other competing health care priorities. Implementing CRC screening programs in a consortium of CHCs is inherently challenging. Technical assistance from the Task Force was viewed positively and helped to mitigate challenges both before and during the pandemic. Future research should explore opportunities to increase the robustness of technical assistance offered by groups such as SF CAN to support cancer screening activities in CHCs serving low-income communities. The online version contains supplementary material available at 10.1186/s43058-023-00439-x.
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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：
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通讯作者：
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影响因子：
2.8
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影响因子：
4.4
作者：
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影响因子：
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作者：
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