Facilitators and Hindrances of Implementing Colorectal Cancer Screening Intervention Among Vietnamese Americans

Abstract

Background Little is published about the factors that facilitate and hinder the intervention implementation process. Objective to examine factors that facilitated and hindered the implementation of a culturally-appropriate colorectal cancer screening intervention targeting Vietnamese Americans in a Federally Qualified Health Center located in the Puget Sound area of Washington. Methods Three focus group discussions (two during the implementation phase and one during the maintenance phase) with the Medical Assistants (n=13) who were the intervention implementation agents were conducted at the Federally Qualified Health Center. Three research team members independently analyzed the data using content analysis and then compared for agreement. We re-read and re-coded the transcripts until consensus was reached. The themes were clustered by similar codes and categorized into four groups, each including facilitators and hindrances of implementation: identification of implementation agents, implementation environment, intervention recipients, and the colorectal cancer screening intervention. Results Facilitators included Medical Assistants’ high motivation with a positive attitude toward the intervention, team approach, and simplicity of the intervention, whereas hindrances included lack of time, forgetfulness, staff turnover, and language barriers. Conclusion The findings emphasized the importance of supporting implementation agents to ensure effective intervention program implementation. Implications for practice Oncology nurses need to particularly take into consideration the evidence-based findings when planning any intervention programs.

Multilevel and multicomponent intervention to promote colorectal cancer screening among underserved Vietnamese Americans: A cluster randomized trial

“…Interventions aimed at increasing CRC screening uptake in Vietnamese Americans primarily focused on addressing individual-level barriers. These include enhancing knowledge about CRC risks and screening methods, raising awareness of CRC screening resources, and providing logistic assistance to CRC screening [13][14][15][16][17]. However, increasing evidence underscores the need for multilevel interventions that target risk factors, barriers or social determinants of health on more than one level, including individual, interpersonal, community, healthcare provider, and health system levels [18,19].…”

“…However, increasing evidence underscores the need for multilevel interventions that target risk factors, barriers or social determinants of health on more than one level, including individual, interpersonal, community, healthcare provider, and health system levels [18,19]. Among studies that have reached beyond the individual level, two studies have incorporated an interpersonallevel component by using lay health workers or young adult family advocates to facilitate group discussion on CRC screening among family group chats on WhatsApp or Facebook Messenger [14,20]. One study adopted a community-level approach by distributing culturally tailored educational comic strips at local Vietnamese grocery stores, through which the researchers hoped to promote communitylevel awareness and to remove stigmas associated with CRC and screening [21].…”

A Lung Cancer Screening Education Program Impacts both Referral Rates and Provider and Medical Assistant Knowledge at Two Federally Qualified Health Centers

“…MAs conduct medical history intake, including the patients' smoking history and status prior to the appointment with the provider. While studies suggest that MAs can help improve care and access to diagnostic tests for colorectal and breast cancer, [43][44][45][46][47] no studies have evaluated the benefit of educating MAs about LCS or exploring their role in LCS.…”