Implementing lung cancer screening in primary care: needs assessment and implementation strategy design
| Autor: | Tanner J. Caverly, Chelsey R. Schlechter, Rachel Hess, Guilherme Del Fiol, Kensaku Kawamoto, Thomas J. Reese, Teresa Taft, Charlene R. Weir, Heidi Kramer, Polina V. Kukhareva, Michael Flynn |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Expectancy theory
Process management Lung Neoplasms Primary Health Care Decision Making Context (language use) Clinical decision support system Task (project management) Behavioral Neuroscience Needs assessment Key (cryptography) Humans Mass Screening Psychology Applied Psychology Lung cancer screening Early Detection of Cancer Needs Assessment Social influence Cancer |
| Zdroj: | Transl Behav Med |
| Popis: | Lung cancer screening with low-dose computed tomography (CT) could help avert thousands of deaths each year. Since the implementation of screening is complex and underspecified, there is a need for systematic and theory-based strategies. Explore the implementation of lung cancer screening in primary care, in the context of integrating a decision aid into the electronic health record. Design implementation strategies that target hypothesized mechanisms of change and context-specific barriers. The study had two phases. The Qualitative Analysis phase included semi-structured interviews with primary care physicians to elicit key task behaviors (e.g., ordering a low-dose CT) and understand the underlying behavioral determinants (e.g., social influence). The Implementation Strategy Design phase consisted of defining implementation strategies and hypothesizing causal pathways to improve screening with a decision aid. Three key task behaviors and four behavioral determinants emerged from 14 interviews. Implementation strategies were designed to target multiple levels of influence. Strategies included increasing provider self-efficacy toward performing shared decision making and using the decision aid, improving provider performance expectancy toward ordering a low-dose CT, increasing social influence toward performing shared decision making and using the decision aid, and addressing key facilitators to using the decision aid. This study contributes knowledge about theoretical determinants of key task behaviors associated with lung cancer screening. We designed implementation strategies according to causal pathways that can be replicated and tested at other institutions. Future research is needed to evaluate the effectiveness of these strategies and to determine the contexts in which they can be effectively applied. |
| Databáze: | OpenAIRE |
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