An embedded multiple case study: using CFIR to map clinical food security screening constructs for the development of primary care practice guidelines
| Autor: | Michael C. Fagen, Sabira Taher, Angela Odoms-Young, Courtney K. Suh, Nadine Peacock, Naoko Muramatsu |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Process management
Food security Primary Health Care Food insecurity Computer science Public Health Environmental and Occupational Health Dissemination Primary care Semi-structured interviews United States Food security screening Food Security Primary care practice Implementation Multiple case Humans Mass Screening Consolidated framework for implementation research Public aspects of medicine RA1-1270 Delivery of Health Care Produce prescription programs Qualitative Research Research Article |
| Zdroj: | BMC Public Health, Vol 22, Iss 1, Pp 1-14 (2022) BMC Public Health |
| ISSN: | 1471-2458 |
| Popis: | BackgroundFood insecurity (FI), the limited access to healthy food to live an active and healthy life, is a social determinant of health linked to poor dietary health and difficulty with disease management in the United States (U.S.). Healthcare experts support the adoption of validated screening tools within primary care practice to identify and connect FI patients to healthy and affordable food resources. Yet, a lack of standard practices limits uptake. The purpose of this study was to understand program processes and outcomes of primary care focused FI screening initiatives that may guide wide-scale program implementation.MethodsThis was an embedded multiple case study of two primary care-focused initiatives implemented in two diverse health systems in Chicago and Suburban Cook County that routinely screened patients for FI and referred them to onsite food assistance programs. The Consolidated Framework for Implementation Research and an iterative process were used to collect/analyze qualitative data through semi-structured interviews withN = 19 healthcare staff. Intended program activities, outcomes, actors, implementation barriers/facilitators and overarching implementation themes were identified as a part of a cross-case analysis.ResultsPrograms outcomes included: the number of patients screened, identified as FI and that participated in the onsite food assistance program. Study participants reported limited internal resources as implementation barriers for program activities. The implementation climate that leveraged the strength of community collaborations and aligned internal, implementation climate were critical facilitators that contributed to the flexibility of program activities that were tailored to fill gaps in resources and meet patient and clinician needs.ConclusionHighly adaptable programs and the healthcare context enhanced implementation feasibility across settings. These characteristics can support program uptake in other settings, but should be used with caution to preserve program fidelity. A foundational model for the development and testing of standard clinical practice was the product of this study. |
| Databáze: | OpenAIRE |
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