Implementing culturally competent transplant care and implications for reducing health disparities: A prospective qualitative study.
Background: Despite available evidence‐based interventions that decrease health disparities, these interventions are often not implemented. Northwestern Medicine's® Hispanic Kidney Transplant Program (HKTP) is a culturally and linguistically competent intervention designed to reduce disparities in l...
| Publicado en: | Health Expectations Vol. 23; no. 6; pp. 1450 - 1466 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=147714105&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 147714105 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13696513 EVY jtl: Health Expectations issn: 13696513 maglogo: Y pubinfo: dt: Dec2020 vid: 23 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 147714105 146352850 147714105 147714105 10.1111/hex.13124 147714105 ppf: 1450 ppct: 16 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Implementing culturally competent transplant care and implications for reducing health disparities: A prospective qualitative study. aug: au: Gordon, Elisa J. Romo, Elida Amórtegui, Daniela Rodas, Alejandra Anderson, Naomi Uriarte, Jefferson McNatt, Gwen Caicedo, Juan Carlos Ladner, Daniela P. Shumate, Michelle affil: Division of Transplantation, Department of Surgery, Northwestern Medicine, Chicago IL,, USA sug: subj: Program Implementation Cultural Competence Kidney Transplantation Patient Care Healthcare Disparities Health Services Accessibility Evaluation Hispanic Americans Human Prospective Studies Qualitative Studies Interviews Administrative Personnel Nurses Physicians Stakeholder Participation Group Processes Motivation Patient Attitudes Health Education Information Needs Insurance, Health Health Knowledge Coercion Conceptual Framework Implementation Science Audiorecording Coding Data Analysis Software Descriptive Statistics Funding Source ab: Background: Despite available evidence‐based interventions that decrease health disparities, these interventions are often not implemented. Northwestern Medicine's® Hispanic Kidney Transplant Program (HKTP) is a culturally and linguistically competent intervention designed to reduce disparities in living donor kidney transplantation (LDKT) among Hispanics/Latinos. The HKTP was introduced in two transplant programs in 2016 to evaluate its effectiveness. Objective: This study assessed barriers and facilitators to HKTP implementation preparation. Methods: Interviews and group discussions were conducted with transplant stakeholders (ie administrators, nurses, physicians) during implementation preparation. The Consolidated Framework for Implementation Research (CFIR) guided interview design and qualitative analysis. Results: Forty‐four stakeholders participated in 24 interviews and/or 27 group discussions. New factors, not found in previous implementation preparation research in health‐care settings, emerged as facilitators and barriers to the implementation of culturally competent care. Implementation facilitators included: stakeholders' focus on a moral imperative to implement the HKTP, personal motivations related to their Hispanic heritage, and perceptions of Hispanic patients' transplant education needs. Implementation barriers included: stakeholders' perceptions that Hispanics' health insurance payer mix would negatively impact revenue, a lack of knowledge about LDKT disparities and patient data disaggregated by ethnicity/race, and a perception that the family discussion component was immoral because of the possibility of coercion. Discussion and Conclusions: Our study identified novel barriers and facilitators to the implementation preparation of a culturally competent care intervention. Healthcare administrators can facilitate organizations' implementation of culturally competent care interventions by understanding factors challenging care delivery processes and raising clinical team awareness of disparities in LDKT. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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