Building Cancer Prevention and Control Research Capacity in Rural Appalachian Kentucky Primary Care Clinics During COVID-19: Development and Adaptation of a Multilevel Colorectal Cancer Screening Project.

Autor: Kruse-Diehr AJ; University of Kentucky College of Public Health, 151 Washington Avenue, Bowman Hall 345, Lexington, KY, 40536, USA. kruse-diehr@uky.edu.; Markey Cancer Center, Lexington, KY, USA. kruse-diehr@uky.edu., Dignan M; Markey Cancer Center, Lexington, KY, USA.; University of Kentucky College of Medicine, Prevention Research Center, Lexington, KY, USA., Cromo M; University of Kentucky College of Medicine, Prevention Research Center, Lexington, KY, USA., Carman AL; University of Kentucky College of Public Health, 151 Washington Avenue, Bowman Hall 345, Lexington, KY, 40536, USA., Rogers M; Markey Cancer Center, Lexington, KY, USA., Gross D; Northeast Kentucky Area Health Education Center, Morehead, KY, USA., Russell S; Northeast Kentucky Area Health Education Center, Morehead, KY, USA.
Jazyk: angličtina
Zdroj: Journal of cancer education : the official journal of the American Association for Cancer Education [J Cancer Educ] 2022 Oct; Vol. 37 (5), pp. 1407-1413. Date of Electronic Publication: 2021 Feb 18.
DOI: 10.1007/s13187-021-01972-w
Abstrakt: This study describes the development of a colorectal cancer (CRC) screening multilevel intervention with four primary care clinics in rural Appalachian Kentucky. We also discuss barriers experienced by the clinics during COVID-19 and how clinic limitations and needs informed project modifications. Four primary care clinics were recruited, key informant interviews with clinic providers were conducted, electronic health record (EHR) capacity to collect data related to CRC screening and follow-up was assessed, and a series of meetings were held with clinic champions to discuss implementation of strategies to impact clinic CRC screening rates. Analysis of interviews revealed multilevel barriers to CRC screening. Patient-level barriers included fatalism, competing priorities, and financial and literacy concerns. The main provider- and clinic-level barriers were provider preference for colonoscopy over stool-based testing and EHR tracking concerns. Clinics selected strategies to address barriers, but the onset of COVID-19 necessitated modifications to these strategies. Due to COVID-19, changes in clinic staffing and workflow occurred, including provider furloughs, a state-mandated pause in elective procedures, and an increase in telehealth. Clinics adapted screening strategies to match changing needs, including shifting from paper to digital educational tools and using telehealth to increase annual wellness visits for screening promotion. While significant delays persist for scheduling colonoscopies, clinics were encouraged to promote stool-based tests as a primary screening modality for average-risk patients.
(© 2021. American Association for Cancer Education.)
Databáze: MEDLINE
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