Adaptation of an Evidence-Based Colorectal Cancer Screening Program Using the Consolidated Framework for Implementation Research

Cole, Allison; Esplin, Andrea; Baldwin, Laura Mae

doi:10.5888/pcd12.150300

Cited by 28 publications

(38 citation statements)

References 17 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Evidence-based guidelines for promoting cancer screening include the Guide to Community Preventive Services which recommends both client- and provider-oriented approaches to increase screening rates [ 6 ]. As in many areas of health care, however, there is a gap between evidence-based guidelines and actual practice [ 7 ]. In safety net health care systems, which include public hospitals, federally-funded community health centers and Federally Qualified Health Centers (FQHCs), local health department clinics, and free clinics that provide care for low-income, uninsured and vulnerable patients, this gap may be particularly wide.…”

Section: Introductionmentioning

confidence: 99%

“…Relatively few studies have examined implementation of EBPs to increase cancer screening. A recent study used CFIR before actual implementation to inform the adaptation of an evidence-based program promoting CRC screening in a FQHC [ 7 ]. A second qualitative study of factors influencing cancer prevention in FQHCs did not use a conceptual model per se but identified competing priorities (e.g., medical home transformation), lack of reimbursement, and insufficient patient insurance as barriers to screening [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research

et al. 2015

View full text Add to dashboard Cite

BackgroundImplementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies.MethodsData are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation.ResultsOf 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation.ConclusionsOur study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover, our analytic approach is similar to previous case studies using CFIR and hence could facilitate comparisons across studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-016-0477-4) contains supplementary material, which is available to authorized users.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research

et al. 2015

View full text Add to dashboard Cite

show abstract

“…They were satisfied with the application of evidence in their regular practice and were therefore assigned new tasks and responsibilities (Gifford et al, 2011). They also thought they could be encouraged by the creation of incentives that would be assessed through performance reports (Cole et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

“…Other resources the nurses found helpful were international collaboration, staff familiarity with research tools, and previous experiences that could guide peers (Cole et al, 2015; Gifford et al, 2018; Helmle et al, 2018; Malik et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

Context as a Facilitator of the Implementation of Evidence-based Nursing: A Meta-synthesis

et al. 2020

View full text Add to dashboard Cite

Nurses have numerous difficulties in implementing science due to obstacles related to the work context. The aim is to explore the work-context-related facilitators of the application of evidence in clinical practice by nursing professionals. Qualitative meta-synthesis of primary studies on nurses’ experiences of work-context-related facilitators, as defined by the Promoting Action on Research Implementation in Health Services model. Using the Qualitative Appraisal and Review Instrument of the Joanna Briggs Institute. Of the total 57 primary research articles included, an explanatory model of the facilitating factors related to the work context was generated on the basis of four general categories: institutional support (leadership), multidisciplinary support (teamwork and communication), culture of improving quality of care (nursing professionals’ attitudes towards change) and use of research (valuing research). Action can be taken on the facilitating factors of the evidence-based practice application in nursing clinical environments, providing resources and motivation from the organization.

show abstract

“…The scope of the problem, although wide, actually is well defined and the solutions are simple: screen appropriate patients, diagnose and treat according to guidelines, and provide adequate follow‐up . There are resources available to help health care providers improve outreach to, and outcomes for, underserved populations in need of screening for and treatment of CRC …”

mentioning

confidence: 99%

Moving from theory to practice: A call to action on cancer disparities

Moses

2019

Cancer

View full text Add to dashboard Cite

Cancer disparities among black individuals in the United States have been well described, and well known, since Congress commissioned a report on cancer incidence by race in 1950. 1 Blacks were thought to be more susceptible to infectious disease or trauma, and therefore not prone to the development of cancer, which was considered a disease of culture and civilization. To the surprise of the establishment, black individuals did develop cancer, and at disproportionate rates for certain malignancies such as cervical and prostate cancers. Since that time, multiple population-level studies have demonstrated persistent disparities between black and white individuals with regard to incidence and mortality for most cancers. Colorectal cancer (CRC) fits squarely in this space, because blacks have the highest incidence of CRC of any ethnic group in the United States, and death rates are reported to be 47% higher in black men and 34% higher in black women. 2 There are several factors that play a role in the disparities noted in CRC, including differences in screening rates, risk factors for the development of cancer, and receipt of treatment. In an analysis of the National Health Interview Study, Ahmed et al found that black individuals were 26% less likely to receive a recommendation for CRC screening, and Hispanics were 34% less likely. 3 Black women were at the highest risk of not receiving a screening recommendation, and were found to be approximately one-half as likely as black men to receive a recommendation. Importantly, only adjustment for educational attainment, not insurance status or access to usual source of care, was found to reduce the disparity to a nonsignificant difference. This highlights the importance of literacy-based interventions for improving screening behaviors.The disparity in CRC is not unusual because the literature reflects a similar trend in other screen-detected cancers. For example, black men have the highest mortality rate for prostate cancer of any racial or ethnic group in the United States at a rate that is 2.3 times higher than that reported in white men. 2 Despite this high-risk status, black men continue to be screened less often than white men, and are less likely to receive treatment after being diagnosed, regardless of disease risk stratification. 4,5 Similarly, black women have a 39% higher mortality rate from breast cancer compared with white women, with excess deaths on a state-to-state basis ranging from 20% in Nevada to 66% in Louisiana. 6 Despite screening mammography rates having improved over the past 2 decades, black women and uninsured women continue to have lower rates of use of mammography services. 7 Screening guidelines are quite clear (prostate cancer notwithstanding) with regard to whom screening should be offered. However, to my knowledge, nowhere in any guideline is there a provision for offering differential care based on race, insurance status, sex, or income. Yet in nearly every type of cancer, this is the case. This fact represents an abject failure of the med...

show abstract

Adaptation of an Evidence-Based Colorectal Cancer Screening Program Using the Consolidated Framework for Implementation Research

Abstract: Introduction

Cited by 28 publications

References 17 publications

Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research

Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research

Context as a Facilitator of the Implementation of Evidence-based Nursing: A Meta-synthesis

Moving from theory to practice: A call to action on cancer disparities

Contact Info

Product

Resources

About