Forging Implementation of Cancer Screening Reminder Systems (FICSRS)

描述(申请人提供)：这项为期两年的队列研究将评估2006年1月开始的大规模筛查乳房X光检查患者提醒计划的实施情况。这一真实世界的案例研究将被用来提炼实施癌症筛查提醒系统的“FICS-It”概念模型(“伪造癌症筛查的实施”)。FICS-IT模式考虑了外部环境、干预设计、传播-实施基础设施，以及采用组织(特别强调卫生保健团队)及其患者。我们的工作将提供建议，以改善乳房X光检查筛查提醒计划的覆盖范围、有效性、采用率、实施和维护(RE-AIM评估框架)。这项探索性研究的结果将用于开发和评估改进的癌症筛查提醒计划的实施方法。在40岁或40岁以上应重复筛查乳房X光检查的女性健康计划成员(n=32,500)及其卫生保健团队和其他关键工作人员中，主要目标是：1.使用量化方法评估：a)改善重复乳房X光检查的患者提醒计划的总体有效性和维持性程度；b)卫生保健团队实施工作实践对整体计划有效性和维护性的影响。2.在一个全面的概念框架指导下，使用混合方法和多个视角描述和解释乳房X光检查患者提醒计划的覆盖范围、有效性、采用、实施和维护。3.建议改进的方法，以提高筛查乳房X光检查患者提醒计划的覆盖面、有效性、采用率、实施和维护，并根据目标1和2的研究结果，为未来的研究完善概念框架和研究工具。

DESCRIPTION (provided by applicant): This 2-year cohort study will evaluate the implementation of a large-scale screening mammography patient reminder program that began in January 2006. This real-world case study will be used to refine the "FICS-it" conceptual model for implementation of cancer screening reminder systems ("Forging Implementation of Cancer Screening"). The FICS-it model considers the external environment, intervention design, dissemination-implementation infrastructure, and adopting organization (with particular emphasis on the health care team) and its patients. Our work will provide recommendations to improve mammography screening reminder program Reach, Effectiveness, Adoption, Implementation, and Maintenance (the RE-AIM evaluation framework). Findings from this exploratory study will be used to develop and evaluate improved implementation methods for cancer screening reminder programs. Among women health plan members aged 40 or older who are due for a repeat screening mammogram (n= 32,500) and their health care teams and other key staff, primary aims are to: 1. Evaluate using quantitative methods: a) the degree of overall effectiveness and maintenance of a patient reminder program to improve repeat mammography screening and b) the impact of health care team implementation work practices on overall program effectiveness and maintenance. 2. Describe and explain the mammography patient reminder program Reach, Effectiveness, Adoption, Implementation, and Maintenance using mixed methods and multiple perspectives guided by a comprehensive conceptual framework. 3. Recommend improved methods to enhance Reach, Effectiveness, Adoption, Implementation, and Maintenance of screening mammography patient reminder programs, and refine the conceptual framework and research instruments for future research based on the findings from aims 1 and 2.