Implementing Shared Decision-Making for Lung Cancer Screening across a Veterans Health Administration Hospital Network: A Hybrid Effectiveness–Implementation Study Protocol

Khanna, Aishwarya; Fix, Gemmae M.; McCullough, Megan; Herbst, Abigail N; Li, Mingfei; Miano, Danielle; Barker, Anna M; Wiener, Renda Soylemez

doi:10.1513/annalsats.202105-620sd

Cited by 4 publications

(1 citation statement)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this qualitative study among rural primary care team members (clinicians, staff, patients) in multiple clinical settings (federally qualified health centers, private practices, and health system owned clinics), investigators used RE-AIM for data analysis and to process diagram how decisions impacted the different RE-AIM domains (i.e., Reach, Effectiveness, Adoption, Implementation, Maintenance) ( 31 ). In another study, a VA team has used RE-AIM to guide its implementation outcomes in a hybrid-effectiveness study that will test a lung cancer screening shared decision-making tool in New England VAs ( 40 ). Our study is unique in its application of RE-AIM to VHA program evaluation of lung cancer screening.…”

Section: Discussionmentioning

confidence: 99%

Rural barriers and facilitators of lung cancer screening program implementation in the veterans health administration: a qualitative study

Lewis,

Bonnet,

Schlundt

et al. 2023

Front. Health Serv.

View full text Add to dashboard Cite

IntroductionTo assess healthcare professionals' perceptions of rural barriers and facilitators of lung cancer screening program implementation in a Veterans Health Administration (VHA) setting through a series of one-on-one interviews with healthcare team members.MethodsBased on measures developed using Reach Effectiveness Adoption Implementation Maintenance (RE-AIM), we conducted a cross-sectional qualitative study consisting of one-on-one semi-structured telephone interviews with VHA healthcare team members at 10 Veterans Affairs medical centers (VAMCs) between December 2020 and September 2021. An iterative inductive and deductive approach was used for qualitative analysis of interview data, resulting in the development of a conceptual model to depict rural barriers and facilitators of lung cancer screening program implementation.ResultsA total of 30 interviews were completed among staff, providers, and lung cancer screening program directors and a conceptual model of rural barriers and facilitators of lung cancer screening program implementation was developed. Major themes were categorized within institutional and patient environments. Within the institutional environment, participants identified systems-level (patient communication, resource availability, workload), provider-level (attitudes and beliefs, knowledge, skills and capabilities), and external (regional and national networks, incentives) barriers to and facilitators of lung cancer screening program implementation. Within the patient environment, participants revealed patient-level (modifiable vulnerabilities) barriers and facilitators as well as ecological modifiers (community) that influence screening behavior.DiscussionUnderstanding rural barriers to and facilitators of lung cancer screening program implementation as perceived by healthcare team members points to opportunities and approaches for improving lung cancer screening reach, implementation and effectiveness in VHA rural settings.

show abstract

Section: Discussionmentioning

confidence: 99%