Lung cancer screening in rural primary care practices in Colorado: time for a more team-based approach?
Lung cancer screening in rural primary care practices in Colorado: time for a more team-based approach?
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DOI：
10.1186/s12875-023-02003-x
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发表时间：
2023-03-03
期刊：
影响因子：
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中科院分区：
文献类型：
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Despite lung cancer being a leading cause of death in the United States and lung cancer screening (LCS) being a recommended service, many patients eligible for screening do not receive it. Research is needed to understand the challenges with implementing LCS in different settings. This study investigated multiple practice members and patient perspectives impacting rural primary care practices related to LCS uptake by eligible patients. This qualitative study involved primary care practice members in multiple roles (clinicians n = 9, clinical staff n = 12 and administrators n = 5) and their patients (n = 19) from 9 practices including federally qualified and rural health centers (n = 3), health system owned (n = 4) and private practices (n = 2). Interviews were conducted regarding the importance of and ability to complete the steps that may result in a patient receiving LCS. Data were analyzed using a thematic analysis with immersion crystallization then organized using the RE-AIM implementation science framework to illuminate and organize implementation issues. Although all groups endorsed the importance of LCS, all also struggled with implementation challenges. Since assessing smoking history is part of the process to identify eligibility for LCS, we asked about these processes. We found that smoking assessment and assistance (including referral to services) were routine in the practices, but other steps in the LCS portion of determining eligibility and offering LCS were not. Lack of knowledge about screening and coverage, patient stigma, and resistance and practical considerations such as distance to LCS testing facilities complicated completion of LCS compared to screening for other types of cancer. Limited uptake of LCS results from a range of multiple interacting factors that cumulatively affect consistency and quality of implementation at the practice level. Future research should consider team-based approaches to conduct of LCS eligibility and shared decision making.
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影响因子：
2.2
作者：
Carter-Harris, Lisa;Brandzel, Susan;Buist, Diana S. M.
通讯作者：
Buist, Diana S. M.
影响因子：
2.8
作者：
Jenkins, Wiley D;Matthews, Alicia K;Patera, Julie
通讯作者：
Patera, Julie
县医院系统中患者的粮食不安全，社会需求和吸烟状况。
影响因子：
2.8
作者：
Kim-Mozeleski, Jin E.;Chagin, Kevin M.;Sehgal, Ashwini R.;Misak, James E.;Fuehrer, Susan M.
通讯作者：
Fuehrer, Susan M.
影响因子：
9.6
作者：
Fedewa SA;Bandi P;Smith RA;Silvestri GA;Jemal A
通讯作者：
Jemal A
DOI：
10.1016/j.jtho.2018.05.014
发表时间：
2018-08
期刊：
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
影响因子：
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作者：
Hamann HA;Ver Hoeve ES;Carter-Harris L;Studts JL;Ostroff JS
通讯作者：
Ostroff JS