Using qualitative and participatory methods to refine implementation strategies: universal family psychosocial screening in pediatric cancer.
Using qualitative and participatory methods to refine implementation strategies: universal family psychosocial screening in pediatric cancer.
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使用定性和参与式方法来完善实施策略：儿科癌症中的普遍家庭社会心理筛查。
DOI：
10.1186/s43058-021-00163-4
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发表时间：
2021-06-05
影响因子：
--
通讯作者：
Barakat LP
中科院分区：
文献类型：
--
作者：
Deatrick JA;Kazak AE;Madden RE;McDonnell GA;Okonak K;Scialla MA;Barakat LP
患有癌症的儿童及其家人面临短期和长期心理社会困难的风险。对心理社会风险的筛查仍然不一致，导致获得心理社会服务的机会不公平。心理社会评估工具（PAT）是一种基于证据的家庭心理社会风险护理报告筛选器，准备在全国范围内的随机分组试验中实施，该试验将在18个儿科癌症中心测试两种实施策略。目前的研究是为试验做准备，征求了主要利益相关者对先前研究中确定的两项拟议实施战略的看法，重点是健康公平和所有家庭的筛查（普遍筛查）。研究结果被用来完善实施策略，以便在随后的试验中进行测试。对19个关键利益相关者（父母、医疗保健提供者、儿科肿瘤学组织和儿科医疗保健领导者）进行了关于这两种实施策略的半结构化访谈。战略一是培训网络研讨会;战略二是培训+实施增强资源，其中包括每个站点的冠军和每月的同行支持咨询电话。数据进行了分析，使用直接内容分析与演绎推导代码的基础上的交互系统框架和归纳代码的基础上出现的数据。与利益攸关方的访谈提供了丰富的数据，可用于严格修改拟议的实施战略。根据这些建议修改了执行战略：通过将家庭心理社会筛查作为更有效和更有效的做法的机会，使提供者参与进来;对100%的儿童及其家庭进行筛查的重要性设定明确的期望，以实现普遍筛查、公平护理和减少差异的目标;并调整成功的战略，系统地实施筛查，以确保儿童及其家人在整个照料过程中的最佳参与。利益攸关方的投入加强了执行战略，提出了强调健康公平和减少健康差距的修改建议。利用实施科学的方法，建立在一个长期的研究计划，提供了有关家庭的迫切需要和历史的见解结构性不平等，如语言差异和获得服务的实际见解。由此产生的战略解决了儿童癌症护理的社会生态的各个层面，包括患者，家庭，提供者，医疗保健系统和社区。NCT 04446728 2020年6月23日在线版本包含补充材料，可通过10.1186/s43058-021-00163-4获得。
Children with cancer and their families are at risk for short- and long-term psychosocial difficulties. Screening for psychosocial risk remains inconsistent, leading to inequitable access to psychosocial services. The Psychosocial Assessment Tool (PAT) is an evidence-based caregiver report screener of family psychosocial risk ready for implementation in a nationwide cluster randomized trial that will test two implementation strategies across 18 pediatric cancer centers. The current study, conducted in preparation for the trial, solicited the perspectives of key stakeholders about two proposed implementation strategies identified during previous research which focus on health equity and screening of all families (universal screening). Results were used to refine the implementation strategies for testing in the subsequent trial. Semi-structured interviews with 19 key stakeholders (parents, health care providers, pediatric oncology organizations, and pediatric healthcare leaders) were conducted regarding the two implementation strategies. Strategy I is a training webinar; Strategy II is training + implementation enhanced resources, which includes a champion at each site and monthly peer support consultation calls. Data were analyzed using directed content analysis with deductively derived codes based on the Interactive Systems Framework and inductive codes based on emerging data. Stakeholder interviews provided rich data to rigorously modify the proposed implementation strategies. Implementation strategies were modified in consistent with these recommendations: engaging providers by framing family psychosocial screening as an opportunity for more efficient and effective practice; setting clear expectations about the importance of screening 100% of children and their families to achieve the goal of universal screening, equity of care, and reduction of disparities; and adapting successful strategies for systematic implementation of screening to ensure optimal engagement with children and their families throughout their care. Stakeholder input strengthened implementation strategies by suggesting modifications that emphasized health equity and reduction in health disparities. Using implementation science methods to build on a long-standing program of research provided practical insights about immediate needs of families and historical insights regarding structural inequities such as language differences and access to services. Resulting strategies address all levels of the social ecology for children’s cancer care, including the patient, family, provider, healthcare system, and community. NCT04446728 June 23, 2020 The online version contains supplementary material available at 10.1186/s43058-021-00163-4.
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DOI：
10.1007/s10488-014-0552-6
发表时间：
2015-09
影响因子：
2.6
作者：
Green, Carla A.;Duan, Naihua;Gibbons, Robert D.;Hoagwood, Kimberly E.;Palinkas, Lawrence A.;Wisdom, Jennifer P.
通讯作者：
Wisdom, Jennifer P.
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：
Scialla MA;Canter KS;Chen FF;Kolb EA;Sandler E;Wiener L;Kazak AE
通讯作者：
Kazak AE
影响因子：
3.2
作者：
Scialla MA;Canter KS;Chen FF;Kolb EA;Sandler E;Wiener L;Kazak AE
通讯作者：
Kazak AE
影响因子：
3.2
作者：
Kazak, Anne E.;Abrams, Annah N.;Kupst, Mary Jo
通讯作者：
Kupst, Mary Jo