Evaluating and improving the implementation of a community-based hereditary cancer screening program
Evaluating and improving the implementation of a community-based hereditary cancer screening program
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DOI：
10.1007/s12687-018-0357-5
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发表时间：
2019-01-01
影响因子：
1.9
通讯作者：
Marvin, Monica
中科院分区：
文献类型：
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作者：
Greenberg, Samantha;Yashar, Beverly M.;Marvin, Monica
在提供癌症遗传服务方面存在医疗差异，包括与BRCA 1/2突变相关的遗传咨询和检测。为了在社区卫生环境中解决这一问题，创建了一个筛查工具，以确定高危妇女。这项研究评估了该工具的实施情况，并确定了改善癌症遗传筛查的机会，包括定期的临床医生教育。一种混合方法的方法被用来评估临床医生利用的筛查工具在计划生育附属机构。新的调查，评估接受和实施管理的临床医生（n=14）和半结构化访谈（n=6），用于探讨临床医生的观点，并确定其利用的差距。利用教育后调查（n=8）开发、实施和评价了解决差距的教育模块。临床医生报告了管理和解释筛查工具的信心，但报告了他们对癌症遗传学知识和将客户与遗传咨询和检测联系起来的能力的信心较低（p=.003）。教育模块导致临床医生在遗传学主题方面的知识有了显著的提高（p
Healthcare disparities exist in the provision of cancer genetic services including genetic counseling and testing related to BRCA1/2 mutations. To address this in a community health setting a screening tool was created to identify high-risk women. This study evaluates the implementation of the tool and identifies opportunities for improved cancer genetic screening, including regular clinician education. A mixed-method approach was used to evaluate clinician utilization of the screening tool at Planned Parenthood affiliates. Novel surveys that evaluated acceptance and implementation were administered to clinicians (n=14) and semi-structured interviews (n=6) were used to explore clinicians' perspectives and identify gaps in its utilization. Educational modules that addressed gaps were developed, implemented, and evaluated using a post-education survey (n=8). Clinicians reported confidence in administering and interpreting the screening tool, but reported less confidence in their knowledge of cancer genetics and ability to connect clients with genetic counseling and testing (p=.003). Educational modules resulted in significant gains in clinician knowledge on genetic topics (p